Association of body mass index with progression from binge-eating behavior into binge-eating disorder among adolescents in the United States: a prospective analysis of pooled data

Abstract

The association between body mass index (BMI) and binge-eating disorder (BED) is well-established. However, data on the extent to which BMI is associated with progression from binge-eating behavior into BED among adolescents are limited, which was the aim of this investigation. Participants were 9,964 U.S. adolescents from the Adolescent Brain Cognitive Development (ABCD) Study, aged 9-13 at the time of study enrollment. A computerized parent-reported assessment was used to establish adolescents’ binge-eating behaviors and BED. Cox proportional hazards models adjusting for sociodemographic covariates were used to examine prospective associations between BMI and likelihood of BED onset among a) adolescents with binge-eating behavior, and b) adolescents with no binge-eating behavior. Of 975 adolescents who met study criteria for binge-eating behavior, 89 (9.1%) subsequently met study criteria for BED. Of 8,989 adolescents with no binge-eating behavior, 82 (0.9%) subsequently met study criteria for BED. BMI percentile was significantly associated with the likelihood of BED onset in participants with [ adjusted HR =1.03 (1.00, 1.06)] and participants without [adjusted HR =1.05 (1.03, 1.07)] binge-eating behavior. Results were also significant when examining BMI as a dichotomous predictor (above and below 85th percentile) among those with [adjusted HR =2.60 (1.00, 6.68) and those without [adjusted HR =6.01 (3.90, 11.10)] binge-eating behavior. Overall, results indicate that elevated BMI is prospectively associated with a greater risk for BED onset among U.S. adolescents with or without binge-eating behavior. Adolescents with a higher BMI may benefit from screening for binge eating, and prevention/early intervention strategies to mitigate the risk for developing BED.