Risk factors for eating disorders in children

Risk factors for binge eating and purging may vary between boys and girls and by age group in girls, according to a report in the June issue of Archives of Pediatrics & Adolescent Medicine.

"Concerns about weight and body shape are common in pre-adolescents and adolescents and are probably related to the development of unhealthy weight control behaviors and binge eating," according to background information in the article. Although there have been studies of eating disorders, little is known about the development of binge eating and purging (vomiting or using laxatives to control weight) in teens that are not seeking treatment.

Alison E. Field, Sc.D., of the Children's Hospital Boston and Harvard Medical School, Boston, and colleagues analyzed data from 1996 to 2003 in 6,916 girls and 5,618 boys (age 9 to 15 at the beginning of the study) to examine the association between various risk factors (such as frequent dieting, trying to look like persons in the media, negative weight comments from fathers or peers and having a mother with history of an eating disorder) and the development of frequent binge eating, purging or both.

During 7 years of follow-up, 10.3 percent of the girls and 3 percent of the boys started to binge eat or purge at least once a week. Slightly more girls started to purge (5.3 percent) than binge eat (4.3 percent), while binge eating was more common than purging (2.1 percent vs. 0.8 percent) among boys. Only a small proportion of boys and girls engaged in both binge eating and purging.

Although girls under age 14 whose mothers had a history of an eating disorder were almost three times as likely than their peers to start purging at least once a week, "maternal history of an eating disorder was unrelated to risk of starting to binge eat or purge in older adolescent females," the authors write. "Frequent dieting and trying to look like persons in the media were independent predictors of binge eating in females of all ages. In males, negative comments about weight by fathers was predictive of starting to binge at least weekly."

"Our results suggest that prevention of disordered eating and eating disorders may need to be age- and sex-specific. Efforts aimed at females should contain media literacy and other approaches to make young persons less susceptible to the media images they see," the authors conclude. "In addition, programs for females should focus more on becoming more resilient to teasing from males, whereas programs for males should focus on approaches to becoming more resilient to negative comments about weight by fathers."