Elevated Childhood Weight May Increase Susceptibility to Eating Disorders

Women with a tendency for excessive weight gain during development may be more susceptible to developing an eating disorder, Drexel research finds.

What causes people to develop eating disorders?

This question has been a source of research and debate for many years. Research has consistently supported the view that disordered eating stems from some combination of psychological factors, such as low self-esteem and concern about looks, and social factors, such as the emphasis in the media and popular culture on appearance.

But a group of researchers at Drexel University, headed up by Michael Lowe, PhD, a clinical psychologist who studies the psychobiology of eating and weight regulation and a professor of psychology in Drexel’s College of Arts and Sciences, is suggesting that actual elevations in body mass during childhood may play a much bigger role in the development of disordered eating than previously thought.

The teams’ recent findings suggest that women with a tendency for excessive weight gain during development may be more susceptible to developing an eating disorder. The research evidence revealed that women with bulimia nervosa were heavier than their peers during adolescence – before they developed an eating disorder. 

The team also found that women who go on to develop anorexia during adolescence are heavier than their peers from grades one through six. Although puberty is a period of natural weight gain for women, those who are heavier than their peers before puberty may be more vulnerable to developing an eating disorder.

“Our work adds a novel perspective on eating disorders and where they come from,” said Lowe. “Previously, little thought had been given to whether people who develop an eating disorder might be responding to a higher than average body mass during development. Rather, researchers and clinicians have focused on the damage done by ruminating on how peers or the media say one’s body should look. Could it be that girls who go on to develop an eating disorder aren’t just mentally and emotionally susceptible to these messages, but they are more vulnerable to such messages because their bodies are in fact larger than their peers’?"

“Previously, little thought had been given to whether people who develop an eating disorder might be responding to a higher than average body mass during development." 

A compelling argument for this biological viewpoint, according to Lowe, is the simultaneous rise of bulimia and obesity.

“Bulimia nervosa didn’t always exist,” said Lowe. “But now, more women suffer from bulimia than anorexia. Bulimia was first recognized around the time that the obesity epidemic started, around the late 1970s. This makes perfect sense because, as obesity climbed, so did the number of women who engaged in radical dieting to reverse weight gain, thereby increasing their risk for developing bulimia.” 

This dramatic new finding has implications for how eating disorders are prevented and treated.

“So much of how we prevent eating disorders is focused on protecting women from internalizing societal imperatives about beauty and thinness, said Lowe. “Counteracting this focus is certainly needed, but the situation is more complicated than that. Part of the reason for girls’ sensitivity about their weight is a real – not just an imagined – problem with accelerated weight gain.”  

"Part of the reason for girls’ sensitivity about their weight is a real – not just an imagined – problem with accelerated weight gain.” 

Lowe acknowledges that this creates something of a “catch-22”: do you tell girls whose body weights are significantly above average that they are becoming overweight, possibly inducing them to engage in dangerous forms of dieting? Or do you say nothing, which might mean you’ve missed an opportunity to prevent further weight gain and possible health problems?

“As a country we obviously have a serious problem with obesity, and the weight gain that eventually results in obesity sometimes starts early in life,” said Lowe. “On one hand, the best approach to solving our weight problem is to prevent weight gain because it is so hard to treat once it becomes established. However, if you place too much emphasis on weight – especially during adolescence when girls are especially sensitive about their weight and appearance – you could inadvertently spur unhealthy dieting and rapid weight loss, which could contribute to an eating disorder. So there is a balance that needs to be struck, but few people are aware of this dilemma or how to cope with it.”

"There is a balance that needs to be struck, but few people are aware of this dilemma or how to cope with it.”

These topics are currently being investigated in two of Lowe’s research grants, funded by the National Institute of Mental Health. The first study, which is being conducted by Drexel researchers along with those from the Columbia Center for Eating Disorders, is a four-year project that began in 2012. The study uses cell phone technology to survey participants about their behavior throughout the day.

The second grant is a five-year collaboration with Anna Rose Childress, PhD, a professor and neuroimage researcher from the University of Pennsylvania. This study looks at the brain’s response to pictures of various food stimuli.

Women with eating disorders who are interested in participating in either study may call 215-553-7171 or email dueatingdisorders@gmail.com for more information. All participants are compensated.

Lowe studies eating and weight regulation – and eating and weight disorders – from the perspective of clinical psychology, nutritional science, psychobiology and neuroscience. His specific research areas include: the relationship between dieting, overeating and weight control; obesity and the prevention of weight gain and weight regain; eating disorders research; integrating biological and psychological perspectives on eating and weight regulation; and research on the “power of food.” He was a consultant to Weight Watchers for many years and currently is the research consultant to the Renfrew Center for eating disorders in Philadelphia.