Nationwide trends in pediatric hospitalizations for eating disorders in France between 2013 and 2022: a retrospective study using the national health insurance database

BMC Med. 2025 Dec 5. doi: 10.1186/s12916-025-04558-1. Online ahead of print.

ABSTRACT

BACKGROUND: Eating disorders (EDs) are extreme eating behaviors with health consequences that sometimes require hospitalization. The prevalence of these disorders is difficult to estimate but appears to be increasing. The aim of this study was to analyze trends in hospitalizations for eating disorders in pediatric care in France over a ten-year period to determine whether these hospitalizations have increased and to characterize the nature of such changes.

METHODS: We conducted a retrospective observational study based on the French National Health Insurance Database (SNDS) for patients aged 6-18 years who were hospitalized for an eating disorder. Data were collected for the years 2013, 2017, and 2022. The primary objective was to compare the number and duration of hospitalizations across different years. The secondary objectives include: characteristics of initial stays, characteristics of patients, rehospitalizations and/or death in the year.

RESULTS: The study included 9,085 children aged 6 to 18 years who were hospitalized for eating disorders. The incidence doubled, increasing from 0.017% in 2013 to 0.036% in 2022. The duration of stays is generally longer than a few days (15 [5-43] vs 15 [5-50]). The median age was 15 years and showed an increasing trend, with a decreasing proportion of boys. Anorexia nervosa remains predominant with stable proportions, but there was a notable increase in "other eating disorders" between 2013 and 2022. Severe malnutrition increased, affecting more than 23% of patients in 2022, and anxiety disorders doubled, affecting 20.7% of patients in 2022. Emergency admissions rose (from 31% in 2013 to 37% in 2022), with a lower readmission rate. The role of psychiatric services increased, representing 25% of hospitalizations in 2022. All regions of France were affected.

CONCLUSIONS: This study revealed, between 2013 and 2022, a doubling of hospitalizations for EDs in children without a reduction in stay time. Patients have more anxiety and severe malnutrition. The diagnostic categories are changing, resulting in a more significant expansion of psychiatric services.

PMID:41351002 | DOI:10.1186/s12916-025-04558-1