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Int J Eat Disord. 2019 Aug;52(8):885-894. doi: 10.1002/eat.23118. Epub 2019 Jun 19.

Eating disorder symptoms across the weight spectrum in Australian adolescents.

Hughes EK1,2,3, Kerr JA1,2, Patton GC1,2,3, Sawyer SM1,2,3, Wake M1,2,4, Le Grange D5,6, Azzopardi P1,2,3,7,8.

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Department of Paediatrics, The University of Melbourne, Melbourne, Victoria, Australia.
Murdoch Children's Research Institute, Melbourne, Victoria, Australia.
Centre for Adolescent Health & Department of Adolescent Medicine, Royal Children's Hospital, Melbourne, Victoria, Australia.
Department of Paediatrics & The Liggins Institute, University of Auckland, Auckland, New Zealand.
Department of Psychiatryand UCSF Weill Institute for Neurosciences, University of California San Francisco, San Francisco, California.
Department of Psychiatry and Behavioral Neuroscience, The University of Chicago, Chicago, Illinois (Emeritus).
Maternal and Child Health Program, Burnet Institute, Melbourne, Victoria, Australia.
Wardliparingga Aboriginal Research Unit, South Australian Health and Medical Research Institute and School of Medicine, University of Adelaide, Adelaide.



Despite known associations between eating disorders and obesity, little is known about the current prevalence of symptoms of eating disorders across the weight spectrum. This study therefore aimed to estimate the population prevalence of eating disorder symptoms in relation to weight status in adolescents.


The sample comprised 3,270 participants (14-15 years; 52% boys) drawn from Wave 6 of the Longitudinal Study of Australian Children. Symptoms of anorexia nervosa (AN) and bulimia nervosa (BN) were assessed using self-report on the Branched Eating Disorder Test. This measure identifies clinically significant symptoms in the past 3 months according to the Diagnostic and Statistical Manual of Mental Disorders, fifth edition. Using study-derived cross-sectional population weights, the prevalence of each symptom was estimated for the total population and by sex and weight status.


The estimated population prevalence was high (14.3-25.7%) for body image symptoms such as fear of weight gain and overvaluation of body weight but lower (0.5-3.7%) for behavioral symptoms such as binge eating and compensatory behaviors. Symptoms were more prevalent among adolescents with overweight or obesity. Although most symptoms tended to have higher prevalence among girls than boys, boys with obesity had higher prevalence of binge eating and excessive exercise than girls with obesity. The overall estimated population prevalence for AN and BN was 0.20% and 0.10%, respectively.


The study highlights a need for clinicians to be cognizant of disordered eating behaviors regardless of weight status and has implications for both eating disorder and obesity prevention and intervention.


adolescents; anorexia nervosa; bulimia nervosa; eating disorders; obesity; overweight; prevalence

[Indexed for MEDLINE]

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