Predictors and long-term health outcomes of eating disorders

Katie M O'Brien, Denis R Whelan, Dale P Sandler, Janet E Hall, Clarice R Weinberg, Katie M O'Brien, Denis R Whelan, Dale P Sandler, Janet E Hall, Clarice R Weinberg

Abstract

Anorexia and bulimia nervosa may have long-term effects on overall and reproductive health. We studied predictors of self-reported eating disorders and associations with later health events. We estimated odds ratios (ORs) for these associations in 47,759 participants from the Sister Study. Two percent (n = 967) of participants reported a history of an eating disorder. Risk factors included being non-Hispanic white, having well-educated parents, recent birth cohort (OR = 2.16, 95% confidence interval [CI]: 2.01-2.32 per decade), and having a sister with an eating disorder (OR = 3.68, CI: 1.92-7.02). As adults, women who had experienced eating disorders were more likely to smoke, to be underweight, to have had depression, to have had a later first birth, to have experienced bleeding or nausea during pregnancy, or to have had a miscarriage or induced abortion. In this descriptive analysis, we identified predictors of and possible long-term health consequences of eating disorders. Eating disorders may have become more common over time. Interventions should focus on prevention and mitigation of long-term adverse health effects.

Conflict of interest statement

Competing Interests: The authors have declared that no competing interests exist.

