Eating disorders and altered eating behaviors in adolescents of normal weight in a Spanish city

Purpose: To study the prevalence of altered eating behaviors or eating diso rder-related behaviors among adolescents of normal weight that do not fulfi ll criteria for anorexia nervosa and bulimia nervosa. Method: Cross-sectional study by means of a self-completed questionnaire (S chool of Nutrition of Granada, Spain) and measurement of weight and height in a population of 491 schoolchildren aged 14-18 years. The statistical inf erences and estimation of risk are based on comparison of proportions and m eans test, and the relative inequality of prevalences. Results: Of 491 adolescents of normal weight, 9% (females 2:1) were followi ng diets; 42% presented "recurrent episodes of binging" with the sensation of loss of self-control; and 41%% avoided specific types of food. Overall, 46.2% presented altered eating behavior. Factors significantly associated w ith this were the occurrence of periods of food abstinence and the use of p urgatives [confidence interval 95% (CI 95%) prevalence ratio (PR) 1.41-2.02 ]. Compensatory behaviors were present in 33% of the adolescents, predomina ntly in females (CI 95% FR 1.79-3.07). The prevalences of abnormal eating b ehaviors were 16.3% for those related to anorexia (A-RB) and 17.1% for thos e related to bulimia (B-RB), with a clear predominance of females (2:1) and public education. There seems to be a greater aesthetic concern among thos e with B-RB and more worry about weight among those with A-RE. Conclusions: A high proportion of adolescents with abnormal eating behavior s and an altered perception of body fat may currently be diagnosed as havin g atypical eating disorder" (Diagnostic and Statistical Manual of Mental Di sorders, Fourth Revision) considering that their body mass index was within normal range. (C) Society for Adolescent Medicine, 2001.