Do changes during puberty affect disordered eating?
Reprinted from Eating Disorders Review
November/December Volume 25, Number 6
Loss of control (LOC) eating among children and teens generally predicts binge eating and other disordered eating, weight gain, and metabolic dysfunction later in life. LOC usually starts in middle childhood to early adolescence, and persists in about half of those affected.
A paper by Anna Vannucci and colleagues at the National Institute of Child Health and Human Development recently evaluated LOC eating at different stages of puberty among 468 girls and boys from 8 to 17 years of age (Int J Eat Disord 2014; 47:738). The researchers wanted to know how the physical and chemical changes during puberty might affect LOC eating.
Participants were recruited throughout the greater Washington, DC, area, using flyers posted on public bulletin boards at the NIH, in libraries, supermarkets, and in school parent email listservs. The 468 participants and a parent or guardian were interviewed, and after interviews, filling out questionnaires and undergoing physical examinations, a final group of 244 young participants completed laboratory test meals. The median age was 14.8 years, and the group was 53.4% female.
Two test meals
After an overnight fast, in random order the youths had either a “normal meal,” at which they were instructed to “Eat as much as you would at a normal meal,” or an “LOC meal,” at which they were instructed to “Let yourself go and at as much as you want.” Aside from the instructions, the test meal conditions were identical. On the day of each test meal, the participants had a 288-kcal breakfast, composed of 7% protein, 19% fat, and 74% carbohydrate. No food was allowed then until the test meal—and then the participants were presented with a multiple-item, 9,835-kcal food array varied in macronutrient composition, including a wide assortment of foods.
The effects of puberty on uncontrolled eating
The study findings suggest that puberty may be a critical risk period that can be associated with body image
disturbances and obesity- promoting behaviors in boys and girls with LOC eating. The study showed that the overall frequency of LOC eating did not differ by stage of puberty. LOC eating during the past month was reported by 26% of the youths, who recounted having a median number of two LOC episodes in the past month. But, among participants who did have LOC eating, those in early-to-mid-puberty described more disordered eating attitudes than did youths in pre-puberty. Those in late puberty with LOC eating consumed more carbohydrates and snack foods.
No single stage of puberty seems to promote LOC eating, and because of this the authors suggest that interventions for LOC eating before the onset of puberty be carefully evaluated before they are initiated.