OBJECTIVE To examine whether childhood body mass index (BMI) trajectories are prospectively associated with later eating disorder (ED) diagnoses. METHOD Using a subsample from the Avon Longitudinal Study of Parents and Children (N = 1,502), random-coefficient growth models were used to compare premorbid BMI trajectories of individuals who later developed anorexia nervosa (n = 243), bulimia nervosa (n = 69), binge-eating disorder (n = 114), and purging disorder (n = 133) and a control group without EDs or ED symptoms (n = 966). BMI was tracked longitudinally from birth to 12.5 years of age and EDs were assessed at 14, 16, and 18 years of age. RESULTS Distinct developmental trajectories emerged for EDs at a young age. The average growth trajectory for individuals with later anorexia nervosa veered significantly below that of the control group before 4 years of age for girls and 2 years for boys. BMI trajectories were higher than the control trajectory for all other ED groups. Specifically, the mean bulimia nervosa trajectory veered significantly above that of controls at 2 years for girls, but boys with later bulimia nervosa did not exhibit higher BMIs. The mean binge-eating disorder and purging disorder trajectories significantly diverged from the control trajectory at no older than 6 years for girls and boys. CONCLUSION Premorbid metabolic factors and weight could be relevant to the etiology of ED. In anorexia nervosa, premorbid low weight could represent a key biological risk factor or early manifestation of an emerging disease process. Observing children whose BMI trajectories persistently and significantly deviate from age norms for signs and symptoms of ED could assist the identification of high-risk individuals.

中文翻译：

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纵向人群队列中患有饮食失调的青少年的发育前体重指数轨迹。


目的 研究儿童体重指数 (BMI) 轨迹是否与后来的饮食失调 (ED) 诊断存在前瞻性相关。方法 使用雅芳家长和儿童纵向研究 (N = 1,502) 的子样本，使用随机系数增长模型来比较后来出现神经性厌食症 (n = 243)、神经性贪食症 (n = 69) 的个体病前 BMI 轨迹）、暴食症（n = 114）和清除障碍（n = 133），以及没有 ED 或 ED 症状的对照组（n = 966）。从出生到 12.5 岁纵向追踪 BMI，并在 14、16 和 18 岁时评估 ED。结果 ED 在年轻时就出现了独特的发展轨迹。晚期神经性厌食症患者的平均生长轨迹在女孩 4 岁之前和男孩 2 岁之前显着低于对照组。所有其他 ED 组的 BMI 轨迹均高于对照轨迹。具体来说，女孩 2 岁时的平均神经性贪食症轨迹明显高于对照组，但后来患有神经性贪食症的男孩并没有表现出更高的 BMI。女孩和男孩在不超过 6 岁的时候，暴食症和清除障碍的平均轨迹与对照轨迹存在显着差异。结论 病前代谢因素和体重可能与 ED 的病因有关。在神经性厌食症中，病前低体重可能代表一个关键的生物危险因素或新出现的疾病过程的早期表现。观察 BMI 轨迹持续且显着偏离年龄标准的 ED 体征和症状的儿童可以帮助识别高危个体。