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Jess Haines, PhD, MHSc, RD; Ken P. Kleinman, ScD; Sheryl L. Rifas-Shiman, MPH; Alison E. Field, ScD; S. Bryn Austin, ScD

Arch Pediatr Adolesc Med. 2010;164(4):336-343.

Objective  To identify shared risk and protective factors for purging, binge eating, and overweight.

Design  Prospective cohort study.

Setting  Population-based questionnaires of children and adolescents residing across the United States.

Participants  Girls (n = 6022) and boys (n = 4518), aged 11 to 17 years in 1998, in the ongoing Growing Up Today Study.

Main Exposures  Putative risk and protective factors within the psychological, behavioral, and socioenvironmental domains.

Main Outcome Measures  Overweight, use of laxatives or purging (vomiting), and binge eating. Because of the low prevalence of purging, we did not examine shared factors for this behavior among boys.

Results  In 1998, a total of 219 girls (3.7%) and 30 boys (0.7%) reported purging behaviors, 426 girls (7.1%) and 90 boys (2.0%) reported binge eating, and 1019 girls (17.4%) and 1040 boys (24.6%) were overweight. From 1999 through 2001, 331 girls (7.8%) initiated purging behaviors, 503 girls (11.8%) and 132 boys (4.5%) initiated binge eating behaviors, and 424 girls (10.0%) and 382 boys (13.6%) became overweight. Concern for weight was directly associated with all 3 weight-related problems among boys and girls. Among girls, dieting, parental weight-related teasing, and family meal frequency had a shared effect on the weight-related problems examined.

Conclusions  Factors within the psychological, behavioral, and socioenvironmental domains may have a shared effect on purging, binge eating, and overweight. Further research is needed to determine if an intervention designed to address these shared risk and protective factors is effective in simultaneously reducing these weight-related problems.

Author Affiliations: Obesity Prevention Program, Department of Population Medicine, Harvard Medical School/Harvard Pilgrim Health Care (Drs Haines and Kleinman and Ms Rifas-Shiman); Division of Adolescent/Young Adult Medicine, Department of Medicine, Children's Hospital Boston (Drs Field and Austin), and Channing Laboratory, Department of Medicine, Brigham and Women's Hospital, Harvard Medical School (Drs Field and Austin); and Departments of Epidemiology (Dr Field) and Society, Human Development, and Health (Dr Austin), Harvard School of Public Health, Boston, Massachusetts.

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