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Eating disorder symptom trajectories in adolescence

Adolescence is a period of developmental risk for eating disorders and eating disorder symptoms.

Authors:
Allen KL, Crosby R, Oddy W, Byrne S

Authors notes:
Journal of Eating Disorders. 2013;1(1):32.

Keywords:
Eating disorders, adolescents, binge eating, purging, depression, mental health

Abstract:
Adolescence is a period of developmental risk for eating disorders and eating disorder symptoms.

This study aimed to describe the prevalence and trajectory of five core eating disorder behaviours (binge eating, purging, fasting, following strict dietary rules, and hard exercise for weight control) and a continuous index of dietary restraint and eating, weight and shape concerns, in a cohort of male and female adolescents followed from 14 to 20 years.

It also aimed to determine the effect of early adolescent depressive symptoms on the prevalence and trajectory of these different eating disorder symptoms.

Symptom trajectories varied according to the eating disorder symptom studied, participant sex, and the presence of depressive symptoms in early adolescence.

For males, eating disorder symptoms tended to be stable (for purging, fasting and hard exercise) or decreasing (for binge eating and global symptom scores) from 14 to 17 years, and then stable to 20 years.

For females, fasting and global symptom scores increased from age 14 to peak in prevalence at age 17.

Rates of binge eating in females were stable from age 14 to age 17 and increased significantly thereafter, whilst rates of purging and hard exercise increased from age 14 to age 17, and then remained elevated through to age 20.

Depressive symptoms at age 14 impacted on eating disorder symptom trajectories in females, but not in males.

Prevention, screening and intervention initiatives for adolescent eating disorders need to be tailored to gender and age.

Purging behaviour appears to be an important target for work with early to middle adolescent females.