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Onset of adolescent eating disorders: population based cohort study over 3 years.

Abstract

OBJECTIVE

To study the predictors of new eating disorders in an adolescent cohort.

DESIGN

Cohort study over 3 years with six waves.

SUBJECTS

Students, initially aged 14-15 years, from 44 secondary schools in the state of Victoria, Australia.

OUTCOME MEASURES

Weight (kg), height (cm), dieting (adolescent dieting scale), psychiatric morbidity (revised clinical interview schedule), and eating disorder (branched eating disorders test). Eating disorder (partial syndrome) was defined when a subject met two criteria for either anorexia nervosa or bulimia nervosa according to the Diagnostic and Statistical Manual of Mental Disorders, fourth edition (DSM-IV).

RESULTS

At the start of the study, 3.3% (29/888) of female subjects and 0.3% (2/811) of male subjects had partial syndromes of eating disorders. The rate of development of new eating disorder per 1000 person years of observation was 21.8 in female subjects and 6.0 in male subjects. Female subjects who dieted at a severe level were 18 times more likely to develop an eating disorder than those who did not diet, and female subjects who dieted at a moderate level were five times more likely to develop an eating disorder than those who did not diet. Psychiatric morbidity predicted the onset of eating disorder independently of dieting status so that those subjects in the highest morbidity category had an almost sevenfold increased risk of developing an eating disorder. After adjustment for earlier dieting and psychiatric morbidity, body mass index, extent of exercise, and sex were not predictive of new eating disorders.

CONCLUSIONS

Dieting is the most important predictor of new eating disorders. Differences in the incidence of eating disorders between sexes were largely accounted for by the high rates of earlier dieting and psychiatric morbidity in the female subjects. In adolescents, controlling weight by exercise rather than diet restriction seems to carry less risk of development of eating disorders.

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  • Authors+Show Affiliations

    ,

    Centre for Adolescent Health, Department of Paediatrics, University of Melbourne, Parkville Victoria 3052, Australia. patton@cryptic.rch.unimelb.edu.au

    , , ,

    Source

    BMJ (Clinical research ed.) 318:7186 1999 Mar 20 pg 765-8

    MeSH

    Adolescent
    Age of Onset
    Cohort Studies
    Cross-Sectional Studies
    Diet
    Feeding and Eating Disorders
    Female
    Humans
    Incidence
    Male
    Regression Analysis
    Victoria

    Pub Type(s)

    Journal Article
    Research Support, Non-U.S. Gov't

    Language

    eng

    PubMed ID

    10082698

    Citation

    Patton, G C., et al. "Onset of Adolescent Eating Disorders: Population Based Cohort Study Over 3 Years." BMJ (Clinical Research Ed.), vol. 318, no. 7186, 1999, pp. 765-8.
    Patton GC, Selzer R, Coffey C, et al. Onset of adolescent eating disorders: population based cohort study over 3 years. BMJ. 1999;318(7186):765-8.
    Patton, G. C., Selzer, R., Coffey, C., Carlin, J. B., & Wolfe, R. (1999). Onset of adolescent eating disorders: population based cohort study over 3 years. BMJ (Clinical Research Ed.), 318(7186), pp. 765-8.
    Patton GC, et al. Onset of Adolescent Eating Disorders: Population Based Cohort Study Over 3 Years. BMJ. 1999 Mar 20;318(7186):765-8. PubMed PMID: 10082698.
    * Article titles in AMA citation format should be in sentence-case
    TY - JOUR T1 - Onset of adolescent eating disorders: population based cohort study over 3 years. AU - Patton,G C, AU - Selzer,R, AU - Coffey,C, AU - Carlin,J B, AU - Wolfe,R, PY - 1999/3/20/pubmed PY - 1999/3/20/medline PY - 1999/3/20/entrez SP - 765 EP - 8 JF - BMJ (Clinical research ed.) JO - BMJ VL - 318 IS - 7186 N2 - OBJECTIVE: To study the predictors of new eating disorders in an adolescent cohort. DESIGN: Cohort study over 3 years with six waves. SUBJECTS: Students, initially aged 14-15 years, from 44 secondary schools in the state of Victoria, Australia. OUTCOME MEASURES: Weight (kg), height (cm), dieting (adolescent dieting scale), psychiatric morbidity (revised clinical interview schedule), and eating disorder (branched eating disorders test). Eating disorder (partial syndrome) was defined when a subject met two criteria for either anorexia nervosa or bulimia nervosa according to the Diagnostic and Statistical Manual of Mental Disorders, fourth edition (DSM-IV). RESULTS: At the start of the study, 3.3% (29/888) of female subjects and 0.3% (2/811) of male subjects had partial syndromes of eating disorders. The rate of development of new eating disorder per 1000 person years of observation was 21.8 in female subjects and 6.0 in male subjects. Female subjects who dieted at a severe level were 18 times more likely to develop an eating disorder than those who did not diet, and female subjects who dieted at a moderate level were five times more likely to develop an eating disorder than those who did not diet. Psychiatric morbidity predicted the onset of eating disorder independently of dieting status so that those subjects in the highest morbidity category had an almost sevenfold increased risk of developing an eating disorder. After adjustment for earlier dieting and psychiatric morbidity, body mass index, extent of exercise, and sex were not predictive of new eating disorders. CONCLUSIONS: Dieting is the most important predictor of new eating disorders. Differences in the incidence of eating disorders between sexes were largely accounted for by the high rates of earlier dieting and psychiatric morbidity in the female subjects. In adolescents, controlling weight by exercise rather than diet restriction seems to carry less risk of development of eating disorders. SN - 0959-8138 UR - https://www.unboundmedicine.com/medline/citation/10082698/full_citation L2 - http://www.bmj.com/cgi/pmidlookup?view=long&pmid=10082698 DB - PRIME DP - Unbound Medicine ER -