Topic of Interest: eating Disorders
A person with an eating disorder will exhibit an abnormal attitude towards food, resulting in a
change in behavior and eating habits.
Eating disorder sufferers with anorexia or bulimia may focus excessively on their weight, body
shape, and image causing them to make unhealthy choices about food which can have damaging
results to their health.
Eating disorders may be dealt with in primary care, however in this report we will focus on those
which resulted in hospital admissions.
Between June 2010 and May 2011
There were 2,566 finished consultant episodes (FCEs) for all eating disorders compared
to 2,575 in the previous 12 months, representing a decrease of 0.3%.
89% (2,289) of the FCEs were female, representing a one percentage point decrease on
the previous 12 months when 90% (2,318) were female.
The average episode duration was 38 days
The graph below shows the number of finished consultant episodes (FCEs) per month from June
2009 to May 2011. For the purpose of this report we have classified eating disorders by the ICD10 Code F50 – Eating Disorders.
NHS Choices1 states “Anyone can develop an eating disorder, regardless of age,
sex or cultural or racial background. But the people most likely to be affected tend
to be young women, particularly between the ages of 15 and 25.”
The graph of HES data below shows that young women aged between 10 and 24
are most likely to be admitted to hospital for an eating disorder.
However, when focussing on individual ages we see that largest number of
episodes is for 14-16 year olds.
Types of eating disorders
Eating disorders include a range of conditions that can affect someone physically,
psychologically (mentally) and socially (their ability to interact with others).
Common types of eating disorders include:
Anorexia Nervosa – This is characterized by deliberate weight loss, induced by
the patient, usually by under eating and/or over exercising. This can lead to
disturbances in normal body function. Atypical anorexia nervosa is a disorder
associated with anorexia but with one or more of the key symptoms missing.
Bulimia Nervosa – is characterised by repeated bouts of over eating
(binge eating) followed by vomiting or the use of purgatives (such as laxatives).
Atypical bulimia nervosa is a condition associated with bulimia but with one or
more of the key symptoms is missing.
Other eating disorders (which fall into the F50 ICD-10 code) include, overeating or
vomiting associated with psychological disturbances as well as other or
unspecified eating disorders.
1. http://www.nhs.uk/Livewell/teengirls/Pages/eatingdisorders.aspx
The pie charts show the number of finished consultant episodes for types of
eating disorders.
NHS Choices states “Bulimia is around five times more common than anorexia
nervosa and 90% of people with bulimia are female. It usually develops around
the age of 18 or 19.”
Despite this higher prevalence of bulimia, the number of inpatient attendances for
anorexia is much higher.
The percentage of types of eating disorders has remained almost constant over
the past 2 years.
Finished Consultant Episode (FCE)
A finished consultant episode (FCE) is a continuous period of admitted patient care under
one consultant within one healthcare provider. FCEs are counted against the year in
which they end. Figures do not represent the number of different patients, as a person
may have more than one episode of care within the same stay in hospital or in different
stays in the same year.
Primary diagnosis
The primary diagnosis is the first of up to 20 (14 from 2002-03 to 2006-07 and 7 prior to
2002-03) diagnosis fields in the Hospital Episode Statistics (HES) data set and provides
the main reason why the patient was admitted to hospital.
ICD-10 F50 Eating Disorders - 4 character diagnosis codes:
Anorexia
F50.0 Anorexia nervosa
F50.1 Atypical anorexia nervosa
Bulimia
F50.2 Bulimia nervosa
F50.3 Atypical bulimia nervosa
Other eating disorders
F50.4 Overeating associated with other psychological disturbances
F50.5 Vomiting associated with other psychological disturbances
F50.8 Other eating disorders
F50.9 Eating disorder, unspecified
Data quality
Hospital Episode Statistics (HES) are compiled from data sent by more than 300 NHS
trusts and primary care trusts (PCTs) in England and from some independent sector
organisations for activity commissioned by the English NHS. The NHS Information Centre
for health and social care liaises closely with these organisations to encourage
submission of complete and valid data and seeks to minimise inaccuracies. While this
brings about improvement over time, some shortcomings remain.
Provisional data
Data from April 2009 – June 2010 is provisional and may be incomplete or contain errors
for which no adjustments have yet been made. Counts produced from provisional data
are likely to be lower than those generated for the same period in the final dataset. There
may also be errors due to coding inconsistencies that have not yet been investigated and
corrected.
Assessing growth through time
HES figures are available from 1989-90 onwards. Changes to the figures over time need
to be interpreted in the context of improvements in data quality and coverage (particularly
in earlier years), improvements in coverage of independent sector activity (particularly
from 2006-07) and changes in NHS practice. For example, apparent reductions in activity
may be due to a number of procedures which may now be undertaken in outpatient
settings and so no longer include in admitted patient HES data.