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For Teen Girls, It's More Purge than Binge

We hear the term "binge and purge" used to describe bulimia nervosa so commonly that, to my mind, anyway, the two activities -- eating way too much food at one sitting and then getting rid of that food by inducing vomiting or using laxatives -- seem inextricably linked.

But a new study in the Archives of Pediatrics & Adolescent Medicine shows that, among a group of 12,534 adolescents -- male and female, ages 9 to 15 at the start of the study -- surveyed over seven years about their eating habits and the influences that might help shape those habits, very few engaged in both bingeing and purging.

Females were more likely to start purging than bingeing, and males were more inclined to binge than to purge. And while there was overlap in the circumstances that may have led them to these behaviors, they all had to do with the teens' basic insecurities -- based on their own feelings or their perceptions of other people's feelngs -- about their own bodies.

(Last September's issue of the Archives of General Psychiatry featured a study noting that among adults, purging, sans bingeing, is more common than had been thought and suggesting purging be considered an eating disorder unto itself.)

Just over 10 percent of the females became disordered eaters during that seven-year period; 4.3 percent took up binge eating, and 5.3 percent started purging to control their weight. Among the males, 3 percent became disordered eaters; 2.1 percent started bingeing, and .8 percent started purging. Hardly any kids in the study took up both behaviors.

Among females (the study is careful to use "male and female" instead of "boy and girl," saying the former terms are appropriate across all age groups) frequent dieting, a high level of concern about their weight, and trying to look like people of their own gender in the media were predictive of increased risk of bingeing. It also appeared that negative comments about weight by males, the importance of weight to fathers, and importance of weight to peers were associated with increased risk of binge eating.

For males, the strongest predictors of bingeing were concern about their weight and negative comments about their weight by their fathers. Trying to look like guys in the media wasn't much of a factor.

A maternal history of eating disorders didn't seem linked to kids' bingeing. But when it came to purging, females under 14 whose mothers had histories of disordered eating were 3 times more likely than the others to start purging; maternal history had no apparent tie to purging for older females. That same treacherous trio -- dieting, weight concerns, and trying to look like Miley Cyrus -- were predictive of starting to purge; those negative comments from males appeared to play a role here, too.

For the guys, those who reported that their own weight was very important to their peers were way more likely to start purging at least once a week than fellows whose friends didn't give a hoot how much they weighed.

The study's authors say that their findings argue against one-size-fits-all approaches to preventing disordered eating. Females need help learning to resist being influenced by images of perfect bodies in the media, the study suggests, and they need to learn to shrug off teasing from males. And the guys need to learn to be more resilient to negative comments about weight from their fathers.

Um, I've got another idea. How about all you jerky boys out there stop teasing girls about their weight? And all you dads, why don't you shut the heck up about your sons' physiques?

That would be a step in the right direction, anyway.

By Jennifer LaRue Huget  |  June 4, 2008; 7:00 AM ET
Categories:  Nutrition and Fitness  
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