UF study: Adolescent girls who set goals too high may risk anorexia

November 07, 2002

GAINESVILLE, Fla. --- Perfectionism puts adolescent girls with unhealthy eating habits at risk for becoming anorexic and the body imperfections that go along with it as they grow older, a new University of Florida study finds.

"The hard thing is that we encourage girls to set goals," said Julia Graber, a UF psychology professor and one of the study's researchers. "We want adolescents to find things to strive for - that they think are important and want to work hard for - but when they set unrealistic goals, it leads to problems."

The study also found that girls who showed some bulimic tendencies, such as binge eating and occasional purging, were more likely to develop a full-blown version of the disorder if they reported symptoms of depression. The findings are reported in the current issue of the International Journal of Eating Disorders.

About 20 percent of adolescent girls and young women experience some signs of eating disorders, with serious consequences for those whose conditions worsen, Graber said.

"They really do end up killing themselves because it affects so many systems in the body," she said.

Anorexics can develop severe heart problems because heart muscles deteriorate, while bulimics damage their gastrointestinal tracts with constant vomiting, Graber said. Many young women who experiment with these extreme weight-control measures also develop osteoporosis - a condition not normally seen in their age group - because they don't get proper nutrition at a time when bones are still growing, she said.

As many as 3.7 percent of women suffer from anorexia nervosa and as many as 4.2 percent are estimated to have bulimia in their lifetimes, according to the National Institute for Mental Health. Full-syndrome eating disorders are relatively uncommon so their impact on public health often is not fully appreciated, however they are associated with considerable impairment in health and interpersonal adjustment, have high relapse rates and carry increased risk for death, according to the institute.

The study's researchers interviewed 157 predominantly white, middle- to upper-middle-class girls who attended private schools in New York City. The girls were interviewed between the ages of 12 and 16, and then again when they were 14 to 18 and 20 to 24. Working with Graber were Audrey Tyrka, a resident in the department of psychiatry and human behavior at Brown University School of Medicine; Ingrid Waldron, a biologist at the University of Pennsylvania; and Jeanne Brooks-Gunn, a psychologist at Columbia University.

Although experts once believed girls from middle- to upper-middle-class backgrounds were more prone to eating disorders, large-scale studies have recently suggested that social class differences are less important than previously thought, Graber said.

The UF study was unusual in that it followed adolescents into young adulthood, a period when eating disorders tend to increase, Graber said. "Because so many people engage in unhealthy dieting, it's hard to figure out who is going to have a serious, full-blown disorder," she said.

Anorexia nervosa symptoms that girls reported in the early years included being at least 15 percent underweight and preoccupied with dieting, as well as experiencing purging, compulsive eating habits and feelings that food controlled their lives, the paper reported. Those who went on to develop the full-blown clinical definition of the disease by their early 20s were usually perfectionists, Graber said. They felt they were failures if they didn't meet unattainable goals they set for themselves, not just body image goals but goals in general, she said.

"It may be that the body is the one thing they have more control over and so they meet those goals, even if they're extremely unhealthy, because they can't meet the unrealistic expectations they have for the rest of their lives," she said.

Parents may find it difficult to spot warning signs of eating disorders in their teenage daughters because so many of the behaviors are secretive, such as purging.

Mood changes in teenagers also may deserve closer attention in light of the study's finding that girls with depressed feelings and bulimic symptoms are more likely to develop the full-blown bulimic disorder, she said.

"People think that adolescent girls are supposed to be moody and depressed," she said. "While there may be some occasions of heightened conflict, with adolescents driving their parents crazy, sustained periods of emotional upheaval are not necessarily normal and may be a sign something is wrong."

Families can try to avoid some of these problems by emphasizing the importance of moderation to achieve healthy eating behaviors, Graber said. "Unfortunately, dieting is such an important part of our culture. Diet-related products and programs are very heavily marketed," she said.
Writer: Cathy Keen

Source: Julia Graber

University of Florida

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