Department of Public Health, University of Helsinki, Helsinki, Finland.
Int J Eat Disord. 2023 Oct;56(10):1854-1865. doi: 10.1002/eat.24013. Epub 2023 Jun 23.
Eating disorders are associated with subsequent alcohol problems, but it is not known whether this association also extends to broader eating disorder symptoms not captured by clinical diagnoses. We assessed the longitudinal association of broad eating disorder symptoms with alcohol problems in a nationwide twin sample (FinnTwin16).
Finnish women (N = 1905) and men (N = 1449) self-reported their eating disorder symptoms using the Eating Disorder Inventory-2 Bulimia, Drive for Thinness, and Body Dissatisfaction subscales at the mean age of 24.4 years in 2000-2003. A subsample of participants also completed items on drive for muscularity, height dissatisfaction, and muscle-enhancing supplement use. Alcohol problems were assessed 10 years later at the age of 34.1 in 2010-2012 with the Rutgers Alcohol Problem Index.
Eating disorder symptoms were associated with later alcohol problems (odds ratio per point increase 1.02-1.18). Bulimia showed stronger associations among men than women (p for interaction .012). Drive for muscularity and height dissatisfaction were also associated with later alcohol problems, but supplement use was not. When accounting for baseline alcohol problems, only Bulimia (among women and men) and Drive for Thinness (among men) were significantly associated with later alcohol problems. Bulimia was also significantly associated with later alcohol problems in within-twin-pair analyses among dizygotic twins, but not among monozygotic twins.
In a longitudinal setting, eating disorder symptoms were associated with later alcohol problems. Bulimic symptoms were a stronger risk factor for men than women. These associations may be attributable to baseline alcohol problems, childhood environment and genetic liability.
This study found that both young adult women and men with broad eating disorder symptoms are at a higher risk of alcohol-related problems than those without such symptoms. Men with bulimic symptoms were at a particularly high risk. These findings emphasize the need for better prevention and treatment of disordered eating, body image concerns and alcohol problems for both young adult women and men.
饮食失调与随后的酒精问题有关，但尚不清楚这种关联是否也扩展到更广泛的饮食失调症状，而这些症状无法通过临床诊断来捕捉。我们在一项全国性的双胞胎样本（芬兰双胞胎 16 号）中评估了广泛的饮食失调症状与酒精问题的纵向关联。
芬兰女性（N=1905）和男性（N=1449）在 2000-2003 年平均年龄 24.4 岁时使用饮食失调问卷-2 的贪食、消瘦和身体不满子量表自我报告他们的饮食失调症状。部分参与者还完成了关于肌肉发达、身高不满和肌肉增强补充剂使用的项目。2010-2012 年，在 34.1 岁时，使用罗格斯酒精问题指数评估了 10 年后的酒精问题。
饮食失调症状与以后的酒精问题有关（每增加一个点的优势比为 1.02-1.18）。贪食症在男性中的关联比女性更强（交互作用的 p 值.012）。肌肉发达和身高不满也与以后的酒精问题有关，但补充剂的使用没有。当考虑到基线酒精问题时，只有贪食症（在女性和男性中）和消瘦症（在男性中）与以后的酒精问题显著相关。在同卵双胞胎的双胞胎内分析中，贪食症也与以后的酒精问题显著相关，但在异卵双胞胎中没有。
在纵向环境中，饮食失调症状与以后的酒精问题有关。贪食症症状对男性的风险因素大于女性。这些关联可能归因于基线酒精问题、儿童期环境和遗传易感性。
这项研究发现，无论是年轻女性还是男性，只要有广泛的饮食失调症状，他们发生与酒精相关问题的风险就高于没有这些症状的人。有贪食症症状的男性风险特别高。这些发现强调了需要更好地预防和治疗年轻女性和男性的饮食失调、身体形象问题和酒精问题。
