title: Adolescent Eating Disorders Predict Psychiatric, High-Risk Behaviors and Weight Outcomes in Young Adulthood.
abstract: OBJECTIVE
  To investigate whether anorexia nervosa (AN), bulimia nervosa (BN), binge eating disorder (BED), and other specified feeding and eating disorders (OSFED), including purging disorder (PD), subthreshold BN, and BED at ages 14 and 16 years, are prospectively associated with later depression, anxiety disorders, alcohol and substance use, and self-harm.
  
  
  METHODS
  Eating disorders were ascertained at ages 14 and 16 years in 6,140 youth at age 14 (58% of those eligible) and 5,069 at age 16 (52% of those eligible) as part of the prospective Avon Longitudinal Study of Parents and Children (ALSPAC). Outcomes (depression, anxiety disorders, binge drinking, drug use, deliberate self-harm, weight status) were measured using interviews and questionnaires about 2 years after predictors. Generalized estimating equation models adjusting for gender, socio-demographic variables, and prior outcome were used to examine prospective associations between eating disorders and each outcome.
  
  
  RESULTS
  All eating disorders were predictive of later anxiety disorders. AN, BN, BED, PD, and OSFED were prospectively associated with depression (respectively AN: odds ratio [OR] = 1.39, 95% CI = 1.00-1.94; BN: OR = 3.39, 95% CI = 1.25-9.20; BED: OR = 2.00, 95% CI = 1.06-3.75; and PD: OR = 2.56, 95% CI = 1.38-4.74). All eating disorders but AN predicted drug use and deliberate self-harm (BN: OR = 5.72, 95% CI = 2.22-14.72; PD: OR = 4.88, 95% CI = 2.78-8.57; subthreshold BN: OR = 3.97, 95% CI = 1.44-10.98; and subthreshold BED: OR = 2.32, 95% CI = 1.43-3.75). Although BED and BN predicted obesity (respectively OR = 3.58, 95% CI = 1.06-12.14 and OR = 6.42, 95% CI = 1.69-24.30), AN was prospectively associated with underweight.
  
  
  CONCLUSIONS
  Adolescent eating disorders, including subthreshold presentations, predict negative outcomes, including mental health disorders, substance use, deliberate self-harm, and weight outcomes. This study highlights the high public health and clinical burden of eating disorders among adolescents.
authors.affiliation: Institute of Child Health, Child and Adolescent Mental Health Palliative Care and Pediatrics Section, University College London, and Icahn School of Medicine at Mount Sinai, New York. Electronic address: n.micali@ucl.ac.uk.
authors.forename: Nadia
authors.initials: N
authors.lastname: Micali
authors.affiliation: University College London.
authors.forename: Francesca
authors.initials: F
authors.lastname: Solmi
authors.affiliation: Amherst College, Amherst, MA.
authors.forename: Nicholas J
authors.initials: NJ
authors.lastname: Horton
authors.affiliation: Neuropsychiatric Research Institute, Fargo, ND, and University of North Dakota School of Medicine and Health Sciences, Fargo.
authors.forename: Ross D
authors.initials: RD
authors.lastname: Crosby
authors.affiliation: Eating Disorders Clinical and Research Program, Massachusetts General Hospital, Boston, and Harvard Medical School, Boston.
authors.forename: Kamryn T
authors.initials: KT
authors.lastname: Eddy
authors.affiliation: Division of Adolescent Medicine, Boston Children's Hospital and Harvard Medical School.
authors.forename: Jerel P
authors.initials: JP
authors.lastname: Calzo
authors.affiliation: Human Nutrition Program, University of Michigan School of Public Health, Ann Arbor.
authors.forename: Kendrin R
authors.initials: KR
authors.lastname: Sonneville
authors.affiliation: Harvard School of Public Health, Boston.
authors.forename: Sonja A
authors.initials: SA
authors.lastname: Swanson
authors.affiliation: Division of Adolescent Medicine, Boston Children's Hospital, and Harvard Medical School, Harvard School of Public Health, and Channing Division of Network Medicine, Brigham and Women's Hospital, Boston.
authors.forename: Alison E
authors.initials: AE
authors.lastname: Field
mesh_terms: D000293:Adolescent; D000856:Anorexia Nervosa / Q000150:complications / Q000523:psychology; D001008:Anxiety Disorders / Q000209:etiology; D063425:Binge Drinking / Q000209:etiology; D001835:Body Weight; D002032:Bulimia / Q000150:complications / Q000523:psychology; D052018:Bulimia Nervosa / Q000150:complications / Q000523:psychology; D003863:Depression / Q000209:etiology; D001068:Feeding and Eating Disorders / Q000150:complications* / Q000523:psychology; D005260:Female; D006801:Humans; D007406:Interview, Psychological; D008137:Longitudinal Studies; D008297:Male; D001523:Mental Disorders / Q000209:etiology*; D011446:Prospective Studies; D016728:Self-Injurious Behavior / Q000209:etiology; D019966:Substance-Related Disorders / Q000209:etiology; D011795:Surveys and Questionnaires; D055815:Young Adult
keywords: ALSPAC; eating disorders; outcomes; psychiatric; weight