Screening for Weight and Eating Concerns Among Teens

Primary care physicians may be one key to early detection of disordered eating.

Excessive concerns about weight and eating are common among teens: an estimated 40% report body dissatisfaction and up to 77% report dieting at some time. Controlling weight may mean moderately excessive dieting or clinical eating disorders.

Catherine Chamay Weber, MD and her colleagues at Geneva University Hospitals and the University of Geneva, Switzerland, studied a representative sample of 7,548 students 16 to 20 years of age who completed a self-administered questionnaire on health-related topics (the 2002 Swiss Multicenter Adolescent Health Survey) (J Pediatr 2010;157:32). Teens who indicated excessive concerns about weight and eating were compared with control subjects for frequency of somatic complaints and primary care visits in the past year.

In this study, the teens answered four questions from the Weight and Eating Concern Inventory, a scale designed to assess attitudes toward weight and eating among children and adolescents. The possible responses are fixed, ranging from 1 (never) to 4 (every day). A typical question was, “I feel unattractive when I have eaten too much.” Subjects with a mean score of 3 or higher were categorized as having excessive concerns.

Worries about excessive weight and eating were common in teens, especially among the girls in the study (girls, 13.9%; boys, 1.6%).Teens with such concerns also had more frequent somatic complaints compared with their peers. Nearly 80% of students were in contact with a primary care physician at least once a year, and those with excessive concerns visited primary care physicians more often than did their peers. Twelve percent of the girls were overweight (body mass index of more than 25 kg/m2, and 7.8% of boys were overweight.

The authors feel that primary care physicians can be a good source of screening for teens with concerns about weight and who may be at risk of body dissatisfaction and excessive dieting.