RÉSUMÉ
BACKGROUND: Recognition of atypical anorexia nervosa (AAN) has challenged underweight as a defining factor of illness severity in anorexia nervosa (AN). The present study aimed to compare rates of medical instability in adolescents with underweight (AN) and non-underweight (AAN) anorexia nervosa. METHODS: The study examined assessment data from specialist eating disorder services in the UK between January and December 2022. Participants (n = 205) aged 11-18 years were recruited across eight eating disorder clinics and diagnosed with AN (n = 113) or AAN (n = 92) after clinical assessment. Parameters associated with risk of medical instability were compared between AN and AAN groups, using t tests and regression analysis. RESULTS: Rates of bradycardia and hypotension did not differ significantly between AN and AAN groups (p = 0.239 and p = 0.289). Although white blood cell counts were lower in the AN group, rates of leukopaenia could not be statistically compared as a result of there being too few counts in at least one group. No incidences of hypophosphataemia were found in the sample. A significant regression equation was found for percentage median body mass index, but not rate of weight loss, as a predictor of blood pressure, serum phosphorous and magnesium. CONCLUSIONS: Our findings indicate that medical instability occurs across a range of body weights in young people with AN and AAN. Although certain parameters of risk such as blood pressure, serum phosphorous and magnesium may be worsened at lower weight, both AN and AAN are serious mental health conditions that can lead to medical instability.
RÉSUMÉ
BACKGROUND: While there is increased concern around mental health problems in universities, the experience of students with eating disorders (EDs) has received less attention. This is problematic as the detrimental consequences of a lack of adequate support are profound. METHODS: A qualitative study was adopted to investigate students' perspectives of the availability, accessibility and suitability of support services. One hundred university students with experience of EDs completed an online survey. A further 18 students completed semi-structured interviews. Descriptive data are reported alongside analysis of qualitative data. RESULTS: Three overarching themes were identified; awareness of support, confidence in asking for help and early experiences with services. Most students were aware of support through their GP and university counselling services. Few identified ED-specific sources of support. Barriers to help-seeking included self-stigma and gaps in service availability. Early experiences with services were often negative, problems included; difficulty accessing services, a lack of ED specific support and continuity of care between home and university. CONCLUSIONS: There is substantive progress to be made in ensuring that students with EDs receive the support they need to thrive at university. While it is important that good treatments exist, the pathway to accessing these treatments equally important. As universities increasingly recognise the need for action around student mental health attention must also be directed towards EDs and the provision of specific services.
