Is Puberty a Risk Factor for Eating Disorders?

Joel D. Killen

155 citations0/0 files storedArchives of Pediatrics and Adolescent Medicine

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Eating Disorders and Behaviors Nutrition, Health and Food Behavior Child Nutrition and Feeding Issues

Abstract

OBJECTIVE: To examine the association between stage of sexual maturation and eating disorder symptoms in a community-based sample of adolescent girls. PARTICIPANTS: All sixth- and seventh-grade girls (N = 971) enrolled in four northern California middle schools. MAIN VARIABLES EXAMINED: Pubertal development measured using self-reported Tanner stage and body mass index (kg/m2). The section of the Structured Clinical Interview for DSM-III-R Disorders (SCID) discussing bulimia nervosa was used to evaluate symptoms of bulimia nervosa. RESULTS: Girls manifesting eating disorder symptoms, while not significantly older than their peers without such symptoms, were more developmentally advanced as determined with Tanner self-staging. The odds ratio for the association between sexual maturity and symptoms was 1.8 (95% confidence interval, 1.2 to 2.8); ie, at each age, an increase in sexual maturity of a single point was associated with a 1.8-fold increase in the odds of presenting symptoms. The odds ratio for the association between body mass index (adjusted for sexual maturity) and symptoms was 1.02 (95% confidence interval, 1.0 to 1.05). There was no independent effect of age or of the interaction between age and the sexual maturity index. CONCLUSIONS: These results suggest that (1) puberty may be a risk factor for the development of eating disorders, and (2) prevention efforts might best be directed at prepubertal and peripubertal adolescents.

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References

1986Toward an understanding of risk factors for bulimia.1990Studies of the epidemiology of bulimia nervosa 1981Childhood obsessive-compulsive disorder 1983Fear of Obesity 1988Abnormal eating attitudes in London schoolgirls — a prospective epidemiological study: factors associated with abnormal response on screening questionnaires

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2001Association between puberty and disordered eating, body image, and other psychological variables 2006The Michigan State University Twin Registry (MSUTR): Genetic, Environmental and Neurobiological Influences on Behavior Across Development 2008Childhood Sexual Abuse and Eating Disorders in Females 2001Early puberty and early sexual activity are associated with bulimic-type eating pathology in middle adolescence11The full text of this article is available via JAH Online at http://www.elsevier.com/locate/ajpmonline.2007An association of early puberty with disordered eating and anxiety in a population of undergraduate women and men 2007Puberty moderates genetic influences on disordered eating 2009Childhood Risk Factors for Lifetime Anorexia Nervosa by Age 30 Years in a National Birth Cohort

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