Eating Disorders Predict Illicit Drug Use

Megan Brooks

December 10, 2012

Adolescents and young adults who overeat or binge eat may be more likely to start using marijuana or other illicit drugs than their counterparts with normal eating habits, a new study suggests.

The researchers found that both binge eating and overeating predicted the onset of marijuana use and that overeating predicted the onset of marijuana and other drug use, whereas binge eating, but not overeating, predicted the onset of overweight/obesity and worsening depressive symptoms.

"These findings suggest that loss of control is an important indicator of severity of overeating episodes," Kendrin R. Sonneville, ScD, RD, of Boston Children's Hospital, Massachusetts, and colleagues write.

The study was published online December 10 in Archives of Pediatrics and Adolescent Medicine.

The longitudinal prospective study investigated overeating without loss of control and binge eating with loss of control and adverse outcomes in 16,882 persons. Participants were aged 9 to 15 years in 1996; eating habits were assessed by questionnaire every 12 to 24 months between 1996 and 2005.

At the time of the first assessment, 22.3% of participants were overweight or obese, 4.3% were binge drinking frequently, 12.2% had used marijuana, and 9.1% had used a drug other than marijuana. Between the ages of 16 and 24 years, binge eating was more common in girls (2.3% to 3.1%) than in boys (0.3% to 1%).

In fully adjusted models, binge eating, but not overeating, was associated with incident overweight/obesity (odds ratio [OR], 1.73; 95% confidence interval [CI], 1.11 - 2.69) and the onset of depressive symptoms (OR, 2.19; 95% CI, 1.40 - 3.45). Neither overeating nor binge eating appeared to be associated with initiation of binge drinking.

However, both overeating (OR, 2.67; 95% CI, 1.68 - 4.23) and binge eating (OR, 1.85; 95% CI, 1.27 - 2.67) were significantly associated with starting to use marijuana in fully adjusted statistical models. Overeating (OR, 1.89; 95% CI, 1.18 - 3.02) and binge eating (OR, 1.59; 95% CI, 1.08 - 2.33) were also significantly associated with starting to use other drugs.

These findings, coupled with previous research, suggest that loss of control (LOC) is "an important indicator of severity of overeating episodes and highlight the importance of ascertaining LOC, in addition to whether adolescents engage in overeating episodes," the authors note.

Largest Study to Date

"Given that binge eating is uniquely predictive of some adverse outcomes and because previous work has found that binge eating is amenable to intervention, clinicians should be encouraged to screen adolescents for binge eating," they conclude.

School- and community-based interventions focused on prevention of binge eating might prevent both eating disorders and obesity among young people, they add.

The authors note that the study sample was 90% white and likely underrepresents youth of low socioeconomic status. Reliance on self-reports is another limitation. Nonetheless, they note that this is the largest prospective study to follow a sample through adolescence and into young adulthood, a period of high risk for developing overweight/obesity and high depressive symptoms and for starting to use illicit drugs.

The study was supported by the National Institutes of Health. The authors have disclosed no relevant financial relationships.

Arch Pediatr Adolesc Med. Published online December 10, 2012. Abstract