title: Is puberty a risk factor for eating disorders?
abstract: OBJECTIVE
  To examine the association between stage of sexual maturation and eating disorder symptoms in a community-based sample of adolescent girls.
  
  
  METHODS
  All sixth- and seventh-grade girls (N = 971) enrolled in four northern California middle schools.
  
  
  METHODS
  Pubertal development measured using self-reported Tanner stage and body mass index (kg/m2). The section of the Structured Clinical Interview for DSM-III-R Disorders (SCID) discussing bulimia nervosa was used to evaluate symptoms of bulimia nervosa.
  
  
  RESULTS
  Girls manifesting eating disorder symptoms, while not significantly older than their peers without such symptoms, were more developmentally advanced as determined with Tanner self-staging. The odds ratio for the association between sexual maturity and symptoms was 1.8 (95% confidence interval, 1.2 to 2.8); ie, at each age, an increase in sexual maturity of a single point was associated with a 1.8-fold increase in the odds of presenting symptoms. The odds ratio for the association between body mass index (adjusted for sexual maturity) and symptoms was 1.02 (95% confidence interval, 1.0 to 1.05). There was no independent effect of age or of the interaction between age and the sexual maturity index.
  
  
  CONCLUSIONS
  These results suggest that (1) puberty may be a risk factor for the development of eating disorders, and (2) prevention efforts might best be directed at prepubertal and peripubertal adolescents.
authors.affiliation: Stanford (Calif) University School of Medicine.
authors.forename: J D
authors.initials: JD
authors.lastname: Killen
authors.forename: C
authors.initials: C
authors.lastname: Hayward
authors.forename: I
authors.initials: I
authors.lastname: Litt
authors.forename: L D
authors.initials: LD
authors.lastname: Hammer
authors.forename: D M
authors.initials: DM
authors.lastname: Wilson
authors.forename: B
authors.initials: B
authors.lastname: Miner
authors.forename: C B
authors.initials: CB
authors.lastname: Taylor
authors.forename: A
authors.initials: A
authors.lastname: Varady
authors.forename: C
authors.initials: C
authors.lastname: Shisslak
mesh_terms: D000293:Adolescent; D015992:Body Mass Index; D002648:Child; D001068:Feeding and Eating Disorders / Q000453:epidemiology*; D005260:Female; D006801:Humans; D016015:Logistic Models; D000297:Psychology, Adolescent; D002666:Psychology, Child; D011627:Puberty / Q000523:psychology*; D012307:Risk Factors