Physician awareness of eating disorders from the patient's perspective

Research suggests that anorexia and bulimia nervosa prevalence is increasing, the disorders have an earlier age of onset than in past decades, and early detection and treatment increases the likelihood of a favorable prognosis. However, the shame and denial that often accompanies these disorders interfere with individuals with these disorders referring themselves for treatment. This leaves primary care physicians with the responsibility of early detection, as they are often the first health care provider these individuals see. However, research suggests that physicians have a low suspicion for eating disorders and often misdiagnose anorexia or bulimia nervosa.; The current study examined the role of physicians in the detection of anorexia and bulimia nervosa from the patient's perspective. Participants were individuals with anorexia nervosa, bulimia nervosa, or an eating disorder not otherwise specified who were in treatment for their eating disorder at the time of the study. Participants completed the Physician Detection of Eating Disorders Questionnaire (PDEDQ), a self-report instrument designed to examine the role of the respondent's primary care physician in the detection of his/her eating disorder. Participants also completed the abbreviated version of the Eating Attitudes Test which was used to assess the severity of their symptoms.; The statistical approach used in this study included use of correlations, chi-square analysis, t tests, and analysis of variance procedures. As hypothesized, the results indicated that the number of physical symptoms experienced by participants in the first two years of their illness was positively correlated with severity of eating disorder. Also, the participant reported age of onset of disordered eating was negatively correlated with parental awareness and not physician awareness. The study failed to show a relationship between comfort with physician and participants' willingness to ask their physician questions about their symptoms. The results also suggested no significant relationship between type, gender, or age of physician and the number of symptoms the physician queried.{09}Finally, the current sample reported they did not perceive their physicians as being more likely to ask about physical symptoms than emotional symptoms or more involved in the diagnosis of anorexia nervosa than other eating disorders.; Despite some limitations in terms of demographics of the sample and format of the PDEDQ, this study provides valuable information to physicians regarding symptoms that should be detected and behavioral clues which should raise the index of suspicion for a possible eating disorder. Future studies should focus on obtaining a larger sample size, recruiting more adolescents both with and without eating disorders, and using methodologies that eliminate the need for a retrospective questionnaire. It is hoped that these results will increase the quality of training provided to medical students regarding detection of eating disorders and cause current physicians to seek out resources to assist them in their increasing their awareness and detection of eating disorders.