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Journal of Eating Disorders

Open Access

Rural-metropolitan health differential for young persons with eating disorders referred for specialist treatment

  • Jeremy Alman1,
  • Kimberley Hoiles2Email author,
  • Hunna Watson3,
  • Sarah Egan1,
  • Matthew Hamilton2,
  • Julie McCormack2,
  • Julie Potts2,
  • David A Forbes4 and
  • Chloe Shu1, 2
Journal of Eating Disorders20142(Suppl 1):O55

Published: 24 November 2014


Rural AreaEating DisorderYoung PersonLower Body Mass IndexMedical Complication


The aim was to explore associations between residing in a rural area and clinical characteristics of children and adolescents with eating disorders presenting to a specialist eating disorders program.


The data source was the Helping to Outline Paediatric Eating Disorders (HOPE) Project registry (N ~ 1000), a prospective ongoing registry study comprising consecutive paediatric tertiary eating disorder referrals. The sample (N = 399) comprised children and adolescents presenting with a DSM-5 eating disorder, with ages ranging from 8 to 16 years (M = 14.49, 92% female).


Consistent with the hypotheses, living in a rural area was associated with a lower body mass index z-score, and a higher likelihood of medical complications at intake assessment. Contrary to our hypothesis, eating pathology and living in a rural area were negatively associated. No relationship was observed between living in a rural area and duration of illness or greater percentage of bodyweight lost.


The results suggest that living in a rural area and being a greater distance from specialist services is associated with more severe malnutrition and medical complications by the time the young person and their family obtain specialist care. These findings have implications for service planning and provision for rural communities. The modifications to service delivery in the study setting will be described.

This abstract was presented in the Service Initiatives: Child and Adolescent stream of the 2014 ANZAED Conference.

Authors’ Affiliations

School of Psychology and Speech Pathology, Division of Health Sciences, Curtin University, Perth, Australia
Eating Disorders Program, Specialized Child and Adolescent Mental Health Service, Child and Adolescent Health Service, Perth, Australia
UNC Center of Excellence for Eating Disorders, University of North Carolina, Chapel Hill, United States
School of Paediatrics and Child Health, Faculty of Medicine, Dentistry and Health Sciences, The University of Western Australia, Perth, Australia


© Alman et al; licensee BioMed Central Ltd. 2014

This article is published under license to BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. The Creative Commons Public Domain Dedication waiver ( applies to the data made available in this article, unless otherwise stated.