Objective: There is much ambiguity regarding Eating Disorder (ED) diagnosis, including when a patient actually develops the disease. Many studies have focused on behaviors during late adolescence as a crucial time for ED development, but few have focused on menarche. This study seeks to identify possible behavioral traits during menarche, including emotion toward the first period, which can be used as a warning sign for future ED development. Method: An anonymous online survey was distributed to approximately 1000 female students and faculty at Rowan University School of Osteopathic Medicine and 100 females on an ED Recovery Facebook group. The survey was created and responses were recorded using Rowan Qualtrics system in order to protect patient responses and ensure anonymity. Data was analyzed using SPSS. Results: There were many significant differences found in this study; feelings of fear (p = 0.009), sadness (p = 0.021) and disgust (p = 0.026) toward menarche were significantly higher in those who have been diagnosed with an ED. Additionally, ED patients felt significantly less prepared (p = 0.015) for the body changes that occurred during puberty. Those with an ED also experienced significantly increased focus on weight both prior to and during menarche, and reported an increased incidence of self-criticizing their weight to others (p < 0.001). Conclusion: The results of this study give insight into behavioral attributes, fear, sadness and disgust, toward a concrete event (menarche) which parents, pediatricians and even school teachers can use to detect early signs of ED behaviors. This provides insight into the development of future diagnostic criteria that caretakers can use to establish early intervention with young, at-risk females to prevent a future ED.
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