Is puberty a risk factor for eating disorders?
J. D. Killen, C. Hayward, I. Litt, L. D. Hammer, D. M. Wilson, B. Miner, C. B. Taylor, A. Varady and C. Shisslak
Stanford (Calif) University School of Medicine.
OBJECTIVE--To examine the association between stage of sexual maturation
and eating disorder symptoms in a community-based sample of adolescent
girls. PARTICIPANTS--All sixth- and seventh-grade girls (N = 971) enrolled
in four northern California middle schools. MAIN VARIABLES
EXAMINED--Pubertal development measured using self-reported Tanner stage
and body mass index (kg/m2). The section of the Structured Clinical
Interview for DSM-III-R Disorders (SCID) discussing bulimia nervosa was
used to evaluate symptoms of bulimia nervosa. RESULTS--Girls manifesting
eating disorder symptoms, while not significantly older than their peers
without such symptoms, were more developmentally advanced as determined
with Tanner self-staging. The odds ratio for the association between sexual
maturity and symptoms was 1.8 (95% confidence interval, 1.2 to 2.8); ie, at
each age, an increase in sexual maturity of a single point was associated
with a 1.8-fold increase in the odds of presenting symptoms. The odds ratio
for the association between body mass index (adjusted for sexual maturity)
and symptoms was 1.02 (95% confidence interval, 1.0 to 1.05). There was no
independent effect of age or of the interaction between age and the sexual
maturity index. CONCLUSIONS--These results suggest that (1) puberty may be
a risk factor for the development of eating disorders, and (2) prevention
efforts might best be directed at prepubertal and peripubertal adolescents.
