Pediatric Patients Hospitalized With Eating Disorders in Ontario, Canada, Over Time

Abstract

Importance: Understanding the evolving characteristics of pediatric patients hospitalized for eating disorders is important to ensure that services and treatments align with patient needs. Objective: To examine temporal trends in the rates of hospitalizations for pediatric eating disorders by clinical and demographic characteristics in Ontario, Canada, over a 17-year period. Design, Setting, and Participants: This population-based, repeated, cross-sectional study used linked health administrative and demographic databases in Ontario, Canada, to identify individuals aged 5 to 17 years hospitalized with eating disorder diagnoses from April 1, 2002, to March 31, 2020. Data analyses were performed from May 2021 to June 2023. Exposure: Fiscal year (April 1-March 31) of eating disorder hospitalization. Main Outcomes and Measures: Outcomes of interest were absolute and relative changes in pediatric eating disorder hospitalization rates overall and stratified by patient sex, age groups, and eating disorder diagnostic groups. Results: Over the study period, there were 11654 pediatric eating disorder hospitalizations, of which 5268 (45.2%) were for anorexia nervosa and 1374 (11.8%) were for bulimia nervosa. There were a total of 10648 hospitalizations (91.4%) among female patients, and the median (IQR) age was 15.0 (14-0-16.0) years. Hospitalization rates increased 139% from 2002 to 2019, from 2.0 per 10000 population to 4.8 per 10000 population. The largest relative changes were observed among male patients (416%; from 0.2 per 10000 population to 1.1 per 10000 population), individuals aged 12 to 14 years (196%; from 2.2 per 10000 population to 6.6 per 10000 population), and individuals with eating disorders other than anorexia or bulimia nervosa (255%; from 0.6 per 10000 population to 2.1 per 10000 population). Male patients, younger adolescents, and individuals with other eating disorders also represented larger proportions of hospitalizations by fiscal 2019. Conclusions and Relevance: In this cross-sectional study of eating disorder hospitalizations, pediatric hospitalizations increased over time, particularly among populations traditionally considered atypical. Existing eating disorder programs must adapt to accommodate changing patient presentations and increased volumes to ensure effective care delivery.