References

    1. Hudson JI, Hiripi E, Pope HG Jr., Kessler RC. The prevalence and correlates of eating disorders in the National Comorbidity Survey Replication. Biol Psychiatry. 2007;61(3):348–58. doi: ; PubMed Central PMCID: PMCPMC1892232.
    1. Swanson SA, Crow SJ, Le Grange D, Swendsen J, Merikangas KR. Prevalence and correlates of eating disorders in adolescents. Results from the national comorbidity survey replication adolescent supplement. Arch Gen Psychiatry. 2011;68(7):714–23. doi: .
    1. Hjern A, Lindberg L, Lindblad F. Outcome and prognostic factors for adolescent female in-patients with anorexia nervosa: 9- to 14-year follow-up. Br J Psychiatry. 2006;189:428–32. doi: .
    1. Steinhausen HC, Jakobsen H, Helenius D, Munk-Jorgensen P, Strober M. A nation-wide study of the family aggregation and risk factors in anorexia nervosa over three generations. Int J Eat Disord. 2015;48(1):1–8. doi: .
    1. Misra M, Aggarwal A, Miller KK, Almazan C, Worley M, Soyka LA, et al. Effects of anorexia nervosa on clinical, hematologic, biochemical, and bone density parameters in community-dwelling adolescent girls. Pediatrics. 2004;114(6):1574–83. doi: .
    1. Poyastro Pinheiro A, Thornton LM, Plotonicov KH, Tozzi F, Klump KL, Berrettini WH, et al. Patterns of menstrual disturbance in eating disorders. Int J Eat Disord. 2007;40(5):424–34. doi: .
    1. Ruuska J, Kaltiala-Heino R, Koivisto A-M, Rantanen Pi. Puberty, sexual development and eating disorders in adolescent outpatients. European Child & Adolescent Psychiatry. 2003;12(5):214–20. doi:
    1. Micali N, dos-Santos-Silva I, De Stavola B, Steenweg-de Graaff J, Jaddoe V, Hofman A, et al. Fertility treatment, twin births, and unplanned pregnancies in women with eating disorders: findings from a population-based birth cohort. BJOG. 2014;121(4):408–16. doi: ; PubMed Central PMCID: PMCPMC4155863.
    1. Easter A, Treasure J, Micali N. Fertility and prenatal attitudes towards pregnancy in women with eating disorders: results from the Avon Longitudinal Study of Parents and Children. BJOG. 2011;118(12):1491–8. doi: .
    1. Bulik CM, Hoffman ER, Von Holle A, Torgersen L, Stoltenberg C, Reichborn-Kjennerud T. Unplanned pregnancy in women with anorexia nervosa. Obstetrics and Gynecology. 2010;116:1136–40. doi:
    1. Ekeus C, Lindberg L, Lindblad F, Hjern A. Birth outcomes and pregnancy complications in women with a history of anorexia nervosa. BJOG. 2006;113(8):925–9. doi: .
    1. Linna MS, Raevuori A, Haukka J, Suvisaari JM, Suokas JT, Gissler M. Pregnancy, obstetric, and perinatal health outcomes in eating disorders. Am J Obstet Gynecol. 2014;211(4):392 e1-8. doi: .
    1. Solmi F, Sallis H, Stahl D, Treasure J, Micali N. Low birth weight in the offspring of women with anorexia nervosa. Epidemiol Rev. 2014;36:49–56. doi: ; PubMed Central PMCID: PMCPMC3873840.
    1. Micali N, Stemann Larsen P, Strandberg-Larsen K, Nybo Andersen AM. Size at birth and preterm birth in women with lifetime eating disorders: a prospective population-based study. BJOG. 2016;123(8):1301–10. doi: .
    1. Micali N, Simonoff E, Treasure J. Risk of major adverse perinatal outcomes in women with eating disorders. Br J Psychiatry. 2007;190:255–9. doi: .
    1. Torgersen L, Von Holle A, Reichborn-Kjennerud T, Berg CK, Hamer R, Sullivan P, et al. Nausea and vomiting of pregnancy in women with bulimia nervosa and eating disorders not otherwise specified. Int J Eat Disord. 2008;41(8):722–7. doi: ; PubMed Central PMCID: PMCPMC3247760.
    1. O'Brien KM, Whelan DR, Sandler DP, Weinberg CR. Eating Disorders and Breast Cancer. Cancer Epidemiology Biomarkers & Prevention. 2016. doi:
    1. Kelsey JL, Gammon MD, John EM. Reproductive factors and breast cancer. Epidemiologic Reviews. 1993;15(1):36–47.
    1. Xue F, Michels KB. Intrauterine factors and risk of breast cancer: a systematic review and meta-analysis of current evidence. The Lancet Oncology. 2007;8(12):1088–100. doi:
    1. American Psychiatric Association. Diagnostic and statistical manual of mental disorders. 5 ed. Washington, DC2013.
    1. Harrell F. Regression Modeling Strategies: with applications to linear models, logistic regression, and survival analysis New York, NY: Springer-Verlag; 2001. June 5, 2001.
    1. Hoffman EB, Sen PK, Weinberg CR. Within-cluster resampling Biometrika. 2001;88(3):1121–34.
    1. Wei LJ, Lin DY, Weissfeld L. Regression analysis of multivariate incomplete failure time data by modeling marginal distributions. Journal of the American Statistical Association 1989;84(408):1065–73.
