Changes in disordered eating behaviors over 10 or more years: A meta-analysis

Area of Science:

• Psychiatry and Behavioral Sciences
• Public Health
• Longitudinal Epidemiology

Background:

• Disordered eating behaviors (DEBs) represent a significant public health concern.
• Understanding long-term changes in DEBs is crucial for effective intervention and prevention strategies.

Purpose of the Study:

• To conduct a meta-analysis evaluating long-term changes in the risk of engaging in distinct disordered eating behaviors.
• To examine how follow-up duration influences the magnitude of risk reduction for various DEBs.

Main Methods:

• Inclusion of longitudinal studies with at least two assessments and a minimum 10-year follow-up period.
• Calculation of risk ratios for changes in specific DEBs (e.g., binge eating, purging, compensatory exercise) from baseline to 10-14.9 years and ≥15 years.
• Subgroup and meta-regression analyses to explore moderators such as sample type (clinical vs. nonclinical), sex/gender, study bias, and baseline age/BMI.

Main Results:

• A meta-analysis of 17 studies (26 subsamples) revealed an overall decrease in the risk of various restrictive eating and compensatory behaviors over time.
• Risk reductions for compensatory DEBs were more substantial over longer follow-up durations, ranging from 20.0-39.8% at 10 years and 24.7-74.8% at ≥15 years.
• The nature of DEB changes varied based on DEB type, follow-up length, sample composition, and baseline mean age.

Conclusions:

• Findings indicate a long-term reduction in the risk of engaging in many disordered eating behaviors.
• The results underscore the importance of targeted and tailored preventative eating disorder (ED) treatments.
• Consistent community-level implementation of preventative ED strategies is recommended, with a particular focus on youth.