Disordered eating patterns in adolescents were a risk factor for future depression and bullying by peers, results from a prospective longitudinal study indicated.
Disordered eating was significantly associated with future depressive symptoms, with correlation coefficients ranging from 0.15 to 0.48 (P<0.01) at various points during 5 years of follow-up, reported Kirsty S. Lee, PhD, and Tracy Vaillancourt, PhD, of the University of Ottawa in Canada.
Similarly, disordered eating was significantly associated with bullying by peers, the researchers wrote in JAMA Psychiatry.
Although disordered eating habits, such as anorexia nervosa, bulimia nervosa, and binge-eating disorders, are more prevalent amongst adolescent girls, the long-term consequences for both sexes were found to be similar.
Data on 612 adolescent boys and girls ages 13-17 were gathered as part of the ongoing Canadian McMaster Teen Study, examining the associations between bullying, mental health and academic achievement. Mean age of participants was 13, 54% were girls and 71% were white.
Measures were reported by students using self-assessment questionnaires. Perceptions of bullying were assessed against a standard definition using a five point scale. The Short Screen for Eating Disorders assessed clinically significant eating behaviors such as, “how often do you eat in secret,” and “how often do you vomit on purpose after eating.” The Behavior Assessment System for Children was used to assess depressive symptoms.
Cascade modelling provided a means of examining the relationships between the various factors over time, and the age-range chosen was that at which eating disorders and depressive symptoms in adolescents typically present.
Whereas previous studies have focused on disordered eating and depressive thinking as a consequence of bullying, this analysis looked into depressive thoughts and disordered eating as antecedents, with the results affirming the idea of a “symptoms-driven pathway, whereby preexisting psychopathologic symptoms exacerbate the risk of being bullied.”
“Previous studies have found depressive symptoms to be a risk factor for bullying by peers but this is the first study to our knowledge to find disordered eating to be a risk factor for being bullied in a non-clinical sample of adolescents” the authors wrote.
Interrelated environmental and biological factors may predispose adolescents to depression and disordered eating. Both conditions “have been associated with low production of serotonin, which modulates satiety and mood.”
Psychologically, societal demands for “perfectionism” and a failure to meet such expectations has been shown to stimulate depressive thinking and thus acts as a bridge between the two conditions, Lee and Vaillancourt wrote. Furthermore, they indicated disordered eating is linked to broader behavioral and emotional problems that can make teens targets for bullying.
Study limitations included the inability to examine specific types of eating disorders, that results were self-reported, allowing for the possibility of negative affectivity, and that the age range studied barred researchers from delving deeper into the development of antecedent depressive or disordered eating habits that may lead up to adolescence.
Interventions to build positive eating habits and positive attitudes toward food and nutrition could interrupt the potential for depression, disordered eating, and the likelihood of being bullied by peers. These interventions are important given that that worldwide prevalence rates of bullying at some point during adolescence stand at around 30%.
“Currently, interventions to treat disordered eating behavior could prove beneficial for reductions in depressive symptoms and problematic peer relations. Interventions for disordered eating behavior should ideally target negative attitudes, promote healthy weight control behavior, and contain an element of self-compassion, which can reduce symptoms of disordered eating and other psycho-pathologic symptoms,” wrote Lee and Vaillancourt.