Weight Status and DSM-5 Diagnoses of Eating Disorders in Adolescents From the Community

Flament, Martine F.; Henderson, Katherine A.; Buchholz, Annick; Obeid, Nicole; Nguyen, Hien Ngoc; Birmingham, Meagan; Goldfield, Gary S.

doi:10.1016/j.jaac.2015.01.020

Cited by 77 publications

(62 citation statements)

References 56 publications

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“…Results showed that individuals with overweight/obesity had heightened ED pathology compared to those with normal weight or underweight, consistent with the wealth of past research indicating that EDs are not constrained to underweight/normal weight categories (Eichen, Conner, Daly, & Fauber, 2012; Flament et al, 2015; Goldschmidt, Wall, Loth, & Neumark-Sztainer, 2015; Sonneville et al, 2013; Sysko, Hildebrandt, Wilson, Wilfley, & Agras, 2010). Indeed, these results lend continued support for integrating ED intervention and healthy weight management across the weight spectrum using a comprehensive approach targeting all ED-related problem behaviors (Austin, 2011; Ciao et al, 2014; Neumark-Sztainer, 2003, 2012).…”

Section: Discussionsupporting

confidence: 82%

Universal prevention efforts should address eating disorder pathology across the weight spectrum: Implications for screening and intervention on college campuses

et al. 2017

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Purpose Given shared risk and maintaining factors between eating disorders and obesity, it may be important to include both eating disorder intervention and healthy weight management within a universal eating disorder care delivery program. This study evaluated differential eating disorder screening responses by initial weight status among university students, to assess eating disorder risk and pathology among individuals with overweight/obesity versus normal weight or underweight. Methods 1529 individuals were screened and analyzed. Screening was conducted via pilot implementation of the Internet-based Healthy Body Image program on two university campuses. Results Fifteen percent of the sample had overweight/obesity. Over half (58%) of individuals with overweight/obesity screened as high risk for an eating disorder or warranting clinical referral, and 58% of individuals with overweight/obesity endorsed a ≥10-pound weight change over the past year. Compared to individuals with normal weight or underweight, individuals with overweight/obesity were more likely to identify as Black, endorse objective binge eating and fasting, endorse that eating disorder-related concerns impaired their relationships/social life and made them feel badly, and endorse higher weight/shape concerns. Conclusions Results suggest rates of eating disorder pathology and clinical impairment are highest among students with overweight/obesity, and targeted intervention across weight categories and diverse races/ethnicities is warranted within universal eating disorder intervention efforts. Integrating eating disorder intervention and healthy weight management into universal prevention programs could reduce the incidence and prevalence of eating disorders, unhealthy weight control practices, and obesity among university students.

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Section: Discussionsupporting

confidence: 82%

Universal prevention efforts should address eating disorder pathology across the weight spectrum: Implications for screening and intervention on college campuses

et al. 2017

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“…The combined prevalence of these disorders means that a nontrivial percentage of adolescents may be at increased risk for obesity. Given the high public health, societal, and personal health burden of obesity, 45-46 prevention of obesity among adolescents should also address ED.…”

Section: Discussionmentioning

confidence: 99%

Adolescent Eating Disorders Predict Psychiatric, High-Risk Behaviors and Weight Outcomes in Young Adulthood

