A Spotlight on Weight and Disordered Eating Patterns

In a large Norwegian study, weight problems and disordered eating were not distinct from one another.

Reprinted from Eating Disorders Review
November/December Volume 26, Number 6
©2015 IAEDP

While eating disorders such as anorexia nervosa, bulimia nervosa, and binge eating disorder affect from 5% to 10% of the population, an even larger group has disordered eating patterns or subthreshold eating disorders. A general population study of 27,252 Norwegian women 19 to 99 years of age recently revealed a wealth of information, including a 12% prevalence of disordered eating, especially in women with weight problems (BMJ Open 2015; 5:e008125. doi:10.1136/bmjopen-2015-008125).

Trine Eik-Nes, MD and colleagues at the Norwegian University of Science and Technology, Trøndheim, and Levanger Hospital, Levanger, Norway, recently reported the findings from their cross-sectional community study. The information about disordered eating patterns emerged as part of the third survey from the Nord-Trøndelag Health Study (HUNT3). The HUNT survey provides information from the total population, 14 years of age and older, in Nord-Trøndelag County, Norway. The entire county is invited to participate and at the last survey 93,860 women were invited and 52% agreed to join the study. For young adults, the researchers used a shortened version of the Eating Attitudes Test (they termed it the EAT-8) that involved two factors: 'oral control' and 'bulimia and food preoccupation.'

Results: a majority were overweight or obese

The mean body mass index (BMI, kg/m2) was 26.9 for the more than 27,000 women (mean age: 53 years) who participated. Of all women in the sample, 61.1% were either overweight or obese, and 32% were in the obese category. Two-hundred and forty-two women were in the underweight category, and 966 women had a BMI <20. BMI increased with age, and obesity (BMI ≥30 kg/m2) and extreme obesity (BMI ≥35 kg/m2) were most prevalent in women 60 to 70 years of age.

Among women younger than 30 years of age, 11.8% reported disordered eating. Weight problems were associated with disordered eating overall and with oral control and bulimia and food preoccupation. Underweight women had almost 5 times higher odds of high oral control than did normal-weight women, while women in the obese category were more likely than normal-weight women to show symptoms of bulimia and food preoccupation. As for dieting, 58.8% of the entire group reported being dissatisfied with their current weight, and women dissatisfied with their weight were 7 times more likely to be dieting than not. 

More than half of the women in the study reported dieting and treated dieting as a normal practice; dieting was largely dependent on weight dissatisfaction and not on BMI. In fact, the authors noted that a sizeable number of women were dissatisfied with their weight even when their BMIs were within a normal healthy range for their weight.

Disordered eating was not associated with younger age among women 19 to 30 and the authors found no association between age and weight dissatisfaction. Dr. Eik-Nes and colleagues' overall conclusion was that weight problems and disordered eating were not distinct from one another. In addition, they concluded that prevention and treatment for disordered eating and weight control among women should include an assessment of body image as well.