In a recent clinical study, scientists from the University of Minnesota School of Public Health (SPH) attempted to reproduce findings from a prior study that identified prospective links between use of products for weight control and subsequent diagnosis of a first-time eating disorder (ED) in female adolescents and young adults. The study results demonstrated that the risk of being diagnosed rose considerably among these individuals.

The researchers analyzed data from 1,015 females without a prior ED diagnosis who participated in the Project EAT (Eating and Activity in Teens and Young Adults) study. Participants were followed from early or middle adolescence (EAT-I; mean (M) age = 14.9 years) into late adolescence or emerging adulthood (EAT-II; M age = 19.5 years) and young adulthood (EAT-III; M age = 24.8 years). Over a 10-year period, participants were surveyed about their health and behavior, including their use of diet pills and laxatives, as well as whether they received an ED diagnosis.

The study examined the risk of receiving an ED diagnosis within 5 years in persons who did and did not use diet pills and laxatives. First-time receipt of an ED diagnosis was reported by 2.4% of EAT-II and 4.0% of EAT-III participants. After adjustment for demographics and weight status, participants using diet pills (risk ratio [RR] = 3.58, 95% CI 1.96-6.54) and laxatives (RR = 2.77, 95% CI 1.01-7.64) had a greater risk of receiving a first-time ED diagnosis within 5 years than those not using these products.

The authors noted that participants who reported using diet pills had a 258% greater risk of being diagnosed with an ED compared with those who did not, and those who used laxatives to control their weight had a 177% greater risk of receiving an ED diagnosis compared with those who did not. It was concluded that the present study reproduced prior findings, providing further evidence for a prospective link between consumption of products for weight control and subsequent receipt of an ED diagnosis.

In an interview, study coauthor Dr. Dianne Neumark-Sztainer, a professor at SPH, said, "Living in a society that places a strong emphasis on thinness, which goes well beyond any health benefits, can place people at risk for engaging in concerning behaviors such as the use of diet pills and laxatives for weight control purposes, and also for the development of serious eating disorders. The longitudinal nature of this study, over a 10-year period, allows for the assessment of temporality, meaning that the use of diet pills and laxatives preceded the onset of an eating disorder. This could either mean that use of these products is an early marker of an eating disorder, or that these products actually serve as risk factors for eating disorders. If using these products does increase risk for an eating disorder, it could be by contributing to dysregulation of eating behaviors and/or digestion."

Moreover, study lead Vivienne Hazzard, an incoming postdoctoral fellow at SPH who completed the research while at the Sanford Center for Biobehavioral Research, stated, "These findings suggest that using diet pills and laxatives to control weight does seem to predict future diagnosis of an eating disorder." Dr. Hazzard also indicated that the study examined only females and that future research is warranted to assess whether use of diet pills and laxatives to control weight also predicts future diagnosis of an ED among males.

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