Micali¹,

Solmi²,

Horton³

et al. 2015

Journal of the American Academy of Child & Adolescent Psych

183

219

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Objective To investigate whether anorexia nervosa (AN), bulimia nervosa (BN), binge eating disorder (BED), and other specified feeding and eating disorders (OSFED), including purging disorder (PD), subthreshold BN, and BED at ages 14 and 16, are prospectively associated with later depression, anxiety disorders, alcohol and substance use, and self-harm. Method Eating disorders were ascertained at 14 and 16 years of age in 6,140 youth at age 14 (58% of those eligible) and 5,069 at age 16 (52% of those eligible) as part of the prospective Avon Longitudinal Study of Parents and Children (ALSPAC). Outcomes (depression, anxiety disorders, binge drinking, drug use, deliberate self-harm, weight status) were measured using interviews and questionnaires about 2 years following predictors. Generalized estimating equation models adjusting for gender, socio-demographic variables, and prior outcome were used to examine prospective associations between eating disorders and each outcome. Results All eating disorders were predictive of later anxiety disorders. AN, BN, BED, PD, and OSFED were prospectively associated with depression (respectively AN: odds ratio [OR]=1.39 [95% CIs: 1.00-1.94]; BN: OR=3.39[1.25-9.20]; BED: OR=2.00 [1.06-3.75]; PD: OR=2.56 [1.38-4.74]). All eating disorders but AN predicted drug use and deliberate self-harm (BN: OR=5.72[2.22-14.72], PD: OR=4.88[2.78-8.57], subthreshold BN: OR=3.97[1.44-10.98], subthreshold BED: OR=2.32[1.43-3.75]). Whilst BED and BN predicted obesity (respectively OR=3.58 [1.06-12.14] and OR=6.42 [1.69-24.30]), AN was prospectively associated with underweight. Conclusions Adolescent eating disorders, including subthreshold presentations, predict negative outcomes, including mental health disorders, substance use, deliberate self-harm, and weight outcomes. This study highlights the high public health and clinical burden of eating disorders among adolescents.

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“…Weight loss is a defining characteristic of AN, but not BN or BED. In fact, eating disorders are present in all body mass index (BMI) categories (Duncan, Ziobrowski, & Nicol, ; Flament et al, ), and AN is less common than the combined prevalence of other eating disorder diagnoses (Kessler et al, ; Lindvall Dahlgren & Wisting, ; Qian et al, ). On average, the BMI of individuals with AN is lower than the BMI of those with BN, which is lower than the BMI of those with BED.…”

Section: Truth 1: Many People With Eating Disorders Look Healthy Yetmentioning

confidence: 99%

“…Weight and BMI can vary substantially across the different types of eating disorders. In a sample of over 3000 adolescents, eating disorders were present in all BMI categories (Flament et al, ). Restrictive eating disorders in normal‐weight and overweight individuals are increasingly being acknowledged.…”

Section: Truth 5: Eating Disorders Affect People Of All Genders Agesmentioning

confidence: 99%

The Science Behind the Academy for Eating Disorders' Nine Truths About Eating Disorders

Schaumberg

Welch

Breithaupt

et al. 2017

Euro Eating Disorders Rev

193

127

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Objective In 2015, the Academy for Eating Disorders (AED) collaborated with international patient, advocacy, and parent organizations to craft the “Nine Truths About Eating Disorders.” This document has been translated into over 30 languages and has been distributed globally to replace outdated and erroneous stereotypes about eating disorders with factual information. In this paper, we review the state of the science supporting the Nine Truths. Methods The literature supporting each of the Nine Truths was reviewed, summarized, and richly annotated. Results Most of the Nine Truths arise from well-established foundations in the scientific literature. Additional evidence is required to further substantiate some of the assertions in the document. Future investigations are needed in all areas to deepen our understanding of eating disorders, their causes, and their treatments. Conclusions The “Nine Truths About Eating Disorders” is a guiding document to accelerate global dissemination of accurate and evidence-informed information about eating disorders.

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Weight Status and DSM-5 Diagnoses of Eating Disorders in Adolescents From the Community

Cited by 77 publications

References 56 publications

Universal prevention efforts should address eating disorder pathology across the weight spectrum: Implications for screening and intervention on college campuses

Universal prevention efforts should address eating disorder pathology across the weight spectrum: Implications for screening and intervention on college campuses

Adolescent Eating Disorders Predict Psychiatric, High-Risk Behaviors and Weight Outcomes in Young Adulthood

The Science Behind the Academy for Eating Disorders' Nine Truths About Eating Disorders

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