Gender Differences in a Cohort of Children with Eating Disorders: A Retrospective Study.

Introduction: Eating disorders (EDs) are severe psychiatric disorders that significantly impact the psychological and physiological well-being of affected individuals. Despite increasing prevalence in males over the past few decades, EDs are mainly considered a female disease. This retrospective study aims to evaluate the influence of gender on the clinical, laboratory, and developmental characteristics of EDs in pediatric patients. Material and

Methods: A retrospective study was conducted on patients referred to the EDs between 2019 and 2024 at Bambino Gesù Children's Hospital, Rome, Italy. Gender differences were evaluated in the whole cohort and in a sub-cohort of males and females well matched for age.

Results: In the whole cohort of 501 patients (age range 8-17 years), 45 were males and 456 were females. In male patients, EDs occurred at a younger age (12.65 vs. 14.65 years, p < 0.05). When considering the matched cohort, male patients showed more severe clinical conditions, as evidenced by a tendency to a lower BMI SDS at the onset, higher inflammatory parameters (ferritin and transaminase levels), and poorer nutritional status (vitamin D levels: 23.15 vs. 26.9 ng/mL, p < 0.05). However, male patients had a shorter hospital stay (14.8 vs. 19.9 days, p < 0.05) and showed a tendency to a greater clinical improvement. Differences in therapy were also observed, with fewer males receiving pharmacological treatment or nasogastric feeding.

Conclusions: The results of the current study confirm the higher prevalence of EDs in females, even though they suggest EDs are not exclusively a female disease. Male gender may represent a risk factor for a worse clinical course and a younger onset. Further studies with a longer follow-up are required to understand the significant differences between females and males in this complex disorder.