Abstract
PurposeAdolescence represents a critical period for the onset of eating disorders (EDs). The present study aimed to provide the prevalence of individuals at risk for EDs psychopathology in a representative population of adolescents aged 14–19 and to characterize this population regarding interpersonal and psychological factors.MethodsThe percentage of participants at risk for EDs in a representative high school population was assessed through the SCOFF screening questionnaire (cut-off score: 3) in the total sample (N: 6551) and in gender-based subgroups for different body mass index (BMI) categories. Odds ratios for being at risk of ED (SCOFF ≥ 3) were esteemed in a multivariable analysis including self-reported parental education, quality of family and peer relationships, bullying victimization, age at first sexual intercourse, and psychological distress.ResultsA SCOFF score ≥ 3 was found in 31.0% of participants (boys: 19.4%; girls: 44.6%), with a greater prevalence among higher BMI categories. Bad family relationships, being bullied, having the first sexual intercourse before the age of 14, and experiencing high distress were associated with this risk condition. Among girls, bad peer relationships were associated with a low-risk SCOFF score.ConclusionA remarkable percentage of adolescents reported significant body image or eating concerns. Screening programs are deeply needed, and particular attention should be devoted to interpersonal factors, such as the quality of family relationships and interactions with peers, which represent potential indicators of this vulnerability.Level of evidenceLevel V – Cross-sectional study.
Highlights
Recent studies seem to demonstrate an increased incidence of cases of eating disorders (EDs) among adolescents in the last decades [1]
The quality of early sexual experiences has already been reported to be interconnected with EDs psychopathology [23, 24], early sexual activity being associated with bulimic-type pathology in middle adolescence [25]
It is possible to hypothesize that this alarming prevalence may be due to an improved awareness in the general population and to a reduced stigma in reporting ED symptoms, but it may express a real increase in the occurrence of clinical and subthreshold ED symptoms [1, 8]
Summary
Recent studies seem to demonstrate an increased incidence of cases of eating disorders (EDs) among adolescents in the last decades [1]. The presence of shared risk factors between disordered eating and a condition of overweight among adolescents has been clearly outlined [9], and a history of overweight or obesity is potentially associated with the development of EDs [10], including dietary restraint and subsequent weight loss [11] When exploring this framework, perceived social norms and family environment have shown to influence both eating. Eating and Weight Disorders - Studies on Anorexia, Bulimia and Obesity behavior and body image concerns [12], and—since a cultural influence in EDs is clearly established [13]—socioeconomic determinants are probably involved in a complex and multifaceted manner. Considering that ED patients are known to show abnormal emotional reactivity associated with body dissatisfaction in presence of social stressors [26], an early assessment of the abovementioned relational factors may enrich the epidemiological data available, coherently with the interpersonal model of EDs
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