Disordered Eating: Early Intervention Is Needed

Disordered eating patterns, which often begin in adolescence, continue on into young adulthood and beyond, according to the results of a 10-year longitudinal study (J Am Diet Assoc 2001; 111:1004). The study results also underscored the importance of early intervention.

Dianne Newmark-Sztainer, PhD, MPH, RD and colleagues at the University of Minnesota and Columbia University designed the study to track dieting, unhealthy eating and extreme weight control behaviors, along with binge eating, among young men and women (55% of the participants). The Project EAT-III: Eating Among Teens and Young Adults, 1999-2010 followed more than 2,000 young men and women over a decade, from their teens to early adulthood. To better track the effects, the authors divided participants into two age groups. The younger group had a mean age of 12.8 years at baseline and a mean of 23.2 years at follow-up, while the older group had a mean age of 15.9 years at baseline and 26.2 years at follow-up. The participants were selected from a group of junior and senior high students at 31 public schools in Minneapolis/St. Paul, MN.

Early patterns of unhealthy eating set the stage. Among younger girls, the prevalence of unhealthy weight control behaviors remained constant from their early teens to early young adulthood. Among older girls, the prevalence of unhealthy weight control behaviors showed a statistically significant decrease from middle adolescence to middle young adulthood, but still remained very high (from the original mean of 60.7% to a mean of 54.4%).

Approximately one-third of boys also reported using unhealthy ways to control their weight, and the prevalence of these behaviors remained fairly constant during the study period for both age groups. As for extreme weight control behaviors, significant increases from adolescence to young adulthood were found in girls in both age groups.

Binge eating patterns

Binge eating increased in the older cohorts of both girls and boys. Among girls, the prevalence of binge eating increased from 9.9% in middle adolescence to 14.1% in middle young adulthood. The mean increase was lower among boys, where binge eating increased from 3.0% in middle adolescence to 5.9% in middle young adulthood. All groups reported significant increases in diet pill use during the study. For example, use of diet pills among girls jumped from 3.3% to 12.4% and among boys from 6.5% to 16.1% during the study.

The authors believe that all healthcare professionals should ask all young patients about such behaviors before they reach adolescence, and then again throughout adolescence and into young adulthood. In addition, young persons who are concerned about their weight should get support for healthful eating and physical activity that can be implemented on a long-term basis. An editorial in the same issue, by Drs. Megan M. Hood and Joyce A. Corsica, from Rush University Medical Center, Chicago, points out that most successful programs for preventing eating disorders target both risk factors and eating pathology. Dr. Neumark-Sztainer and colleague suggest that targeting interventions to persons in pre- and early adolescence may be a more effective approach to intervening to halt unhealthy eating behaviors.