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Teen Eating Disorders, Psychological Problems Often Hand-in-Hand
Dec. 4, 2000 -- The overall incidence of eatingdisorders among teenage girls is low, but those who develop them are athigh risk for other emotional problems that linger into earlyadulthood.
That is the conclusion of a new study by the OregonResearch Institute in Eugene and published in the Journal of theAmerican Academy of Adolescent Psychiatry. It finds a much higherpercentage of those with bulimia, anorexia, and partial versions ofthose diseases also suffer with more depression, anxiety disorders, andsubstance abuse problems than the general teen population.
"The whole study is based on a large cohort ofhigh school students we recruited in the 1980s, and we've beenfollowing them ever since," says study author Peter M. Lewinsohn,PhD, senior research scientist and professor emeritus in psychology atthe University of Oregon in Eugene.
For this study, the students were examined twice duringadolescence and once in their 24th year. Lewinsohn says that the numberof males with eating disorders in this study was so small that theresearchers only looked at the problem in girls.
The study found that kids with eating disorders weretwice as likely to have a psychological problem as a group of"no-eating-disorder" kids -- and that rate was approaching90%. And among the kids with eating disorders, more than 70% of themcontinued to have psychological problems at age 24.
"I think an eating disorder needs to be understoodin the context of a lot of other problems," Lewinsohn says."It doesn't seem it occurs by itself. We would like to havelooked at "pure" eating disorder people, but thereweren't enough of them."
Lewinsohn suggests adolescent girls be routinelyscreened for eating disorders during physical examination -- especiallyif they are known to have a psychological disorder. Conversely, thosekids with known eating disorders ought to be cross-checked forpsychological problems, he says. "I think the pediatricians arethe gatekeepers here, because they see everybody. They are in a veryimportant position to identify these problems."
One eating disorders expert says it's hard to saywhether all eating disorder patients have mental problems, as well."I know with bulimia, many of the girls, if they develop it later,they view it as 'trying it' because their friends are doing it-- and are less likely to be psychologically impaired," saysElizabeth Carll, PhD, who has a private practice in Long Island, N.Y."The earlier ones have a poorer prognosis."
As for screening teenage girls for eating disorders:"I think it's great," Carll says. "But most girlswill not admit it. With anorexia, it's pretty obvious. But withbulimia, many of the girls are quite secretive. They may admit to beingconcerned with dieting -- which might be a risk factor if they'reat a normal weight."
But "might" is the operative word there.Carll points out that about 75% of American women, if asked at anygiven time, would say they are on a diet -- when only about a thirdreally need to be. "It's a condition both cultural andsociological," she says. "It's an obsession withthinness, and in our culture, an obsession with health andnutrition."
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