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Original Research
Dieting and Disordered Eating Behaviors from Adolescence to Young Adulthood: Findings from a 10-Year Longitudinal Study

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Abstract

Background

Disordered eating behaviors are prevalent in adolescence and can have harmful consequences. An important question is whether use of these behaviors in adolescence sets the pattern for continued use into young adulthood.

Objective

To examine the prevalence and tracking of dieting, unhealthy and extreme weight control behaviors, and binge eating from adolescence to young adulthood.

Design

Population-based, 10-year longitudinal study (Project EAT-III: Eating Among Teens and Young Adults, 1999-2010).

Participants/setting

The study population included 2,287 young adults (55% girls, 52% nonwhite). The sample included a younger group (mean age 12.8±0.7 years at baseline and 23.2±1.0 years at follow-up) and an older group (mean age 15.9±0.8 at baseline and 26.2±0.9 years at follow-up).

Statistical analyses performed

Longitudinal trends in prevalence of behaviors were tested using generalized estimating equations. Tracking of behaviors were estimated using the relative risk of behaviors at follow-up given presence at baseline.

Results

In general, the prevalence of dieting and disordered eating was high and remained constant, or increased, from adolescence to young adulthood. Furthermore, behaviors tended to track within individuals and, in general, participants who engaged in dieting and disordered eating behaviors during adolescence were at increased risk for these behaviors 10 years later. Tracking was particularly consistent for the older girls and boys transitioning from middle adolescence to middle young adulthood.

Conclusions

Study findings indicate that disordered eating behaviors are not just an adolescent problem, but continue to be prevalent among young adults. The tracking of dieting and disordered eating within individuals suggests that early use is likely to set the stage for ongoing use. Findings suggest a need for both early prevention efforts before the onset of harmful behavioral patterns as well as ongoing prevention and treatment interventions to address the high prevalence of disordered eating throughout adolescence and young adulthood.

Section snippets

Study Design and Population

Project EAT-III (Eating and Activity in Teens and Young Adults) is a 10-year longitudinal study aimed at examining eating, activity, and weight-related variables among young people. The sample for our study included 1,030 young men and 1,257 young women. One third of participants (29.9%) were in the younger cohort; at baseline they were in early adolescence (mean age 12.8±0.7 years), and at 10-year follow-up they were in early young adulthood (mean age 23.2±1.0 years). Two thirds of

Prevalence of Dieting and Disordered Eating: Adolescence to Young Adulthood

About half of girls reported dieting in the past year as compared to about a fourth of the boys. Among both age cohorts of girls, the prevalence of dieting remained fairly constant from adolescence through young adulthood (Figure 1). Among boys, the prevalence of dieting stayed constant over time in the younger age cohort, but significantly increased in the older cohort as participants progressed from middle adolescence to middle young adulthood (21.9% to 27.9%, P<0.001).

In younger girls, the

Discussion

This study found that, in general, the prevalence of dieting and disordered eating behaviors was high and either remained constant or increased from adolescence to young adulthood. Of particular concern was the large increase in extreme weight control behaviors among youth transitioning from adolescence to young adulthood. Diet pill use more than tripled in most of the age and sex groups during the 10-year study period. Of concern, one fifth of female young adults reported the use of extreme

Conclusions

The ineffectiveness of dieting for weight gain prevention during adolescence (4, 5, 6, 7, 8), the harmful consequences associated with disordered eating behaviors (19, 34, 35, 36, 37), and the high prevalence of these behaviors during adolescence (21, 38, 39, 40) have been shown in previous studies. This study adds to this concerning body of literature by demonstrating that the high prevalence of these behaviors continues from adolescence through young adulthood. Furthermore, individuals who

D. Neumark-Sztainer, is a professor, Division of Epidemiology and Community Health, School of Public Health, University of Minnesota, Minneapolis

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    D. Neumark-Sztainer, is a professor, Division of Epidemiology and Community Health, School of Public Health, University of Minnesota, Minneapolis

    N. I. Larson is a research associate, Division of Epidemiology and Community Health, School of Public Health, University of Minnesota, Minneapolis

    K. Loth is a research assistant, Division of Epidemiology and Community Health, School of Public Health, University of Minnesota, Minneapolis

    M. E. Eisenberg is an assistant professor of pediatrics and adolescent health, Department of Pediatrics, University of Minnesota, Minneapolis

    M. Wall is a professor of biostatistics in psychiatry, Departments of Biostatistics and Psychiatry, Columbia University, New York, NY; at the time of the study, she was a professor, Division of Biostatistics, School of Public Health, University of Minnesota, Minneapolis

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