Eating disorders can take many forms and research shows that people with one version may transition to another over time. To learn more, researchers with the School of Public Health’s Project EAT (Eating and Activity Among Teens) looked at the types that develop and how they may play out over the transition from adolescence to adulthood.

The study was published in the International Journal of Eating Disorders.

“For the first time, we identified disordered eating groups and looked at the different transitions individuals made between the groups,” said lead author and Medical School postdoctoral fellow Cari Pearson Carter. “We wanted to find out what fueled those transitions over a 10-year period from adolescence to adulthood. The better we are able to understand what factors increase the possibility of developing disordered eating behaviors, the better chance we have to develop effective prevention efforts.”

Three groups emerged during the study:

• Asymptomatic group (those with no eating disorder symptoms)
• Dieting group (those who were trying to lose weight)
• Disordered eating group (those who engaged in binge eating and purging)

The results found that 60 percent of individuals in the asymptomatic group during adolescence stayed in that group and did not develop disordered eating behaviors 10 years later.

In contrast, 75 percent of people in the disordered eating group in adolescence continued to show dieting or disordered eating symptoms a decade later.

“What this is really telling us is that disordered eating behaviors are difficult to stop once they begin,” says Carter.

The study also found that self-esteem played an important role in determining which group adolescents fell into. Those with higher self-esteem in adolescence tended to have a decreased chance of transitioning from the asymptomatic group to the disordered eating group in adulthood. Higher depression, family weight teasing, and substance-use increased the chances of moving to a more severe group or decreased the chances of transitioning to a less severe group by adulthood.

“The major takeaway is that early detection and intervention for disordered eating symptoms is critical — especially in young girls,” says Carter. “Talking to adolescents about behavioral and emotional concerns early on and how to effectively manage those could keep them from forming disordered eating habits that are really difficult to break.”

Carter hopes this study will inform parents and health professionals in providing more effective treatment options for those struggling with eating disorders and also prevent adolescents from developing disordered eating habits in the future.