OBJECTIVE: Despite known associations between eating disorders and obesity, little is known about the current prevalence of symptoms of eating disorders across the weight spectrum. This study therefore aimed to estimate the population prevalence of eating disorder symptoms in relation to weight status in adolescents. METHOD: The sample comprised 3,270 participants (14-15 years; 52% boys) drawn from Wave 6 of the Longitudinal Study of Australian Children. Symptoms of anorexia nervosa (AN) and bulimia nervosa (BN) were assessed using self-report on the Branched Eating Disorder Test. This measure identifies clinically significant symptoms in the past 3 months according to the Diagnostic and Statistical Manual of Mental Disorders, fifth edition. Using study-derived cross-sectional population weights, the prevalence of each symptom was estimated for the total population and by sex and weight status. RESULTS: The estimated population prevalence was high (14.3-25.7%) for body image symptoms such as fear of weight gain and overvaluation of body weight but lower (0.5-3.7%) for behavioral symptoms such as binge eating and compensatory behaviors. Symptoms were more prevalent among adolescents with overweight or obesity. Although most symptoms tended to have higher prevalence among girls than boys, boys with obesity had higher prevalence of binge eating and excessive exercise than girls with obesity. The overall estimated population prevalence for AN and BN was 0.20% and 0.10%, respectively. DISCUSSION: The study highlights a need for clinicians to be cognizant of disordered eating behaviors regardless of weight status and has implications for both eating disorder and obesity prevention and intervention.
We thank the participants and supporters of Growing Up in Australia: The Longitudinal Study of Australian Children (LSAC). LSAC is supported by the Australian Government Department of Social Services. MCRI is supported by the Victorian Government’s Operational Infrastructure Program. Dr. Hughes is supported by a grant from the Baker Foundation. Professor Patton is supported by a NHMRC Senior Principal Research Fellowship (#1019887). Professor Wake is supported by a NHMRC Principal Research Fellowship (#1160906). Dr. Azzopardi is supported by a NHMRC Early Career Fellowship (#1145228). This article uses unit record data from LSAC. LSAC is conducted in partnership between the Department of Social Services, the Australian Institute of Family Studies, and the Australian Bureau of Statistics.