Abigail Matthews1,2, Rachel A Kramer3,4, Laurie Mitan4,5. 1. Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, OH, USA. abigail.matthews@cchmc.org. 2. Division of Behavioral Medicine and Clinical Psychology, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA. abigail.matthews@cchmc.org. 3. Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, OH, USA. 4. Division of Behavioral Medicine and Clinical Psychology, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA. 5. Division of Adolescent and Transition Medicine, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA.
Abstract
PURPOSE: A significant proportion of adolescents with anorexia nervosa (AN) or atypical anorexia nervosa (AAN) experience premorbid overweight/obesity, yet distinct characteristics among this subset of patients remain unclear. This study examined eating disorder (ED) symptom severity, psychological morbidity, and weight stigma in patients with premorbid overweight/obesity as compared to patients with premorbid normal weights. METHODS: Participants included adolescents with AN or AAN (aged 12-18) who received multidisciplinary treatment at a pediatric medical center in the United States. ED symptoms, anxiety, and depression were compared among patients with premorbid overweight/obesity (n = 43) and premorbid normal weights (n = 63). Associations between weight stigma, ED severity, and psychological morbidity were also examined. RESULTS: Patients with premorbid overweight/obesity reported greater ED severity (p = 0.04), anxiety (p < 0.003), depression (p = 0.02), and a higher frequency of weight-based teasing by peers (p = 0.003) and parent weight talk about their own weights (p < 0.001). Weight-based teasing was positively associated with ED symptoms, anxiety, and depression for all patients, regardless of premorbid weight status. CONCLUSIONS: Adolescents with AN or AAN and a history of overweight/obesity may present with greater ED symptom severity and psychological morbidity than patients with normal weight histories. Distinct prevention and treatment interventions for adolescents with AN or AAN and premorbid overweight/obesity may be warranted. LEVEL OF EVIDENCE: Level III, case-control analytic study.
PURPOSE: A significant proportion of adolescents with anorexia nervosa (AN) or atypical anorexia nervosa (AAN) experience premorbid overweight/obesity, yet distinct characteristics among this subset of patients remain unclear. This study examined eating disorder (ED) symptom severity, psychological morbidity, and weight stigma in patients with premorbid overweight/obesity as compared to patients with premorbid normal weights. METHODS: Participants included adolescents with AN or AAN (aged 12-18) who received multidisciplinary treatment at a pediatric medical center in the United States. ED symptoms, anxiety, and depression were compared among patients with premorbid overweight/obesity (n = 43) and premorbid normal weights (n = 63). Associations between weight stigma, ED severity, and psychological morbidity were also examined. RESULTS: Patients with premorbid overweight/obesity reported greater ED severity (p = 0.04), anxiety (p < 0.003), depression (p = 0.02), and a higher frequency of weight-based teasing by peers (p = 0.003) and parent weight talk about their own weights (p < 0.001). Weight-based teasing was positively associated with ED symptoms, anxiety, and depression for all patients, regardless of premorbid weight status. CONCLUSIONS: Adolescents with AN or AAN and a history of overweight/obesity may present with greater ED symptom severity and psychological morbidity than patients with normal weight histories. Distinct prevention and treatment interventions for adolescents with AN or AAN and premorbid overweight/obesity may be warranted. LEVEL OF EVIDENCE: Level III, case-control analytic study.
Authors: Grace A Kennedy; Sara F Forman; Elizabeth R Woods; Albert C Hergenroeder; Kathleen A Mammel; Martin M Fisher; Rollyn M Ornstein; S Todd Callahan; Neville H Golden; Cynthia J Kapphahn; Andrea K Garber; Ellen S Rome; Tracy K Richmond Journal: J Adolesc Health Date: 2017-03-08 Impact factor: 5.012
Authors: Ashley A Witt; Staci A Berkowitz; Christopher Gillberg; Michael R Lowe; Maria Råstam; Elisabet Wentz Journal: J Consult Clin Psychol Date: 2014-07-21