Adolescent risk factors for purging in young women: findings from the national longitudinal study of adolescent health

BACKGROUND: There exists a dearth of prospective adolescent eating disorder studies with samples that are large enough to detect small or medium sized effects for risk factors, that are generalizable to the broader population, and that follow adolescents long enough to fully capture the period of development when the risk of eating disorder symptoms occurring is highest. As a result, the purpose of this study was to examine psychosocial risk factors for purging for weight control in a nationally representative sample of adolescents. Data were extracted from the restricted-use data sets of the National Longitudinal Study of Adolescent Health (Waves I-III), selecting females with valid demographic and purging information (N = 5,670). RESULTS: The prevalence of purging was 0.88% at Wave II and 0.56% at Wave III. In multivariable multinomial logistic regressions, purging at Wave II was predicted by parental poverty and low levels of self-esteem at Wave I; purging at Wave III was predicted by body mass index and the frequency of delinquent behaviors at Wave I. CONCLUSIONS: Individuals with high body mass index, individuals with low self-esteem, and individuals in families experiencing economic hardship appear specifically at risk for the development of purging behaviors in later years and may benefit from more targeted prevention efforts.