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Steegers et al. using data from the Generation R cohort study examined whether set-shifting difficulties at age 4 predict body dissatisfaction, weight status, and restrictive eating at age 9 as a way to examine whether cognitive rigidity was a risk factor for an eating disorder. The authors concluded that set-shifting difficulties problems were predictive of features of anorexia nervosa. An alternative interpretation is that set shifting is predictive of large weight changes and eating behaviors more generally. It is not clear that set-shifting predicts becoming underweight. Set shifting appears protective against larger weight gains. It is possible that set shifting is related to degree to which the children resist the myriad of cues to eat for reasons other than hunger. Whether this is due to a higher degree of awareness, genetics, or other reasons should be investigated. The results demonstrate that the cognitive process that relate to restrictive behaviors are complex. To better understand those relationships, it will be essential for the field to adopt a conceptualization of eating disorders that includes the earliest stages (disordered eating) of the full range of eating disorders., (© 2022 Wiley Periodicals LLC.)

Objectives: The current standards for classifying eating disorders were primarily informed by adult, clinical study populations, while it is unknown whether an empirically based classification system can be supported across preadolescence through young adulthood. Using latent class analyses, we sought to empirically classify disordered eating in females from preadolescence to young adulthood, and assess the association between classes and adverse outcomes., Method: Latent class models were fit using observations from the 9,039 girls participating in the growing up today study, an on-going cohort following participants annually or biennially since 1996 when they were ages 9-14 years. Associations between classes and drug use, binge drinking, and depressive symptoms were assessed using generalized estimating equations., Results: Across age groups, there was evidence of six classes: a large asymptomatic class, a class characterized by shape/weight concerns, a class characterized by overeating without loss of control, and three resembling full and subthreshold binge eating disorder, purging disorder, and bulimia nervosa. Relative prevalences of classes varied across developmental stages, with symptomatic classes increasing in prevalence with increasing age. Symptomatic classes were associated with concurrent and incident drug use, binge drinking, and high depressive symptoms., Discussion: A classification system resembling broader definitions of DSM-5 diagnoses along with two further subclinical symptomatic classes may be a useful framework for studying disordered eating among adolescent and young adult females., (© 2014 Wiley Periodicals, Inc.)

Objectives: Studies of adolescent psychiatric disorders often collect information from adolescents and parents, yet most eating disorder epidemiologic studies only rely on adolescent report., Method: We studied the eating disorder symptom reports, from questionnaires sent at participants' ages 14 and 16 years, provided by 7,968 adolescents from the Avon Longitudinal Study of Parents and Children (ALSPAC), and their parents. Adolescents and parents were asked questions about the adolescent's eating disorder symptoms (binge eating, vomiting, laxative use, fasting, and thinness). We assessed cross-sectional concordance and prevalence using kappa coefficients and generalized estimating equations. Generalized estimating equations were used to assess prospective associations between symptom reports and adolescent weight outcomes measured at a face-to-face assessment at 17.5 years., Results: Parents and adolescents were largely discordant on symptom reports cross-sectionally (kappas < 0.3), with the parent generally less likely to report bulimic symptoms than the adolescent but more likely to report thinness. Female adolescents were more likely to report bulimic symptoms than males (e.g., two to four times more likely to report binge eating), while prevalence estimates according to parent reports of female vs. male adolescents were similar. Both informants' symptom reports were predictive of body mass and composition measures at 17.5 years; compared to adolescent report, parentally reported binge eating was more strongly predictive of body mass index., Discussion: Parent report of eating disorder symptoms seemed to measure different, but potentially important, aspects of these symptoms during adolescence. Epidemiologic eating disorder studies should consider the potential value added from incorporating parental reports, particularly in studies of males., (© 2014 Wiley Periodicals, Inc.)

