Pre-teen body dissatisfaction predicts adolescent eating disorder behaviours

Children as young as eight have body dissatisfaction that can trigger eating disorder behaviours in adolescence finds a study led by the UCL Institute of Child Health, the research partner of Great Ormond Street Hospital.

The study, published in the British Journal of Psychiatry, reveals a contrasting picture across the genders, with teenage boys only developing body dissatisfaction and becoming worried about their weight and shape if they are overweight and have body dissatisfaction in childhood, while teenage girls develop body dissatisfaction regardless of their own childhood weight.

The researchers, led by Dr Nadia Micali, looked at whether body image and weight in childhood could predict the onset of behaviours and thoughts consistent with eating disorders in adolescence. The team used data from over 6,000 participants from the Children of the 90s study (ALSPAC) when they were aged 14. The study is based at the University of Bristol. Using a scale to assess self-esteem, they found higher scores at 8.5 years had a protective effect against developing body dissatisfaction and eating disorder behaviours as a teenager.

In particular, a one point increase in the self-esteem scale at age 8.5 years decreased the odds of boys later engaging in self-induced vomiting or laxative use for weight loss at age 14 by 19 per cent.

Higher body dissatisfaction at 8.5 years also made boys and girls more likely to say that they felt pressure from the media, their family or peers to lose weight. This suggests that vulnerability to social pressures might be rooted in earlier risk factors.

Researchers are recommending that public health initiatives on body image might need to target younger children to prevent them from developing disordered eating behaviours in their teen years. The study also highlights the need to have campaigns targeted by gender, due to the different risk factors for girls and boys.

Lead author Dr Nadia Micali, Senior Lecturer and Honorary Consultant Psychiatrist at the UCL Institute of Child Health and Associate Professor of Psychiatry at the Icahn Medical School at Mount Sinai, said:

“The findings illustrate that we cannot wait around until young people reach adolescence to promote a healthy body image. Body dissatisfaction and weight problems are important risk factors that are present in childhood and might transition into dangerous disordered eating behaviours in adolescence, so interventions need to target younger children.

“We also need to consider targeted prevention strategies based on the gender-specific risks rather than take a blanket approach. While it would be reasonable to target all girls who have high body dissatisfaction in late childhood, for boys it might make more sense to focus more on those who are actually overweight and have high levels of body dissatisfaction.

“The evidence base for the efficacy of current eating disorder public health interventions is growing, but careful evaluation is required to ensure that the right risk factors are targeted at the right time.”