Micali Nadia, Ploubidis George, De Stavola Bianca, Simonoff Emily, Treasure Janet
Institute of Child Health, Behavioral and Brain Sciences Unit, University College London, London, United Kingdom.
Department of Population Health, London School of Hygiene and Tropical Medicine, London, United Kingdom.
J Adolesc Health. 2014 May;54(5):574-81. doi: 10.1016/j.jadohealth.2013.10.200. Epub 2013 Dec 17.
There are still uncertainties about manifestations of early adolescent eating disorders (ED) and their effects. We aimed to determine the prevalence of ED symptoms in early adolescence, derive symptoms dimensions, and determine their effects on social and psychological outcomes and subsequent body mass index (BMI).
Data on 7,082 adolescents aged 13 years from the Avon Longitudinal Study of Parents and Children were obtained on ED symptoms, resulting impairment and family burden and emotional and behavioral disorders using the parental version of the Developmental and Well-being Assessment. Exploratory structural equation models were used to derive ED symptoms dimensions separately by sex and to relate these to contemporary outcomes (impairment, burden, and emotional and behavioral disorders) and a distal outcome (objective BMI at age 15 years).
Extreme levels of fear of weight gain, avoidance of fattening foods, and distress about weight and shape were common among girls (11%). Three ED symptoms dimensions were identified: bingeing/overeating, weight/shape concern and weight-control behaviors, and food restriction. Bingeing/overeating was strongly associated with higher functional impairment, family burden, and comorbid psychopathology. Bingeing/overeating and weight/shape concern and weight-control behaviors predicted higher BMI 2 years later, whereas food restriction predicted lower BMI. These effects did not change when BMI at age 13 years was included in the model.
Eating disorder cognitions are common among young teenage girls. Eating disorder symptoms have adverse cross-sectional and distal consequences, in particular on increasing body weight 2 years later. These findings have important implications for early identification of adolescents engaging in ED behaviors and for obesity prevention.
青少年早期饮食失调（ED）的表现及其影响仍存在不确定性。我们旨在确定青少年早期饮食失调症状的患病率，推导症状维度，并确定其对社会和心理结果以及随后的体重指数（BMI）的影响。
从雅芳亲子纵向研究中获取了7082名13岁青少年的数据，这些数据涉及饮食失调症状、由此导致的损害和家庭负担以及使用发育与幸福评估的家长版所评估的情绪和行为障碍。探索性结构方程模型用于按性别分别推导饮食失调症状维度，并将这些维度与当前结果（损害、负担以及情绪和行为障碍）和远期结果（15岁时的客观BMI）相关联。
对体重增加的极度恐惧、避免食用易胖食物以及对体重和体型的困扰在女孩中很常见（11%）。确定了三个饮食失调症状维度：暴饮暴食、对体重/体型的关注和体重控制行为以及食物限制。暴饮暴食与更高的功能损害、家庭负担和共病精神病理学密切相关。暴饮暴食以及对体重/体型的关注和体重控制行为预测了两年后更高的BMI，而食物限制则预测了更低的BMI。当将13岁时的BMI纳入模型时，这些影响并未改变。
饮食失调认知在年轻少女中很常见。饮食失调症状具有不良的横断面和远期后果，特别是对两年后体重增加的影响。这些发现对于早期识别有饮食失调行为的青少年以及预防肥胖具有重要意义。
