Obesity and eating disturbances are common in 15-year-old adolescents. A two-step interview study

Abstract

A two-step interview study of eating disorders (EDs) and sub-clinical EDs in 15-year-old adolescents was carried out in western Finland. The sample consisted of all ninth graders in a well-defined catchment area (n=606, 98.2% of eligible students). In the first step, a self-report questionnaire was administered at schools regarding mental health problems and life circumstances. The questions concerning anorectic and bulimic eating pathology were formulated according to the DSM-IV diagnostic criteria of EDs. The second step consisted of a semi-structured interview Rating of Anorexia and Bulimia-Teenager version (RAB-T) to which 128 subjects were invited, on the basis of their answers to questions about eating pathology in the questionnaire. The participation rate in the interview was 88.3%. The lifetime prevalence rate for anorexia nervosa (AN) in 15-year-old girls was 1.8% and the point prevalence rate 0.7%. No cases of AN were found among the boys. All criteria fulfilling cases of bulimia nervosa (BN) were not found in our sample. High rates of AN not otherwise specified (AN-NOS; 4.9%) and sub-clinical EDs (4.9%) were found among the girls; 6.7% of girls and 0.6% of boys were regarded as being “at risk” of developing EDs. Data on height and weight are based on current measurements taken at school healthcare; 22% of boys were overweight or obese compared with 16% of girls.

• Adolescence
• Eating disorder
• Obesity
• Prevalence

Acknowledgements

No competing interests.

Appendix 1: Questions concerning eating pathology formulated according to the DSM-IV diagnostic criteria of ED

Screening for AN on dieting:

1) Did you ever on purpose reduce your weight many pounds or deliberately keep your weight low? (No, Yes)In addition 1–4 of the following questions:

2) Did you then fear gaining weight or becoming fat? (No, Yes, I don't know)

3) Did you feel fat even though family and friends were of the quite opposite opinion? (No, Yes, I don't know)

4) Your lowest weight when dieting? (__ __kg)

5) Did you then stop menstruating? (No, Yes, Haven't menstruated yet)

Screening for BN on bingeing:

1) Did you repeatedly binge a lot of food in a short time (for example, two hours)? (No, Yes)In addition 1–4 of the following questions:

2) Were you afraid of losing control of eating while bingeing? (No, Yes)

3) Did you binge at least twice a week for at least 3 months? (No, Yes)

4) Did you try to avoid weight gain by strict dieting or fasting, heavy exercise, vomiting or using laxatives/diuretics? (No, Yes for each alternative)

5) Did you feel good about nothing or feel like a failure if not slim with an ideal figure? (No, Yes)

Screening for previous eating disorders

1) Have you had, or been suspected of having, an eating disorder? (No, Yes anorexia, Yes bulimia, Yes both anorexia and bulimia)

2) Have you been treated for an eating disorder? (No, Yes)

3) Have you suffered from an eating disorder without seeking help? (No, Yes anorexia, Yes bulimia, Don't know)