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Family, Peer, and Media Predictors of Becoming Eating Disordered
Alison E. Field, ScD;
Kristin M. Javaras, PhD;
Parul Aneja, ScM;
Nicole Kitos, MA;
Carlos A. Camargo Jr, MD, DrPH;
C. Barr Taylor, MD;
Nan M. Laird, PhD
Arch Pediatr Adolesc Med. 2008;162(6):574-579.
Objective To identify predictors of becoming eating disordered among adolescents.
Design Prospective cohort study.
Setting Self-report questionnaires.
Subjects Girls (n = 6916) and boys (n = 5618), aged 9 to 15 years at baseline, in the ongoing Growing Up Today Study (GUTS).
Main Exposures Parent, peer, and media influences.
Main Outcome Measures Onset of starting to binge eat or purge (ie, vomiting or using laxatives) at least weekly.
Results During 7 years of follow-up, 4.3% of female subjects and 2.3% of male subjects (hereafter referred to as "females" and "males") started to binge eat and 5.3% of females and 0.8% of males started to purge to control their weight. Few participants started to both binge eat and purge. Rates and risk factors varied by sex and age group (<14 vs  14 years). Females younger than 14 years whose mothers had a history of an eating disorder were nearly 3 times more likely than their peers to start purging at least weekly (odds ratio, 2.8; 95% confidence interval, 1.3-5.9); however, maternal history of an eating disorder was unrelated to risk of starting to binge eat or purge in older adolescent females. Frequent dieting and trying to look like persons in the media were independent predictors of binge eating in females of all ages. In males, negative comments about weight by fathers was predictive of starting to binge at least weekly.
Conclusions Risk factors for the development of binge eating and purging differ by sex and by age group in females. Maternal history of an eating disorder is a risk factor only in younger adolescent females.
Author Affiliations: Division of Adolescent Medicine, Department of Medicine (Dr Field and Ms Kitos), and Clinical Research Program (Ms Aneja), Children's Hospital Boston; Biological Psychiatry Laboratory, McLean Hospital (Dr Javaras), and Channing Laboratory, Department of Medicine, Brigham and Women's Hospital (Drs Field and Camargo), Harvard Medical School; Departments of Biostatistics (Drs Javaras and Laird) and Epidemiology (Dr Camargo), Harvard School of Public Health, Boston, Massachusetts; and Department of Psychiatry and Behavioral Medicine, Stanford Medical School, Stanford, California (Dr Taylor).
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