Anorexia developing much earlier in SG kids

Patients with anorexia nervosa (AN) in Singapore appear to be getting younger, according to a study. The use of personal computers and social media may have contributed to this trend.

“Medical stabilization of AN patients can be achieved more quickly through a higher calorie inpatient AN protocol,” the researchers said.

Forty-seven patients diagnosed with AN with available retrospective descriptive data were included in this study. Those with admission were stratified according to their nutritional management based on whether they were on the AN protocol or standard hospital care. The researchers then obtained data on the patients’ rate of weight gain, length of stay, and calorie prescription.

Most AN patients in Singapore, just like in previous studies, were female (96.7 percent). However, the age at presentation of AN had decreased compared with earlier local studies (14 vs 16 years). [Singapore Med J 2024;65:564-570]

Moreover, patients on the AN protocol were advised to receive a greater amount of calories relative to those given standard care (2,700 vs 2,317 calories). As a result, the AN protocol group achieved a higher rate of weight gain per week (1.15 vs 0.29 kg) and had a shorter hospital stay (23 vs 36 days).

“In our study, the median age at first presentation of AN was 14 years compared to 16 years reported by Lim [and colleagues] in 2007,” the researchers said. [Singapore Med J 2007;48:222-226]

“This decrease in age of onset of AN coincides with increasing availability of personal computers (69.7 percent to 77 percent in 2003–2008 vs 81.4 percent in 2018),” they added. [https://data.gov.sg] 

“Future local studies examining actual calorie consumption, its effect on weight gain trajectory, severity of refeeding syndrome, and time to remission will be beneficial,” according to the researchers.

Social media

In addition, a 2020 study observed that individuals with no social media accounts had significantly lower Eating Disorder Examination-Questionnaire (EDE-Q) global scores than those with social media accounts, suggesting the association between increased social media exposure and increased risk of eating disorders. [Int J Eat Disord 2020;53:96-106]

Another study found that use of social media among high school students correlated with greater body dissatisfaction 18 months later, but elevated body dissatisfaction at baseline was not associated with social media use 18 months later. [J Youth Adolesc 2016;45:211–224]

“This suggests that social media use leads to elevated body dissatisfaction, but body dissatisfaction does not necessarily lead to a greater need for use of social media,” the researchers said. 

“Therefore, it may be important for parents to control the time their child spends on social media, especially during the preadolescent period, when parents still have more influence over their child’s behaviour than in the later years,” they added. 

In a 2018 study, parental control over the time spent by their preadolescent kids on social media was found to lead to greater preadolescent life satisfaction, partly due to the parents’ involvement in their child’s life or the child’s openness to parental direction. [J Youth Adolesc 2018;47:1456-1468.]

“However, further studies are still needed to determine this relationship,” the researchers said.