Preadolescent eating disorder risk longitudinally predicts later psychological symptoms, weight-gain and lower activity in girls

BACKGROUND: The downstream developmental consequences of elevated eating disorder symptoms in preadolescents are unclear. We examined whether children at ‘high-risk’ of an eating disorder at 9 years differed from ‘low-risk’ children on later weight, behavioural and psychological outcomes. METHODS: Participants from the Gateshead Millennium Study birth cohort (N=526, 51% girls) completed self-report measures of eating disorder symptoms and body dissatisfaction aged 9, 12 and 15 years and depressive symptoms aged 12 and 15. Height, weight, and physical activity (via accelerometer) were measured at each age. RESULTS: 116 (22%) participants (61 girls) had eating disorder symptoms above a high-risk threshold at 9 years old. High-risk girls had greater body dissatisfaction and higher depressive and eating disorder symptoms aged 12 and 15 (all p <.001). High-risk girls also gained more age-adjusted BMI centiles between 9-15 (change in BMI z-score 0.5 vs 0.1, p=0.01, corrected for 9-year-old BMI z-score). High-risk girls were less active at 15 years than low-risk girls (21 vs 27 minutes MVPA/day, p=0.03). High-risk boys had higher disordered eating and depressive symptoms aged 12 (both p<0.01) but did not otherwise differ from low-risk boys. CONCLUSIONS: In this cohort, girls at high-risk of eating disorders aged 9 had more negative psychological outcomes at 12 and 15 years, were less active, and gained more weight by age 15. The impact of earlier eating disorder risk was evident, but more limited, in boys. Preventative efforts for eating disorders, body dissatisfaction, depression, and weight gain, particularly in girls, might beneficially focus on high-risk preadolescents.