P3A045: Comparison of Eating Disorder Treatment Outcomes Between Cisgender Girls and Boys

Background: Eating disorder prevalence varies between adolescent cisgender girls and boys. Although cisgender girls are more likely to be diagnosed, 30% of those with an eating disorder are cisgender boys. The disparity between boys and girls may, in part, be due to a lack of awareness of eating disorders in cisgender boys. However, little research has evaluated eating disorder treatment outcomes between cisgender girls and cisgender boys. This is critical given that current treatments used with youth with eating disorders were developed and trialed on girls and women. The aim of this study was to compare eating disorder treatment outcomes of cisgender girl and boy youth aged 6-24 receiving family-based treatment (FBT) for an eating disorder.

Methods: Empirically validated surveys were completed by patients or caregivers during treatment to evaluate treatment effectiveness including Eating Disorder Examination Questionnaire Short Form (EDE-QS; eating disorder symptoms), Patient Health Questionnaire-9 (PHQ-9; depression), and the Generalized Anxiety Disorder Questionnaire-7 (GAD-7; anxiety). Weight was also obtained twice weekly. Logistic regression and mixed effect models were used to compare treatment outcomes between cisgender girls and boys. Evaluation of our treatment outcomes was reviewed by Western IRB and determined to not be human subjects research. At admission, patients or caregivers consent to treatment data being used and presented for research purposes.

Results: Patients (N=810) had an average age of M=15.7 (SD=2.9). The majority identified as cisgender girls (88%); N=97 identified as cisgender boys. Anorexia nervosa (AN) was the most common diagnosis and cisgender girls were significantly more likely to be diagnosed with AN restricting type (65%; b= -.80 + .22; p <.001) or AN binge/purge (18%; b= -1.02 + .40; p <.05) compared with cisgender boys (45% and 7%, respectively). In contrast, cisgender boys were more likely to be diagnosed with avoidant restrictive food intake disorder (ARFID) compared with cisgender girls (40% vs 10%; b= 1.80 + .24; p <.001). Cisgender girls were also more likely to require weight restoration (80%) compared with cisgender boys (69%; p <.05). At treatment admission, cisgender boys had significantly lower EDE-QS (-3.07 [-4.97, -1.23]), GAD-7 (-1.56 [-2.38, -0.71]), and PHQ-9 (-1.73 [-2.64, -0.80]) scores compared with cisgender girls. No significant differences were observed in rate of change during treatment for any mental health outcome.

Conclusion: Certain characteristics varied across cisgender girl and boy youth at treatment admission for an eating disorder. However, symptoms decreased at similar rates during treatment regardless of starting place. FBT appears to be similarly effective for cisgender girls and boys.