Eating disorders occur at high rates in adolescents with epilepsy and are associated with psychiatric comorbidities and suicidality

Objectives To assess the occurrence rate, characteristics, and impact of eating disorders (EDs) in adolescents with epilepsy. Methods In this observational study, adolescents with epilepsy seen in a single center between 2013 and 2022 who had comorbid EDs were compared to two control groups of adolescents with only epilepsy and only EDs. Patients with intellectual disability or autism spectrum disorder were excluded. Data retrieved included demographic and anthropometric details and clinical variables relating to seizure types, EDs, and psychiatric disorders and behaviors. Results A total of 376 subjects were included in the study: 84 adolescents with both epilepsy and eating disorders, 135 with only epilepsy, and 157 with only EDs. The rate of EDs in adolescents with epilepsy was 7.0% (95% confidence interval [CI] 5.6%–8.5%) overall, 11.3% (95% CI 8.8%–14.3%) in females, and 3.1% (95% CI 1.9%–4.8%) in males. The median (interquartile range [IQR]) time difference between the onset of epilepsy to an ED was 1.6 (.5–3.6) years. Among adolescents with epilepsy, those with an ED were more likely to be female (p = .001) and have a lower body mass index z‐score (zBMI) percentile (p