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May 12, 2022

US Preventive Services Task Force calls for revised eating disorder screening

The USPSTF has called for research into how to improve upon the eating disorder screening procedure, which it recently evaluated.

By GlobalData Healthcare

Although eating disorders affect a rising number of Americans, relatively little comprehensive research has been dedicated to their diagnosis. To address this gap, the United States Preventive Services Task Force (USPSTF) recently evaluated the standard procedure for eating disorder screening, concluding that the current methodology is inadequate. The public health body has, accordingly, called for further research into how to improve upon the standing screening procedure. GlobalData epidemiologists expect that new screening guidelines will impact the diagnosis rates of major eating disorders in the US, especially among groups that have been historically underdiagnosed under current recommendations.

Prior to the recommendation, the USPSTF launched its first systematic review of the screening guidelines for eating disorders—defined as anorexia nervosa, bulimia nervosa, binge eating disorder, avoidant/restrictive food intake disorder, and atypical anorexia nervosa—among asymptomatic adolescents and adults. Of particular interest to the review was the SCOFF screening tool, a questionnaire that inquires into patients’ eating patterns, family histories of eating disorders, and relationships with food and weight.

The tool has remained the standard means of screening for medical practitioners, especially for the diagnosis of anorexia and bulimia nervosa. Despite its utility for the diagnosis of these conditions, the DSM-V has defined several new eating disorders since the tool’s conception. The USPSTF recommends an updated screening tool that is commensurate with a more diverse array of disorders. The authors suggest that research is necessary.

In addition, the task force found that current screening may not be well-suited for all demographic profiles. According to the USPSTF, eating disorders can be diagnosed in individuals of widely varying racial, gender and socioeconomic backgrounds. Given the subjectivity of the SCOFF questionnaire, behaviours that may be considered signs and symptoms of an eating disorder may be overlooked depending on the respondent’s subjective experience. While these variables can present challenges to any diagnostic procedure, the USPSTF suggests the integration of a more segmented approach to eating disorder screening that is better informed by patient demographics.

GlobalData epidemiologists forecast rising cases of eating disorders in the US. The total prevalence of anorexia nervosa is expected to rise from 1,177,010 to 1,282,506 between 2018 and 2028 (as shown in Figure 1). Similarly, the total prevalent cases of binge eating disorders are on the path to increase from 4,247,063 in 2017 to 4,492,719 in 2027.

Though the screening guidelines have not been formulated to reflect the USPSTF’s recommendations, these numbers could likely increase and become more demographically nuanced following their adoption. This is especially true for binge eating disorders given that the SCOFF screening tool was not originally designed for its detection, potentially leading to underdiagnosis.

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