Prospective association of common eating disorders and adverse outcomes.
OBJECTIVE
Anorexia nervosa and bulimia nervosa (BN) are rare, but eating disorders not otherwise specified (EDNOS) are relatively common among female participants. Our objective was to evaluate whether BN and subtypes of EDNOS are predictive of developing adverse outcomes.


METHODS
This study comprised a prospective analysis of 8594 female participants from the ongoing Growing Up Today Study. Questionnaires were sent annually from 1996 through 2001, then biennially through 2007 and 2008. Participants who were 9 to 15 years of age in 1996 and completed at least 2 consecutive questionnaires between 1996 and 2008 were included in the analyses. Participants were classified as having BN (≥ weekly binge eating and purging), binge eating disorder (BED; ≥ weekly binge eating, infrequent purging), purging disorder (PD; ≥ weekly purging, infrequent binge eating), other EDNOS (binge eating and/or purging monthly), or nondisordered.


RESULTS
BN affected ∼1% of adolescent girls; 2% to 3% had PD and another 2% to 3% had BED. Girls with BED were almost twice as likely as their nondisordered peers to become overweight or obese (odds ratio [OR]: 1.9 [95% confidence interval: 1.0-3.5]) or develop high depressive symptoms (OR: 2.3 [95% confidence interval: 1.0-5.0]). Female participants with PD had a significantly increased risk of starting to use drugs (OR: 1.7) and starting to binge drink frequently (OR: 1.8).


CONCLUSIONS
PD and BED are common and predict a range of adverse outcomes. Primary care clinicians should be made aware of these disorders, which may be underrepresented in eating disorder clinic samples. Efforts to prevent eating disorders should focus on cases of subthreshold severity.
Division of Adolescent Medicine, Department of Medicine, Children’s Hospital Boston and Harvard Medical School, Boston, MA 02115, USA. alison.field@childrens.harvard.edu
Alison E
AE
Field
Kendrin R
KR
Sonneville
Nadia
N
Micali
Ross D
RD
Crosby
Sonja A
SA
Swanson
Nan M
NM
Laird
Janet
J
Treasure
Francesca
F
Solmi
Nicholas J
NJ
Horton
D000293:Adolescent; D019973:Alcohol-Related Disorders / Q000453:epidemiology / Q000523:psychology; D000856:Anorexia Nervosa / Q000453:epidemiology / Q000628:therapy; D056912:Binge-Eating Disorder / Q000453:epidemiology / Q000628:therapy; D001835:Body Weight; D052018:Bulimia Nervosa / Q000453:epidemiology / Q000628:therapy; D002648:Child; D003430:Cross-Sectional Studies; D003866:Depressive Disorder / Q000453:epidemiology / Q000523:psychology; D001068:Feeding and Eating Disorders / Q000453:epidemiology* / Q000628:therapy; D005260:Female; D006801:Humans; D009765:Obesity / Q000453:epidemiology / Q000523:psychology; D050177:Overweight / Q000453:epidemiology / Q000523:psychology; D011446:Prospective Studies; D012306:Risk; D019966:Substance-Related Disorders / Q000453:epidemiology / Q000523:psychology; D016896:Treatment Outcome; D014481:United States