Disordered Eating Behaviors Among U.S. Children With Neuropsychiatric Conditions: A Nationally Representative Study

OBJECTIVE: This study documented associations between parent-reported disordered eating behaviors and co-occurring anxiety, depression, behavioral/conduct problems, and attention-deficit/hyperactivity disorder (ADHD) among U.S. children. METHOD: Data were obtained from the combined 2022-2023 National Survey of Children's Health. The sample consisted of 68,000 children aged 6-17 years. Prevalence was estimated for sociodemographic variables, neuropsychiatric disorders, and the following disordered eating behaviors: (1) skipping meals or fasting; (2) having low interest in food; (3) extremely picky eating; (4) binge eating; (5) purging or vomiting; (6) using diet pills, laxatives, or diuretics; (7) over-exercising; and (8) not eating due to fear of vomiting or choking. Multiple logistic regression analysis assessed associations between neuropsychiatric disorders and disordered eating behaviors, adjusting for sociodemographic factors. RESULTS: Prevalence of any disordered eating behavior was 30.1% (95% CI, 29.4%-30.8%). Higher odds of disordered eating behaviors were associated with anxiety (aOR [adjusted odds ratio]: 3.64, 95% CI, 3.34-3.96), depression (aOR: 4.59, 95% CI, 3.99-5.28), behavioral/conduct problems (aOR: 3.40, 95% CI, 3.03-3.81), and ADHD (aOR: 2.63, 95% CI, 2.41-2.88). Significant associations were observed across nearly all examined eating behaviors. DISCUSSION: This is the first nationally representative study to find that U.S. children and adolescents with neuropsychiatric disorders were more likely to exhibit disordered eating behaviors than their counterparts without neuropsychiatric disorders. Findings underscore the need for screening and early intervention to optimize the mental and physical health of these populations. They also highlight the need to address prevention and treatment of these disorders in the context of psychiatric comorbidities.