2008 submissions for publication

Objective: The purpose of the study was to investigate differences in behavioral and psychological health among four groups of patients, categorized by the age of onset of the eating disorder: preadolescent (ages 8 to 12), early adolescent (ages 13 to 15), late adolescent (ages 16 to 18) and adult (ages 19 to 21).

Method: A retrospective chart review was conducted, based on a sample of 208 females, ages 8 to 21, drawn from the patient population of a large Midwestern eating disorder clinic. Patients diagnosed with AN*, BN* and EDNOS* were included in the study. Measures included eating disorder diagnosis and scores on measures of eating disorder symptoms and related pathology, anxiety, depression and self-esteem.

Results: Age of onset was significantly and positively associated with the likelihood to engage in binge-eating and vomiting. No significant differences were found across age-of-onset categories on the duration of the eating disorder, weight status or depression. However, a greater number of patients with preadolescent age of onset were diagnosed with AN than patients with adolescent or young-adult age of onset, and a greater number of patients with adult age of onset were diagnosed with BN than patients with a preadolescent or adolescent age of onset. Age of eating disorder onset during preadolescence was associated with greater maturity fears, less state and trait anxiety* and greater self-esteem than older ages of onset.

Conclusion: Findings show significant differences between age of eating disorder onset and patients’ clinical presentation. Because of these differences, treatment interventions should be tailored to factors relevant to age of onset.

Purpose: Examine differences at the intake assessment and during long-term follow-ups between eating disorder patients who have and have not used laxatives for weight control.

Methods: Of 202 females who completed measures at intake evaluation and treatment outcome, 87 (44.2 percent) reported using laxatives for weight control.
Results: Laxative use was significantly associated with greater BMI* and age at intake assessment. At follow-up, laxative users had:

• significantly lower scores on measures of self-esteem, mental health functioning and self-efficacy for body image and normative eating
• poorer scores on psychological, physical and cognitive quality of life factors
• higher scores on measures of depression, trait anxiety*, dietary restraint, and eating, weight and shape concerns
• more eating disorder behaviors and related concerns than nonlaxative users

Discussion: Laxative-using patients have poorer outcomes than their nonusing peers. Due to the severe medical complications encountered during treatment, future research should address the clinical implications and longer-term impact of laxative use.