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J Adolesc Health. 2016 Oct;59(4):391-6. doi: 10.1016/j.jadohealth.2016.03.011. Epub 2016 May 7.

Factors Predicting an Escalation of Restrictive Eating During Adolescence.

Author information

1
Department of Psychiatry, University of Minnesota Medical Center, Minneapolis, Minnesota. Electronic address: afhaynos@umn.edu.
2
Department of Epidemiology and Community Health, School of Public Health, University of Minnesota, Minneapolis, Minnesota.
3
Department of Family Medicine and Community Health, University of Minnesota, Minneapolis, Minnesota.
4
Department of Psychiatry, University of Minnesota Medical Center, Minneapolis, Minnesota.

Abstract

PURPOSE:

To examine longitudinal risk factors and short-term risk correlates for the development of extreme forms of restrictive eating among adolescent dieters.

METHODS:

Data from Project Eating and Activity in Teens and Young Adults, a population-based study of 2,516 students aged 12-18 years, were collected in 1998-1999 (Time 1) and 5 years later (Time 2). Within this sample, 243 adolescents who reported dieting but not engaging in disordered forms of restrictive eating (e.g., fasting, skipping meals) at Time 1 were followed to determine the self-reported psychological, familial, and social variables predicting initiation of disordered restrictive eating at Time 2. To investigate short-term risk correlates of initiating disordered restrictive eating, the same risk factors were also compared cross-sectionally at Time 2 between the dieters who had and had not initiated disordered restrictive eating. Poisson regression models with robust standard errors were fit for each predictor adjusted for covariates.

RESULTS:

Depressive symptoms and low self-esteem were significantly associated with the initiation of disordered restrictive eating in both longitudinal and cross-sectional analyses. Poor family communication/caring and maternal dieting significantly predicted long-term risk for escalating restrictive eating severity; whereas, individual body image issues (i.e., weight concerns, body dissatisfaction) and social concerns (i.e., weight-related teasing, peer dieting) were significant short-term correlates of initiating disordered restrictive eating.

CONCLUSIONS:

Depressive symptoms and low self-esteem may be especially important targets for risk identification and prevention for disordered restrictive eating. Intervening on family influences may decrease long-term risk, whereas intervening on body image and responses to social influences may decrease short-term risk for disordered restrictive eating.

KEYWORDS:

Anorexia nervosa; Dieting; Eating disorder; Restrictive eating

Comment in

PMID:
27161416
PMCID:
PMC5035549
DOI:
10.1016/j.jadohealth.2016.03.011
[Indexed for MEDLINE]
Free PMC Article

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