A Comprehensive Exploration of the Gender-Specific Clinical, Hematological, and Physiological Effects of Eating Disorders

Barca-Hall, Annalisa

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Year:: 2019
Contributor:: Barca-Hall, Annalisa (creator); Field, Alison (Advisor); Misra, Madhusmita (Reader); Brown University. School of Public Health (sponsor)
Genre:: theses
Subject:: Eating disorders; behavioral health; Anorexia nervosa
Extent:: 5, 17 p.
DOI: https://doi.org/10.26300/810h-xb86

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Abstract:: Abstract of “A Comprehensive Exploration of the Gender-Specific Clinical, Hematological, and Physiological Effects of Eating Disorders” by Annalisa Barca-Hall, MPH, Brown University, May 2019 Objective: Eating disorders (EDs), especially anorexia nervosa (AN), are vastly understudied and highly stigmatized in males. The rates of EDs in males appears to be increasing, particularly within the younger population, and more males appear to be seeking treatment than in previous decades2,4. Males constitute approximately 25% of AN/bulimia nervosa cases in the general population, and up to 67% of patients with adolescent avoidant restrictive food intake disorder (ARFID), but a significantly lower proportion of patients with EDs in the clinical setting 1,2. Due to the lower prevalence and lack of focus on adolescent males within the ED research community, little is known about the specific risk factors for EDs in males or the impact of EDs on male hormone levels, electrolyte levels, or hematologic factors. This study will compare male and female ED patients using a wide range of variables with the aim of addressing a gap in the current literature regarding the gender-specific adverse health effects of EDs. Male and female subjects at least six months post-baseline will also be compared in an effort to identify factors associated with relapse. Based on the present literature, we hypothesize that males will present with more significant adverse health outcomes than their female counterparts at both baseline and follow-up. Methods: A retrospective chart review was performed using data obtained from the Research Patient Data Registry (RPDR) with IRB approval. Analyses were performed at the Massachusetts General Hospital Neuroendocrine Unit using the 13th version of JMP. Only subjects ages 10-25 at baseline, who had been seen in the MGH ambulatory setting, were included. Subjects were included if they had a valid diagnosis of either AN, eating disorder not otherwise specified (EDNOS), or avoidant restrictive food intake disorder (ARFID). The baseline covariates of interest included: age at diagnosis, height, weight, BMI, comorbid anxiety diagnosis, calcium, phosphorus, potassium, TSH, estradiol, vitamin D, WBC, hemoglobin (HGB), hematocrit (HCT), heart rate, blood pressure, and pulse pressure. The T-test was used for parametric data, Wilcoxon Test was used for non-parametric data, and either the Chi. Sq or Fisher’s Exact Test was used for categorical variables. 48 male and 49 female subjects ages 10-25 with an ED diagnosis were included in the final analysis. Results: A significant difference was found between the two genders in regard to ED diagnosis, as a greater proportion of female subjects presented with AN compared to males (p=0.0014). Mean age at baseline and diagnosis was lower for males than females (14.76 ± 2.98 vs. 16.62 ± 3.26, p=0.0042) and (14.67 ± 3.14 vs. 16.51 ± 3.38, p=0.0066). Male subjects presented with higher median HGB levels (14.15 vs. 13.1, p=0.0017) and mean HCT levels at baseline than the females (41.42 ± 3.40 vs. 39.23 ± 2.64, p=0.0280). Male subjects also presented with lower diastolic BP (61.30  7.62 vs. 66.00  9.45, p=0.02) and wider pulse pressures on average compared to the female subjects (44.23  11.54 vs. 37.29  7.70, p=0.0058). A greater proportion of the female group had an anxiety diagnosis compared to the male group (25% vs. 40.82%, p=0.0976). In regard to all other covariates, no statistically significant differences were observed between the two groups. Conclusions: The results of this study suggest that male and female adolescents with EDs may present more similarly at both baseline and follow-up than we initially hypothesized. These findings may help increase early diagnosis and treatment of males in the clinical setting, as previous studies suggested that symptoms may appear more severe in males. Continued efforts should be made within the research community to involve and examine male ED patients, particularly in longitudinal studies.
Notes:: Thesis (M. P. H.)--Brown University, 2019

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Barca-Hall, Annalisa, "A Comprehensive Exploration of the Gender-Specific Clinical, Hematological, and Physiological Effects of Eating Disorders" (2019). Public Health Theses and Dissertations. Brown Digital Repository. Brown University Library. https://doi.org/10.26300/810h-xb86

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Public Health Theses and Dissertations

Theses and Dissertations for the Public Health department.
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