Purpose: To use the lifecourse framework to examine the association between duration of breastfeeding and risk of developing bulimic behaviors or a diagnosed eating disorder., Method: Questionnaires were sent every 12-24 months between 1996 and 2005 to 6,436 females and 5,756 males in the Growing Up Today Study, who were 9-14 years at baseline. Duration of breastfeeding was reported by the participants' mothers in 1997. We used generalized estimating equations to estimate the association of breastfeeding with purging, binge eating, engaging in bulimic behaviors, and having a diagnosed eating disorder., Results: Compared to girls who were breastfed for more than 9 months, those who were breastfed for less than 4 months did not have a significantly different prevalence of purging, binge eating, bulimic behaviors, and self-reported history of diagnosed eating disorders. Adjusting for gestational age/birthweight, age, age at menarche, maternal history of an eating disorder, and maternal body mass index, short duration of breastfeeding was not associated with any outcome among the girls [adjusted odds ratios (AOR) ranged from 0.8 to 1.1]. Among the boys, the results showed no significant associations between duration of breastfeeding and purging, binge eating, and self-reported history of diagnosed eating disorder. However, there was a suggestion that boys who had been breastfed for less than 4 months were at a higher risk of engaging in bulimic behaviors [AOR: 1.5, 95% confidence interval (CI), 1.0-2.3]., Discussion: No association was found between duration of breastfeeding and risk of developing bulimic behaviors or a diagnosed eating disorder among girls or boys with the one exception of longer duration of breastfeeding associated with fewer bulimic behaviors in boys. Although there are many benefits to breastfeeding, our data suggest that breastfeeding does not offer any protection against binge eating or purging, nor does it present harmful effects., (Copyright © 2013 Wiley Periodicals, Inc.)

Objective: We used data from a population-based study of 9,039 adolescent and young adult females, followed prospectively since 1996 as part of the Growing Up Today Study (GUTS), to examine the relationship between season of birth and disordered eating in the U.S., Method: We tested whether the distribution of birth season and month differed for participants who had ever reported both underweight and dieting/weight concern symptoms (n = 134) or both frequent bingeing and purging symptoms (n = 77) compared with other GUTS participants., Results: The two disordered-eating groups had relative birth peaks in the fall and relative birth troughs in the summer compared with other GUTS participants, but only the fall peak was consistently statistically significant., Discussion: It appears that U.S. females born in the fall are more likely to develop disordered eating and that age relative to the rest of their school-year cohort may account for some of this phenomenon., (Copyright © 2010 Wiley Periodicals, Inc.)

Objective: To examine sex- and race/ethnicity-specific relationships between adolescents' self-esteem and weight perception., Method: Descriptive analysis and logistic regression of Wave II of the National Longitudinal Study of Adolescent Health (N = 6,427 males, 6,574 females; ages 11-21) examined associations between low self-esteem and perceived overweight within body mass index (BMI) percentile categories, controlling for sociodemographics and stratified by sex and race/ethnicity., Results: 25.1% and 8% of normal weight females and males, respectively, perceived themselves as overweight, with variation by race/ethnicity. Low self-esteem was most strongly associated with misperceived overweight in moderate BMI percentile categories (males: OR = 2.34; 95% CI: 1.60-3.41; females: OR = 2.39; 95% CI: 1.82, 3.16). Odds of correctly perceived overweight were higher for low (versus high) self-esteem in white and black females but not males of any race/ethnicity., Discussion: Understanding subgroup differences by race/ethnicity in perceived overweight-self-esteem relationships may inform eating disorders' prevention strategies., (2009 by Wiley Periodicals, Inc.)

Objective: To compare self-report to interview assessment of bulimic behaviors among adolescents., Method: A sample of children in an ongoing study were recruited to complete in-depth telephone interviews in 1998 on bulimic behaviors (i.e., binge eating and purging). The sample comprised 449 girls and 50 boys., Results: There was some over-reporting of bulimic behaviors on the 1998 questionnaire (asking about 1997-1998) compared with the interview that may have been due to the shorter and nonoverlapping time frame in the interview compared with the questionnaire. Despite the overestimation, the questionnaire did an excellent job at classifying girls who did not purge (negative predictive values [NPV]: 0.99) or binge eat (NPV = 0.98). When purging on the interview was compared with purging on either the 1998 or 1999 questionnaires, the sensitivity increased substantially from 0.73 to 0.93., Discussion: These findings suggest that a short self-report assessment can be used to screen children engaging in, or at risk of beginning to engage in, binge eating and purging., (Copyright 2003 by Wiley Periodicals, Inc. Int J Eat Disord 35: 86-92, 2004.)