title: Psychosocial and physical impairment in overweight adolescents at high risk for eating disorders.
abstract: OBJECTIVE
  Many overweight adolescents display elevated risk for the development of eating disorders, as seen in higher rates of weight/shape concerns and disordered eating behaviors, but the extent of impairment in this subset of high-risk adolescents has not been explored.
  
  
  METHODS
  Eighty-one overweight adolescents (63% girls) presenting for an Internet-based weight loss program were assessed at baseline using the Eating Disorder Examination Questionnaire, the Depression, Anxiety, and Stress Scale, and the Pediatric Quality of Life questionnaire. Adolescents who earned elevated scores on both the Weight Concern and Shape Concern subscales of the Eating Disorder Examination Questionnaire were considered at high risk for the development of eating disorders (56.8%).
  
  
  RESULTS
  Comparisons of high- and normal-risk groups revealed that high-risk adolescents reported higher levels of depression [F(3,76) = 5.75, p = 0.019], anxiety [F(3,76) = 5.67, p = 0.020], and stress [F(3,75) = 8.50, p = 0.005], and greater impairments in physical health [F(3,77) = 10.7, p = 0.002], emotional functioning [F(3,77) = 5.3, p = 0.024], and social functioning [F(3,77) = 10.0, p = 0.002]. There were no differences in school functioning [F(3,77) = 1.5, p = 0.219]. Among the high-risk adolescents, over half (52.2%) reported binge eating at least once in the past month.
  
  
  CONCLUSIONS
  Results suggest that overweight adolescents at high risk for the development of eating disorders also experience elevated levels of negative affect, impairment in health-related quality of life, and eating disturbances, although prospective data are needed to determine the directionality between eating disorder pathology and general psychopathology. Further research is warranted to evaluate whether behavioral weight loss interventions should be enhanced for this high-risk subset.
authors.affiliation: Department of Psychiatry, The University of Chicago, 5841 South Maryland Avenue, MC 3077, Chicago, IL 60637, USA. acdoyle@uchicago.edu
authors.forename: Angela Celio
authors.initials: AC
authors.lastname: Doyle
authors.forename: Daniel
authors.initials: D
authors.lastname: le Grange
authors.forename: Andrea
authors.initials: A
authors.lastname: Goldschmidt
authors.forename: Denise E
authors.initials: DE
authors.lastname: Wilfley
mesh_terms: D000293:Adolescent; D001007:Anxiety / Q000453:epidemiology; D015992:Body Mass Index; D002648:Child; D003430:Cross-Sectional Studies; D003863:Depression / Q000453:epidemiology; D001068:Feeding and Eating Disorders / Q000453:epidemiology* / Q000209:etiology / Q000523:psychology; D005260:Female; D006801:Humans; D008297:Male; D009765:Obesity / Q000150:complications* / Q000523:psychology; D050177:Overweight; D010809:Physical Fitness / Q000502:physiology* / Q000523:psychology; D000297:Psychology, Adolescent; D011788:Quality of Life; D012307:Risk Factors; D013315:Stress, Psychological