Disordered-Eating Attitudes in Relation to Bone Mineral Density and Markers of Bone Turnover in Overweight Adolescents

Abstract

Purpose To examine the relationships between cognitive eating restraint and both bone mineral density (BMD) and markers of bone turnover in overweight adolescents. Methods One hundred thirty-seven overweight (BMI 39.1 ± 6.8 kg/m 2) African American and Caucasian adolescent (age = 14.4 ± 1.4 years) girls (66.4%) and boys were administered the Eating Disorder Examination (EDE) interview and Eating Inventory (EI) questionnaire and underwent dual energy X-ray absorptiometry (DXA) to measure total lumbar spine BMD. Markers of bone formation (serum bone specific alkaline phosphatase and osteocalcin), bone resorption (24-hour urine N-telopeptides), and stress (urine free cortisol) were measured. Results After accounting for the contribution of demographics, height, weight, serum 25-hydroxyvitamin D, and depressive symptoms, adolescents' weight concern, as assessed by interview, was a significant contributor to the model of urine free cortisol (β = .30, p < .05). Shape concern, as also assessed by interview, was significantly associated with lumbar spine bone mineral density (β = −.15, p < .05). Dietary restraint was not a significant predictor in any of these models. Conclusions These findings suggest that among severely overweight adolescents, dissatisfaction with shape and weight may be salient stressors. Future research is required to illuminate the relationship between bone health and disordered-eating attitudes in overweight adolescents.