BACKGROUND: Eating disorders, such as anorexia, bulimia, and binge-eating disorder, are defined by strong emotions and behaviors related to weight and food. There can be serious mental and physical health consequences as a result of eating disordered behavior. The Utah Department of Health used data from the Youth Risk Behavior Survey (YRBS) to gain an understanding of the magnitude and consequences of eating disordered behaviors among underweight adolescents in Utah.
METHODS: Body Mass Index (BMI) based on age and sex growth charts was used to identify adolescents with a BMI below the 15th percentile. Potential anorexia was defined as a BMI below the 15th percentile and one or more of the following self-reported behaviors: 1) trying to lose weight; 2) fasting for 24 hours or more to lose weight during the past 30 days; 3) taking diet pills to lose weight during the past 30 days; and 4) vomiting or using laxatives to lose weight during the past 30 days.
RESULTS: In 2011 and 2013, 4.0% of female students and 1.4% of male students in grades 9-12 in Utah public schools met a threshold for low weight combined with eating disordered behaviors. Adolescents with potential anorexia reported higher rates than adolescents without potential anorexia for the following measures: felt so sad or hopeless for two weeks that they stopped doing their usual activities (42.3% vs 25.9%); considered suicide during the past 12 months (32.5% vs 14.3%); made a suicide plan (29.8% vs 11.6%); attempted suicide (19.9% vs 6.4%); and were injured as a result of a suicide attempt (5.4% vs 2.1%). Experiences of bullying (33.2% vs 21.5%), electronic bullying (36.5% vs 16.3%) and feeling unsafe at school were significantly higher for those students with potential anorexia. The findings also showed a dramatically higher rate of physical and sexual violence by a dating partner (32.2% and 38.0% respectively) for students with potential anorexia compared to those with no eating disorder (5.6% physical violence and 9.5% sexual violence).
CONCLUSIONS: The association between eating disorders and adverse health experiences is of great concern, but provides valuable information that can applied to efforts for the prevention and intervention of these public health issues. Prevention and early intervention of these behaviors and experiences is critical to the long-term health and well-being of young people and may help mitigate co-morbidity of additional risk behaviors.