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Evidence summaries

Dieting as a Risk Factor for Eating Disorders in Children and Adolescents

Dieting as a treatment for overweight is probably not a significant risk factor for eating disorders. Level of evidence: "C"

A systematic review 1 including 5 studies with a total of 447 subjects was abstracted in DARE.

Effects on eating behaviour. Professionally administered weight loss programmes were associated with a minimal risk of eating disorders. The studies showed a decrease in scores on the external eating subscale and no change in emotional eating on the DEBQ (2 studies). One study showed an increase in restrained eating and one showed no change in restrained eating on the DEBQ. There was a statistical trend towards a reduction in ChEAT scores (1 study), no significant change from baseline on the KEDS (1 study), a significant decrease on the drive for thinness subscale, and no significant change in bulimia measured on the EDI (1 study). One study found 4% of participants reported treatment for bulimia nervosa and none reported treatment for anorexia nervosa over 10 years.

Effects on psychological status (4 studies). The studies showed significant improvements in three of the five assessed areas of self-perceived competence but no significant improvement in global self-worth at 10 months (1 study); significant reductions in symptoms of depression and state anxiety at post-treatment and after 8 months (1 study); and a significant reduction in total behaviour problems after 18 months (1 study). One study found that 12% of the participants had sought treatment for depression during 10 years of follow-up.

Comment: The quality of evidence is downgraded by imprecise results (limited study size for each comparison) and poor quality of the included studies.

References

  • Butryn ML, Wadden TA. Treatment of overweight in children and adolescents: does dieting increase the risk of eating disorders? Int J Eat Disord 2005 May;37(4):285-93. [PubMed]

Primary/Secondary Keywords