Onset of adolescent eating disorders

BMJ 1999;318:1761 ( 26 June )

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Onset of adolescent eating disorders

Dieting may be an early sign, rather than a cause, of eating disorder

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Dieting may be an early sign, rather than a cause, of eating disorder

The first 150 words of the full text of this article appear below.

EDITOR $---$ Patton et al reported a positive association between dieting and the development of eating disorders in adolescents.¹A causal effect of dieting on the development of these seriouspsychiatric conditions was implied in the conclusion. We believe,however, that the data presented did not support the suggestedcausal effect.²

Unlike in a randomised clinical trial, in a cohort study the participants select themselves; in this case the exposure ofinterest was dieting. Participants at risk of developing eatingdisorders may have been more likely to expose themselves to dieting.To avoid bias the exposed and unexposed participants in a cohortstudy should be similar for other important determinants of outcome.³There is no evidence that this was true in this study. In fact,after adjustment for psychiatric disorders at baseline the hazardratio of severe dieting decreased threefold, which suggests thatthe exposed and unexposed groups differed for . . . [Full text of this article]

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Onset of adolescent eating disorders: population based cohort study over 3 years: G C Patton, R Selzer, C Coffey, J B Carlin, and R Wolfe
BMJ 1999 318: 765-768. [Abstract] [Full Text] [PDF]

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