Summary: A new study reports overweight and obese young adults are almost twice as likely than their peers of lower weight to binge, purge and embark on other behaviors associated with eating disorders. Researchers found Asian/Pacific islanders and sexual minorities were also at higher risk of developing eating disorders.
Young adults who are overweight or obese are twice as likely as their leaner peers to binge and purge, use laxatives or diuretics, or force themselves to vomit as a means of controlling their weight, according to a new study led by UCSF Benioff Children’s Hospitals.
These “disordered eating behaviors” put young people at risk for depression, alcohol and tobacco use, poor nutritional intake and significant weight gain over time, the researchers reported in their study, appearing in the Journal of General Internal Medicine on June 12, 2018.
The researchers used data from the National Longitudinal Study of Adolescent to Adult Health that tracked 14,322 nationally representative 18- to 24-year-olds.
They found that among females in the obese and overweight category, 29.3 percent reported that they used unhealthy weight-control techniques, versus 15.8 percent of females who were underweight or normal weight. Among males, the prevalence was 15.4 percent and 7.5 percent, respectively.
Heavier Young Adults May Evade Eating Disorder Diagnosis
Although diagnoses for eating disorders such as anorexia and bulimia were twice as likely to occur in the 18- to 24-year-olds who were of normal weight or underweight, this may reflect under-recognition that these conditions exist in heavier young adults, said first author Jason Nagata, MD, a fellow in the Division of Adolescent and Young Adult Medicine and the Eating Disorders Program at UCSF Benioff Children’s Hospitals.
“Clinicians and parents should be aware that eating disorders occur in people who are overweight and obese. They should ask if and how young people are trying to lose weight and discourage unsafe practices, which can lead to severe illness and hospitalization.”
Ironically, unhealthy weight-control methods may lead to weight gain. A study on identical twin pairs sharing the same body mass index in which one twin used unhealthy ways to lose weight led to them weighing more than their non-dieting sibling, Nagata noted.
“Unhealthy weight control behaviors may predispose to eating disorders, disinhibition and compensatory eating, particularly of calorically dense foods, which can facilitate greater consumption of these foods,” he said.
As expected, disordered eating was found to occur more than twice as frequently in females than in males, but more surprising was its association with race and sexual orientation. The young adults who reported their race as Asian/Pacific Islander had 1.66 times the odds of disordered eating, compared with those who said they were white. Young adults who identified as homosexual, lesbian or bisexual had 1.62 times the odds of disordered eating, compared with those who identified as heterosexual.
“Young adulthood is a critical developmental period that is distinct from adolescence and older adulthood, but unfortunately this period has not received sufficient attention within clinical or research circles,” said senior author and general internist Kirsten Bibbins-Domingo, MD, PhD, MAS.
“Although they are usually assumed to be healthy, young adults often have poor patterns of health behaviors and are less likely to be engaged in medical care,” added Bibbins-Domingo, who is professor of medicine, holds the Lee Goldman, MD, Endowed Chair in Medicine, and is professor and chair of the Department of Epidemiology and Biostatistics at UCSF.
Funding: The research was supported by funding from the American Academy of Pediatrics, the American Pediatric Society and the Norman Schlossberger Research Fund from UCSF.
Co-authors were Andrea Garber, PhD, of the UCSF Division of Adolescent and Young Adult Medicine, Stuart Murray, PhD, of the UCSF Department of Psychiatry and UCSF Weill Institute for Neurosciences, and Jennifer Tabler, PhD, of the University of Texas Rio Grande Valley.
Source: Suzanne Leigh – UCSF
Publisher: Organized by NeuroscienceNews.com.
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Original Research: Abstract for “Prevalence and Correlates of Disordered Eating Behaviors Among Young Adults with Overweight or Obesity” by Jason M. Nagata, Andrea K. Garber, Jennifer L. Tabler, Stuart B. Murray, and Kirsten Bibbins-Domingo in Journal of General Internal Medicine. Published June 11 2018
Prevalence and Correlates of Disordered Eating Behaviors Among Young Adults with Overweight or Obesity
Clinical and community samples indicate that eating disorders (EDs) and disordered eating behaviors (DEBs) may co-occur among adolescents and young adults at a weight status classified as overweight or obese.
To determine the prevalence of EDs and DEBs among young adults at a weight status classified as overweight or obese using a nationally representative sample and to characterize differences in prevalence by sex, race/ethnicity, sexual orientation, and socioeconomic status.
Cross-sectional nationally representative data collected from Wave III of the National Longitudinal Study of Adolescent to Adult Health (Add Health).
Young adults ages 18–24 years old.
ED diagnosis and DEBs (self-reported binge eating or unhealthy weight control behaviors including vomiting, fasting/skipping meals, or laxative/diuretic use to lose weight). Covariates: age, sex, race/ethnicity, sexual orientation, weight status, and education.
Of the 14,322 young adults in the sample, 48.6% were at a weight status classified as overweight or obese. Compared to young adults at a weight status classified as underweight or normal weight, those at a weight status classified as overweight or obese reported a higher rate of DEBs (29.3 vs 15.8% in females, 15.4 vs 7.5% in males). Logistic regression analyses demonstrated that odds of engaging in DEBs were 2.32 (95% confidence interval 2.05–2.61) times higher for females compared to males; 1.66 (1.23–2.24) times higher for Asian/Pacific Islander compared to White; 1.62 (1.16–2.26) times higher for homosexual or bisexual compared to heterosexual; 1.26 (1.09–1.44) times higher for high school or less versus more than high school education; and 2.45 (2.16–2.79) times higher for obesity compared to normal weight, adjusting for all covariates.
The high prevalence of DEBs particularly in young adults at a weight status classified as overweight or obese underscores the need for screening, referrals, and tailored interventions for DEBs in this population.