The association between obesity and the risk for development of eating disorders - A large-scale epidemiological study.

Abstract

Eating disorders and obesity are serious, multifactorial diseases with increasing prevalence worldwide, often manifesting during childhood and adolescence. The aim of this study was to investigate the risk for developing eating disorders in children and adolescents of Primary and Secondary Education, with normal or excessive body weight. A representative sample (N=3504) of students from schools of Western Greece, 50.2% boys, aged 10-16 years old, participated in the present cross-sectional epidemiological study. The students' dietary habits were assessed through multiple-choice questions and the risk for the development of eating disorders was evaluated using the Eating Attitudes Scale (EAT-13) validated questionnaire. Anthropometric measurements were obtained and the BMI, BMI% and BMI z-score were calculated. Nearly 20% of the participants, particularly those with overweight or obesity, were at increased risk for developing eating disorders (25% of normal weight-, 28.2% of overweight- and 33% of participants with obesity). Boys were more likely to develop eating disorders than girls, but not statistically significantly. A positive correlation of: (1) the overall EAT-13 score, (2) food pre-occupation score and (3) dieting score, with BMI z-score and obesity was found, as opposed to a negative correlation of Important Others score with BMI z-score and obesity. Increased awareness regarding the risk for developing eating disorders or disordered eating in children and adolescents with overweight and obesity is recommended to avoid underdiagnosis of this condition. Prompt identification of children at risk contributes to the implementation of targeted and effective prevention and treatment interventions.