Investigators abstracted data from the Avon Longitudinal Study of Parents and Children, a population-based longitudinal cohort of mothers and their children born in southwest England (n=4760). Parent-reported trajectories of overeating, undereating, and fussy eating were obtained at 8 times between the ages of 1.3 and 9.6 years. Binge eating, purging, fasting, and excessive exercise were assessed by self-report when participants were 16 years of age.
Multivariable regression models were used to estimate the association between eating behavior trajectories and eating disorder outcomes in adolescence. Analyses were adjusted for maternal education status, family socioeconomic status, maternal age at birth, birth weight, and assigned sex at birth.
Overeating in childhood was associated with increased risk for binge eating (risk difference, 7%; 95% CI, 2%-11%) and binge eating disorder (risk difference, 1%; 95% CI, 0%-3%) in adolescence. The risk difference was most pronounced among children with an “early increasing overeating” trajectory, or children with an early onset of overeating that increased over time. Among adolescent girls only, persistent undereating in childhood was associated with increased risk for anorexia nervosa (risk difference, 6%; 95% CI, 0%-12%). In the total cohort, persistent fussy eating was also associated with greater anorexia nervosa risk in adolescence (risk difference, 2%; 95% CI, 0%-0.4%).
These data suggest continuity from childhood eating behaviors to eating disorder symptoms later in life. Notably, eating disorders were less frequently reported by boys in the cohort, resulting in low statistical power. Future studies with separate assessments for boys are necessary to assess their particular risk profiles. In addition, further research is necessary to identify appropriate childhood interventions for potentially high-risk eating behaviors.
Disclosure: One study author declared affiliations with the pharmaceutical industry. Please see the original reference for a full list of authors’ disclosures.
Herle M, Stavola B, Hübel C, et al. A longitudinal study of eating behaviours in childhood and later eating disorder behaviours and diagnoses [published online August 5, 2019]. Br J Psychiatry. doi:10.1192/bjp.2019.174