Eating Disorders Prevalent Among Adolescents with Epilepsy According to New Research

Results of a study presented at the 2023 American Epilepsy Society (AES) Annual Meeting show that adolescents with epilepsy are more likely to have a diagnosed eating disorder (ED) than those without epilepsy. Researchers found that 8.4% of adolescents receiving care at an epilepsy clinic had EDs compared with 2.7% of adolescents in the general population. The results also suggest that a diagnosis of epilepsy is associated more strongly with anorexia nervosa, rather than bulimia nervosa, or binge eating disorder. Additionally, they showed that adolescents at epilepsy clinics who had EDs were more likely to have other comorbid mental health conditions.

The study included 438 adolescent participants without intellectual disabilities or autism spectrum disorder who were patients at Boston Children’s Hospital Epilepsy Center clinics during the 10-year period between 2013 and 2022. Of these participants, 146 had epilepsy and an ED, 146 had epilepsy without ED, and 146 had an ED without epilepsy. Researchers analyzed the characteristics of each participant sub-group and compared them to identify trends.

Analysis of the study results revealed the following:

• Adolescents with a diagnosis of epilepsy were 7% more likely to have an ED than those without epilepsy (11.3% more likely for female participants, 3.1% more likely for male participants).
• The proportion of male participants with an ED was significantly higher in the epilepsy and ED group (24%), compared to the ED and no epilepsy group (10%).
• Adolescents in the epilepsy and ED group, especially those with psychogenic non-epileptic seizures (PNES), were more likely to have depression, anxiety, suicidality, and a history of sexual abuse.
• ED was more common among female adolescents, those with PNES, and those with a lower body mass index (BMI).  
• Adolescents with an ED began having seizures at an earlier age than those without an ED.
• The prevalence of ED was consistent regardless of seizure type, duration, or frequency.

Additionally, the results show that adolescents with PNES were more likely to have bulimia nervosa, and adolescents with provoked seizures were more likely to have orthorexia/atypical anorexia nervosa. 

"Adolescents with epilepsy may feel a loss of control because they don’t know when they’ll have a seizure,” said lead author Dr. Tokatly Latzer. “Controlling what they eat or don’t eat can presumably make them feel they have regained some control. This is one of the ways epilepsy may lead to eating disorders, in people who have a biological or psychological predisposition to develop eating disorders.”