Division of Adolescent and Young Adult Medicine, Boston Children's Hospital, Boston, MA, USA.
School of Psychology and Public Health, La Trobe University, Kingsbury Drive, Bundoora, Melbourne, VIC, 3086, Australia.
Qual Life Res. 2020 May;29(5):1203-1215. doi: 10.1007/s11136-019-02396-2. Epub 2020 Jan 22.
To examine the relationship of disordered eating behaviors and eating disorder (ED) diagnosis in young adults with health-related quality of life (HRQL) and to assess the presence of effect modification by gender.
In 2013, participants (N = 9440, ages 18-31 years) in the U.S. Growing Up Today Study cohort reported use of disordered eating behaviors (dieting, diet pills, laxatives, or vomiting to control weight; binge eating with loss of control) over the past year, plus a lifetime history of ED diagnosis. The relative risk (RR) of less-than-full health (EQ-5D-5L health utility score < 1) and of any impairment (score > 1 on EQ-5D-5L dimensions) were compared across participants with and without disordered eating or ED diagnosis, using cross-sectional multivariable regression controlling for confounders. The association between HRQL and disordered eating or ED diagnosis was assessed using multivariable linear regression with the subsample reporting less-than-full health. The presence of effect modification by gender was also examined.
Disordered eating behaviors and ED diagnosis were associated with significantly increased risk of less-than-full health. A significant gender interaction was found for only one variable-ED diagnosis; men who reported ever having received a diagnosis experienced worse decrements in HRQL than did women. Inclusion of BMI in estimation models revealed small attenuations. Across the weight spectrum, the presence of ED was associated with impairment across all EQ-5D-5L dimensions, except self-care.
Disordered eating behaviors and a lifetime history of ED diagnosis are associated with significant decrements in HRQL, but only ED diagnosis is associated with a significant effect modification by gender.
探讨年轻成年人饮食障碍行为和饮食障碍（ED）诊断与健康相关生活质量（HRQL）的关系，并评估性别对其的影响修饰作用。
2013 年，美国“今日成长研究”队列中的参与者（N=9440 人，年龄 18-31 岁）报告了过去一年中使用饮食障碍行为（节食、服用减肥药、使用泻药或催吐来控制体重；暴食失控）的情况，以及一生中 ED 诊断的病史。使用横截面多变量回归控制混杂因素，比较有或无饮食障碍或 ED 诊断的参与者之间健康状况较差（EQ-5D-5L 健康效用评分<1）和任何功能障碍（EQ-5D-5L 维度得分>1）的相对风险（RR）。使用多变量线性回归，对报告健康状况较差的亚样本评估 HRQL 与饮食障碍或 ED 诊断之间的关联。还检查了性别对其的影响修饰作用。
饮食障碍行为和 ED 诊断与健康状况较差的风险显著增加相关。仅 ED 诊断存在显著的性别交互作用；报告曾接受过诊断的男性比女性的 HRQL 下降幅度更大。在估计模型中纳入 BMI 会导致微小的衰减。在整个体重范围内，ED 的存在与除自我护理外所有 EQ-5D-5L 维度的功能障碍有关。
饮食障碍行为和一生中 ED 诊断与 HRQL 显著下降有关，但只有 ED 诊断与性别对其的影响修饰作用显著相关。
