HONOLULU — Four factors can help distinguish a girl who has an eating disorder from one who simply diets, Catherine M. Shisslak, Ph.D., said at the annual meeting of the American Psychological Association.
More than 50% of adolescent girls report dieting chronically, intermittently, or occasionally, according to the results of a longitudinal study of 1,170 girls for 4 years through high school.
Any girl who reports dieting in the past year and has these four risk factors—high body mass index, onset of menstruation by sixth grade, overly concerned with weight or shape, and teasing by peers—should be screened, Dr. Shisslak said in a poster presentation.
Those factors correctly identified 88% who reported they were chronic dieters. Eighty percent were chronic dieters who had an eating disorder at the start of the study or developed one in high school.
The unexpected finding was that peer teasing played such a prominent role in the disorders, Dr. Shisslak said. Other studies have noted how parents' comments about weight can be implicated, but this study suggests comments from peers can be even more devastating.
The results also suggest girls who do not report regular dieting but suddenly start a diet may be more likely to develop a disorder than those who occasionally but regularly diet. Eight percent of intermittent dieters had a disorder, compared with 2% who occasionally dieted.
Intermittent dieters were defined as those who reported dieting only 1 or 2 years during the 4 years of the study.
The investigators followed the girls using a 103-question survey, which they completed each year. They also measured height and weight annually to determine body mass index, and they conducted a semistructured interview designed to identify eating disorders.