A 30-year longitudinal study of body weight, dieting, and eating pathology across women and men from late adolescence to later midlife.

Abstract

Eating disorders (EDs) are more common among younger women compared to older women and in women compared to men. As such, most ED research focuses on late adolescent and young adult females resulting in limited prospective research on gender differences in eating disorder psychopathology across the life span. The present study addresses this gap by examining gender differences in ED diagnoses, eating pathology, and the impact of putative risk factors on eating pathology in women (n ϭ 624) and men (n ϭ 276) over a 30-year period from late adolescence (M (SD) ϭ 20[2] years) to later midlife (M (SD) ϭ 50[2] years). Four assessment waves were conducted, beginning with baseline participation during college and subsequent 10-, 20-, and 30-year follow-up. Retention at 30-year follow-up was 72% (n ϭ 440) for women and 67% (n ϭ 181) for men. Prevalence of DSM-5 ED diagnoses decreased over the 30-year span for women and remained stable for men, with no significant gender difference in point prevalence by age 50. Drive for thinness decreased for women through age 50 and increased for men, while bulimic symptoms decreased as both genders aged. Multilevel models demonstrated that the impact of dieting as a risk factor on drive for thinness decreased prospectively as men aged and remained stable as women aged. Results imply that current risk models require refinement to account for developmental trajectories in which dramatic gender differences observed in late adolescence diminish over time.

Gaining “The Quarantine 15:” Perceived versus observed weight changes in college students in the wake of COVID‐19

“…At both Time 1 and Time 2, participants also were asked to “Select the option that best describes your weight:” with response options of “1 = Very underweight,” “2 = Underweight,” “3 = Normal weight,” “4 = Overweight,” and “5 = Very overweight.” Prior research supports the concurrent and predictive validity of this single‐item assessment of weight description 2 as a measure of body image that demonstrates prospective associations with increased eating pathology and eating disorders (Atlantis & Ball, 2008; Brown, Forney, Klein, Grillot, & Keel, 2020; Keel & Heatherton, 2010).…”

“…Thus, COVID-19 appears to be impacting college students' perceptions of their weight more than their weight, suggesting an increase in cognitive distortions related to risk for eating disorders (Brown et al, 2020;Keel & Heatherton, 2010).…”

“…These findings suggest that COVID-19 may have particularly deleterious effects on those at highest risk for eating disorders due to pre-existing body image concerns.Given uncertainty about when the COVID-19 crisis will pass and what we will find on the other side, the pandemic's impact on mental health may be profound. In prior work(Brown et al, 2020;Keel & Heatherton, 2010), we have demonstrated the unique contribution of weight description as a prospective risk factor for increased eating disorder symptoms and eating disorder maintenance. An increase on this risk factor in 10% of the sample over such a short period of time is a concern.…”

“…Because ratings on these items represented an ordinal versus continuous variable, we conducted a second set of nonparametric analyses to further probe these findings. with eating pathology and eating disorders (Brown et al, 2020;Keel & Heatherton, 2010). Given that weight description represented an ordinal rather than continuous variable and the ability to convert BMI into an ordinal variable using CDC guidelines, we also conducted nonparametric analyses of these variables.…”

A virtual issue highlighting animal studies of eating disorders as valuable tools for examining neurobiological underpinnings and treatment of eating disorders

“…The above papers describe studies that examine key aspects of binge‐eating behavior that are present regardless of other factors that may contribute to binge eating (e.g., caloric restriction). However, given that binge eating in humans is often preceded by a history of dieting (Brown, Forney, Klein, Grillot, & Keel, 2020; Liechty & Lee, 2013), it is important to examine the effects of caloric restriction and weight loss on binge eating in animals. In their featured article, Hagan and Moss (1997) compared binge‐eating behavior in female rats from three groups: (a) rats that were exposed to 12 cycles of food restriction, and then refed on PF; (b) rats that were exposed to 12 cycles of food restriction, and then refed on chow; and (c) rats that did not experience food restriction or refeeding.…”