Eat Weight Disord. 2026 Feb 16. doi: 10.1007/s40519-026-01824-w. Online ahead of print.
ABSTRACT
PURPOSE: To investigate sex differences in prospective associations between eating disorder (ED) symptoms and changes in body mass index (BMI) percentile in early adolescence.
METHODS: This prospective study used survey data from 7111 participants aged 10-12 years at Year 1 from the Adolescent Brain Cognitive Development (ABCD) Study-a diverse, national sample of adolescents from 21 sites across the United States (US). Multivariable linear regression models were used to assess the prospective associations between ED symptoms at Year 1 and BMI percentile at Year 2, adjusting for covariates and BMI percentile at Year 1. Effect moderation was explored in sex-stratified models.
RESULTS: Sex modified the relationship between ED symptoms and changes in BMI percentile. Having binge eating symptoms (B = 3.65, 95% CI 1.80-5.51, p <0.001), distress related to binge eating (B = 2.79, 95% CI 0.05-5.53, p = 0.046), inappropriate compensatory behaviors (B = 6.39, 95% CI 2.16-10.62, p = 0.005), and fear of weight gain (B = 5.26, 95% CI 3.18-7.33, p < 0.001) at Year 1 were significantly associated with higher BMI percentile at Year 2 among males. In the overall sample, distress related to binge eating (B = 2.09, 95% CI 0.40-3.69, p = 0.017) was significantly associated with a higher BMI percentile 1 year later; the interaction by sex was not statistically significant.
DISCUSSION: ED symptoms were associated with higher BMI percentiles 1 year later in early adolescents, although sex-stratified findings revealed that many associations were significant only for males. Clinicians caring for early adolescents should consider evaluating for ED symptoms as potential risk factors for elevated weight.
LEVEL OF EVIDENCE: Level III: Evidence obtained from well-designed cohort or case-control analytic studies.
PMID:41697562 | DOI:10.1007/s40519-026-01824-w
