Screening High School Students for Eating Disorders: Results of a National Initiative

Introduction: Early identification and treatment of disordered eating and weight control behaviors may prevent progression and reduce the risk of chronic health consequences. Methods: The National Eating Disorders Screening Program coordinated the first-ever nationwide eating disorders screening initiative for high schools in the United States in 2000. Students completed a self-report screening questionnaire that included the Eating Attitudes Test (EAT-26) and items on vomiting or exercising to control weight, binge eating, and history of treatment for eating disorders. Multivariate regression analyses examined sex and racial/ethnic differences. Results: Almost 15% of girls and 4% of boys scored at or above the threshold of 20 on the EAT-26, which indicated a possible eating disorder. Among girls, we observed few significant differences between ethnic groups in eating disorder symptoms, whereas among boys, more African American, American Indian, Asian/Pacific Islander, and Latino boys reported symptoms than did white boys. Overall, 25% of girls and 11% of boys reported disordered eating and weight control symptoms severe enough to warrant clinical evaluation. Of these symptomatic students, few reported that they had ever received treatment. Conclusion: Population screening for eating disorders in high schools may identify at-risk students who would benefit from early intervention, which could prevent acute and long-term complications of disordered eating and weight control behaviors

Screening high school students for eating disorders : validity of brief behavioral and attitudinal measures

BACKGROUND: Early identification can greatly impact the trajectory of eating disorders, and school-based screening is 1 avenue for identifying those at risk. To be feasible in a school setting, a screening program must use a brief, valid screening tool. The aim of this study was to assess how well brief attitudinal and behavioral survey items identify adolescents at risk in a large sample of high school students from across the United States. METHODS: Data were drawn from the National Eating Disorder Screening Program, the first-ever national eating disorders screening initiative for US high schools. A 2-stage, clustered sampling method was used to randomly select a subset of student screening forms (n = 5740), which included the Eating Attitudes Test (EAT-26), behavioral questions assessing the frequency of vomiting and binge eating in the past 3 months, and an attitudinal item that assessed preoccupation with thinness. RESULTS: Nearly 12% of females and 3% of males reported vomiting to control their weight and 17% of females and 10% of males reported binge eating 1 or more times per month. Approximately 24% of females and 8% of males report being preoccupied with being thinner. We found that the attitudinal measure yielded high sensitivity and specificity. Combined screening measures that used both the attitudinal and behavioral items yielded slightly higher sensitivity values than those found with the attitudinal measure alone. CONCLUSION: High school administrators should include items that assess both preoccupation with thinness as well as behavioral items that deal with eating disorders on student health surveys.6 page(s

Sexual Orientation and Age at Menarche in Three U.S. Longitudinal Cohorts

PURPOSE: The aim of this study is to examine age at menarche across sexual orientation groups. METHODS: Data were obtained from 131,090 female participants, born 1947-2001, in 3 longitudinal studies-the Growing Up Today Study and Nurses\u27 Health Study 2 and 3. We estimated the association between sexual orientation and age at menarche using regression models adjusted for age, race/ethnicity, birthweight, height, and body mass index. RESULTS: Compared to heterosexual participants, sexual minorities were younger at menarche. Sexual minorities were more likely to have early menarche (≤11 years) and less likely to have late menarche (≥14 years) compared to heterosexual girls. As an example of this pattern, Nurses\u27 Health Study 3 bisexual participants were \u3e30% more likely than heterosexuals to have early versus average menarche (odds ratio 1.37, 95% confidence interval 1.09-1.72). CONCLUSION: Sexual minority girls have a younger age at menarche than heterosexual girls and may benefit from screening for adverse outcomes associated with early menarche