A new study published in the journal Appetite reveals a significant association between body mass index (BMI) and the progression from binge-eating behaviors to binge-eating disorder (BED) among adolescents in the United States.
Binge eating disorder is characterized by recurrent episodes of consuming large quantities of food within a short time frame, occurring at least once a week for three months. BED is the most prevalent eating disorder in the U.S., often accompanied by a loss of control over eating and linked to substantial social, economic, and health-related costs. While the prevalence of binge-eating behaviors among adolescents is approximately 2.5%, research indicates that 10-28% of U.S. adolescent girls may progress from these behaviors to a diagnosis of BED. Understanding the risk factors for BED in early adolescents is crucial for developing preventive and intervention strategies.
The study utilized data from the Adolescent Brain Cognitive Development (ABCD) study, which included 9,964 adolescents aged 9 to 13 at enrollment. Researchers assessed binge-eating behaviors and BED through a computerized evaluation completed by the participants’ parents. The primary hypothesis was that higher BMI would correlate with an increased risk of developing BED, regardless of the presence of binge-eating behaviors.
The analysis revealed that a higher BMI was linked to a greater likelihood of developing BED, independent of binge-eating behavior status. This finding aligns with previous studies that have identified associations between BMI, binge-eating symptoms, and BED in adolescents. Notably, adolescents with a BMI at or above the 85th percentile faced a particularly heightened risk for BED onset.
Several theoretical frameworks may explain the observed relationship between BMI and BED. The restraint theory suggests that chronic dieting can diminish awareness of internal hunger cues while heightening sensitivity to external food cues, potentially leading to binge eating.
The dual-pathway model posits that societal pressures to achieve a thin ideal can foster body dissatisfaction and unhealthy dieting practices, both of which increase the likelihood of binge-eating behaviors. Additionally, the transdiagnostic cognitive behavioral theory indicates that an excessive focus on weight and shape can result in strict dieting and weight-control behaviors that may trigger binge eating.
Furthermore, external factors such as weight-related teasing can exacerbate disinhibited eating patterns among youth. Neurobiological factors associated with higher BMI, including alterations in brain regions responsible for impulse control and executive function, may also contribute to an increased risk of BED.
Adolescents’ rising consumption of ultra-processed foods may negatively impact gut microbiota, which in turn affects the production of signaling molecules and neurotransmitters involved in appetite regulation and mood. Such changes could further elevate the risk of binge-eating behaviors.
The study’s findings underscore the need for early screening of adolescents with higher BMI and highlight the importance of educational campaigns aimed at families and communities. The research benefits from a large, diverse sample and a longitudinal design, allowing for the examination of prospective associations. However, limitations include reliance on parent-reported data, which may not always align with children’s experiences, and the use of BMI as a measure that does not differentiate between fat and muscle mass. Additionally, potential residual confounding effects and the inability to establish causality should be considered.
This research adds to the growing body of evidence linking higher BMI with an increased risk of binge-eating disorder, emphasizing the need for proactive measures to address this public health concern among adolescents.
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