Social Disparity and Treatment-Seeking in Eating Disorders During Childhood and Adolescence: A Nationwide Population-Based Cohort Study.

Authors

Ella C Hesse Krenchel, Andrea Joensen, Else Marie Olsen, Helen Bould, Amanda M Hughes, Claus Thorn Ekstrøm, Katrine Strandberg-Larsen

Published in

JAACAP open. Volume 4. Issue 4. Pages 678-690. Epub Mar 13, 2026.

Abstract

Advantaged socioeconomic circumstances are linked to a higher risk of diagnosed eating disorders (EDs). However, evidence on non-diagnosed cases, that is, individuals reporting ED symptoms without formal diagnosis, remains limited, suggesting detection and treatment-seeking barriers. In this study, we assessed associations between socioeconomic circumstances and clinically diagnosed and non-diagnosed EDs in childhood and adolescence.
This study used data from the Danish National Birth Cohort, linking registry-based diagnosed EDs (participant ages 6-18 years) with self-reported ED symptoms at age 18 years. Data included 523,148 individuals born in Denmark between 1996 and 2003, with 44,552 providing information on self-reported ED symptoms used to classify non-diagnosed EDs. Socioeconomic indicators, including parental education and household income at age 6 years, were analyzed using quasi-Poisson and multinomial logistic regression to estimate incidence rate ratios (IRRs) and relative risk ratios (RRRs).
Diagnosed EDs were more common among individuals with higher parental education, following a stepwise pattern. Compared to short education (∼12 years), long education (∼17-20 years) was associated with higher risk (IRR = 1.35, 95% CI = 1.21-1.52), whereas basic education (∼10 years) was linked to lower risk (IRR = 0.70, 95% CI = 0.59-0.83). The pattern reversed for non-diagnosed EDs, with individuals whose parents had basic education showing a higher risk (RRR = 2.19, 95% CI = 1.83-2.63) compared to individuals whose parents had short education. No clear pattern was observed for household income.
This study highlights socioeconomic disparities in ED diagnosis and treatment. Individuals from educationally advantaged backgrounds were more likely to receive a diagnosis, whereas those from educationally disadvantaged backgrounds had a higher risk of non-diagnosed EDs.
Parental Social Disparity and Adolescent Eating Disorders; https://osf.io/dm24e/.

PMID:
42534372
Bibliographic data and abstract were imported from PubMed on 31 Jul 2026.

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