Changes in body weight and body mass index (BMI) in teenage girls prior to the onset and diagnosis of an eating disorder.
Growth charts from the school health services were used to study weight changes prior to the onset and diagnosis of eating disorders (ED) with weight loss in 122 teenage girls. In these girls menarche started at 12.6 +/- 1.0 y (mean +/- SD), which is the same for the general population. At their maximal premorbid weight, the girls were 14.6 +/- 1.2 y of age and had a higher weight and body mass index (BMI) than the general population, as evidenced by standard deviation scores (SDS) above zero for weight (0.65 +/- 0.95, p < 0.001) and BMI (0.61 +/- 0.94, p < 0.001). Weight gain prior to the onset of weight loss followed two different patterns. Eighty-three (68%) girls tracked upwards through the weight curves to reach their maximal weight, thus putting on weight at a higher rate than expected. Thirty-nine (32%) girls tracked downwards through the weight curves to reach their maximal weight, but did so starting from a weight and BMI at well above average.


CONCLUSIONS
Weight gain in teenage girls prior to the onset of an ED deviates from that of the general population. Being or becoming heavier and less lean than their peers could influence body image and decisions on dieting, which, in turn, may be the start of the development of an ED in the otherwise predisposed. The deviation from normal tracking patterns prior to the onset of disease also causes problems in diagnostic procedures and in setting treatment targets for weight gain, since "normal" or expected weight becomes more difficult to establish.
Swenne
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Department of Women's and Children's Health, Uppsala University, Sweden. Ingemar.swenne@ped.uas.lul.se
D000293:Adolescent; D015992:Body Mass Index; D001835:Body Weight; D002648:Child; D001068:Feeding and Eating Disorders / Q000503:physiopathology*; D005260:Female; D006801:Humans; D008572:Menarche; D012189:Retrospective Studies; D015430:Weight Gain