    1. Alegria M, Woo M, Cao Z, Torres M, Meng XL, Striegel-Moore R. Prevalence and correlates of eating disorders in Latinos in the United States. Int J Eat Disord. 2007;40 Suppl:S15–21. doi: ; PubMed Central PMCID: PMCPMC2680162.
    1. Franko DL. Race, ethnicity, and eating disorders: Considerations for DSM-V. Int J Eat Disord. 2007;40:S31–S4. doi:
    1. Smink FR, van Hoeken D, Hoek HW. Epidemiology of eating disorders: incidence, prevalence and mortality rates. Curr Psychiatry Rep. 2012;14(4):406–14. doi: ; PubMed Central PMCID: PMCPMC3409365.
    1. Lucas AR. The eating disorder "epidemic": More apparent than real? Pediatric Annals. 1992;21(11):746–50.
    1. Mitchison D, Hay PJ. The epidemiology of eating disorders: genetic, environmental, and societal factors. Clin Epidemiol. 2014;6:89–97. doi: ; PubMed Central PMCID: PMCPMC3933432.
    1. Mendelsohn FA, Warren MP. Anorexia, bulimia, and the female athlete triad: evaluation and management. Endocrinol Metab Clin North Am. 2010;39(1):155–67, x. doi: .
    1. Boraska V, Franklin CS, Floyd JA, Thornton LM, Huckins LM, Southam L, et al. A genome-wide association study of anorexia nervosa. Mol Psychiatry. 2014;19(10):1085–94. doi: ; PubMed Central PMCID: PMCPMC4325090.
    1. Wade TD, Gordon S, Medland S, Bulik CM, Heath AC, Montgomery GW, et al. Genetic variants associated with disordered eating. Int J Eat Disord. 2013;46(6):594–608. doi: ; PubMed Central PMCID: PMCPMC3775874.
    1. Wang K, Zhang H, Bloss CS, Duvvuri V, Kaye W, Schork NJ, et al. A genome-wide association study on common SNPs and rare CNVs in anorexia nervosa. Mol Psychiatry. 2011;16(9):949–59. doi: ; PubMed Central PMCID: PMCPMC3859494.
    1. Warren MPaS, A. L. Exercise and female adolescents: effects on the reproductive and skeletal systems. J Am Med Womens Assoc. 1999;54(3):115–1120.
    1. Gershon ES, Schreiber JL, Hamovit JR, Dibble ED, Kaye W, Nurnberger JI Jr., et al. Clinical findings in patients with anorexia nervosa and affective illness in their relatives. Am J Psychiatry. 1984;141(11):1419–22. doi:
    1. Hudson JI, Pope HG, Jonas JM, Yurgelun-Todd D. Family history study of anorexia nervosa and bulimia. The British Journal of Psychiatry. 1983;142(2):133–8. doi:
    1. Hudson JI, Pope HG, Jonas JM, Yurgelun-Todd D, Frankenburg FR. A controlled family history study of bulimia. Psychological Medicine. 1987;17:883–90.
    1. Strober M, Morrell W, Burroughs J, Salkin B, Jacobs C. A controlled family study of anorexia nervosa. J Psychiatry Research. 1985;19(2/3):239–46.
    1. Audrain-McGovern J, Benowitz NL. Cigarette smoking, nicotine, and body weight. Clin Pharmacol Ther. 2011;90(1):164–8. doi: ; PubMed Central PMCID: PMCPMC3195407.
    1. Fulkerson J, French S. Cigarette smoking for weight loss or control among adolescents: gender and racial/ethnic differences. Journal of Adolescent Health. 2003;32(4):306–13. doi:
    1. Stanford School of Medicine. Stanford Research into the Impact of Tobacco Advertising Stanford School of Medicine; [cited 2016 September 22]. Available from: .
    1. Haberland CA, Seddick D, Marcus R, Bachrach LK. A physician survey of therapy for exercise-associated amenorrhea: A brief report. Clinical Journal of Sports Medicine. 1995;5(4):246–50.
    1. Linna MS, Raevuori A, Haukka J, Suvisaari JM, Suokas JT, Gissler M. Reproductive health outcomes in eating disorders. Int J Eat Disord. 2013;46(8):826–33. doi: .
    1. Micali N, De Stavola B, dos-Santos-Silva I, Steenweg-de Graaff J, Jansen PW, Jaddoe VW, et al. Perinatal outcomes and gestational weight gain in women with eating disorders: a population-based cohort study. BJOG. 2012;119(12):1493–502. doi: .
    1. Micali N, Stemann Larsen P, Strandberg-Larsen K, Nybo Andersen AM. Size at birth and preterm birth in women with lifetime eating disorders: a prospective population-based study. BJOG: An International Journal of Obstetrics & Gynaecology. 2016;123(8):1301–10. doi:
    1. Torgersen L, Ystrom E, Haugen M, Meltzer HM, Von Holle A, Berg CK, et al. Breastfeeding practice in mothers with eating disorders. Matern Child Nutr. 2010;6(3):243–52. doi: .
    1. Micali N, Simonoff E, Treasure J. Infant feeding and weight in the first year of life in babies of women with eating disorders. J Pediatr. 2009;154(1):55–60 e1. doi: .
    1. Baker JL, Gamborg M, Heitmann BL, Lissner L, Sorensen TI, Rasmussen KM. Breastfeeding reduces postpartum weight retention. Am J Clin Nutr. 2008;88(6):1543–51. doi: .

Source: PubMed

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