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Social, psychological and physical correlates of eating problems. A study of the general adolescent population in Norway

Published online by Cambridge University Press:  09 July 2009

Lars Wichstrøm*
Research Council of Norway's Centre for Youth Research, Oslo, Norway
1 Address for correspondence: Dr Lars Wichstrøm, The Research Council of Norway's Centre for Youth Research (UNGFORSK), Gaustadalleen 21, N-0371 Oslo, Norway.


The characteristics and concurrent predictors of eating problems were identified. Ninety-seven per cent of a representative sample of Norwegian adolescents (N = 11315) completed a questionnaire containing a 12-item version of the Eating Attitudes Test (EAT) and measures of a large number of physiological, psychological and social factors previously suggested to be of aetiological importance. Social class, drug use and indicators of ‘the model child’ (high grades, high occupational aspirations and much homework) were not related to eating problems. Logistic regression analyses identified perceived obesity as the strongest associated factor, followed by gender, depression, excessive exercise and unstable self-perceptions. In addition, adopting idols with perfect bodies, body dissatisfaction, low self-worth, feminine sex-role orientation, lack of parental care, early pubertal timing, age and number of alcohol intoxications all added to the probability of eating problems. About 6% perceived themselves as obese in spite of subnormal BMI. Such misperceptions increased the risk of high scores on EAT.

Original Articles
Copyright © Cambridge University Press 1995

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Alsaker, F. D. (1992). Pubertal timing, overweight, and psychological adjustment. Journal of Early Adolescence 12, 396419.CrossRefGoogle Scholar
Alsaker, F. D. & Olweus, D. (1986). Assessment of global negative self-evaluations and perceived stability of self in Norwegian preadolescents and adolescents. Journal of Early Adolescence 6, 269278.CrossRefGoogle Scholar
American Psychiatric Association (1987). Diagnostic and Statistical Manual of Mental Disorders, 3rd edn. Revised. APA: Washington, DC.Google Scholar
Attie, I. & Brooks-Gunn, J. (1989). Development of eating problems in adolescent girls: a longitudinal study. Developmental Psychology 25, 7079.CrossRefGoogle Scholar
Baumrind, D. (1967). Child care practices anteceding three patterns of preschool behavior. Genetic Psychology Monographs 75, 4388.Google ScholarPubMed
Bem, S. L. (1974). The measurement of psychological androgyny. Journal of Consulting and Clinical Psychology 42, 634643.CrossRefGoogle ScholarPubMed
Bennion, L. D. & Adams, G. R. (1986). A revision of the Extended Version of the Objective Measure of Ego-identity Status: an identity instrument for use with late adolescents. Journal of Adolescent Research 1, 183198.CrossRefGoogle Scholar
Boskind-Lodahl, M. (1976). Cinderella's stepsisters: a feminist perspective on anorexia nervosa and bulimia. Signs 2, 342356.CrossRefGoogle Scholar
Boskind-White, M. & White, W. C. (1983). Bulimarexia: The Binge/Purge Cycle. Norton: New York.Google Scholar
Bourdieu, P. (1984). Distinction. Routledge: London.Google Scholar
Brown, T. A., Cash, T. F. & Lewis, R. J. (1989). Body-image disturbances in adolescent female binge-purgers: a brief report of the results of a national survey in the USA. Journal of Child Psychology and Psychiatry 30, 605613.CrossRefGoogle Scholar
Bruch, H. (1962). Perceptual and conceptual disturbances in anorexia nervosa. Psychosomatic Medicine 24, 187194.CrossRefGoogle ScholarPubMed
Bruch, H. (1978). The Golden Cage: The Enigma of Anorexia Nervosa. Harvard University Press: Cambridge, MA.Google Scholar
Button, E. J. & Whitehouse, A. (1981). Subclinical anorexia nervosa. Psychological Medicine 11, 509516.CrossRefGoogle ScholarPubMed
Cash, T. F. & Brown, T. A. (1987). Body-image disturbances in anorexia nervosa and bulimia nervosa: a review of the literature. Behavior Modification 11, 487521.CrossRefGoogle Scholar
Cohn, L. D., Adler, N. E., Irwin, C. E., Millstein, S. G., Kegeles, S. M. & Stone, G. (1987). Body-figure preferences in male and female adolescents. Journal of Abnormal Psychology 96, 276279.CrossRefGoogle ScholarPubMed
Crisp, A. H., Palmer, R. L. & Calucy, R. S. (1976). How common is anorexia nervosa ? A prevalence study. British Journal of Psychiatry 128, 549554.CrossRefGoogle ScholarPubMed
Crowne, D. P. & Marlowe, D. (1964). The Approval Motive. Studies in Evaluative Dependence. John Wiley & Sons Inc: New York.Google Scholar
Cullberg, J. & Lindberg, E. M. (1988). Prevalence and incidence of eating disorders in a suburban area. Acta Psychiatrica Scandinavica 78, 314319.CrossRefGoogle Scholar
Dacey, C. M., Nelson, W. M., Clark, V. F. & Aikman, K. G. (1991). Bulimia and body image dissatisfaction in adolescence. Child Psychiatry and Human Development 21, 179184.CrossRefGoogle ScholarPubMed
Dolan, B. M., Lieberman, S., Evans, C. & Lacey, J. H. (1990). Family features associated with normal body weight bulimia. International Journal of Eating Disorders 9, 639647.3.0.CO;2-H>CrossRefGoogle Scholar
Dykens, E. M. & Gerrard, M. (1986). Psychological profiles of purging bulimics, repeat dieters, and controls. Journal of Consulting and Clinical Psychology 54, 283288.CrossRefGoogle ScholarPubMed
Eisele, J., Hertsgaard, D. & Light, H. K. (1986). Factors related to eating disorders in young adolescent girls. Adolescence 21, 283290.Google ScholarPubMed
Eisler, I. & Szmukler, G. I. (1985). Social class as a confounding variable in the Eating Attitudes Test. Journal of Psychiatric Research 19, 171176.CrossRefGoogle ScholarPubMed
Epling, W. F., Pierce, W. D. & Stefan, L. (1983). A theory of activity-based anorexia. International Journal of Eating Disorders 3, 2746.3.0.CO;2-T>CrossRefGoogle Scholar
Fabian, L. J. & Thompson, J. K. (1989). Body image and eating disturbance in young females. International Journal of Eating Disorders 8, 6374.3.0.CO;2-9>CrossRefGoogle Scholar
Fillmore, K. M. (1988). Alcohol Use Across the Life Course. A Critical Review of 70 Years of International Longitudinal Research. Addiction Research Foundation: Toronto.Google Scholar
Fries, H. (1974). Secondary amenorrhoea, self-induced weight reduction and anorexia nervosa. Acta Psychiatrica Scandinavica. Suppl. 248.Google Scholar
Frish, R. E., Wyshak, G. & Vincent, L. (1980). Delayed menarche and amenhorrea in ballet dancers. New England Journal of Medicine 303, 1719.CrossRefGoogle Scholar
Gardner, R. M. & Moncrieff, C. (1989). Body image distortion in anorexics as a non-sensory phenomenon: a signal detection approach. Journal of Clinical Psychology 44, 101107.3.0.CO;2-U>CrossRefGoogle Scholar
Garner, D. M. & Garfinkel, P. E. (1979). The Eating Attitudes Test: an index of the symptoms of anorexia nervosa. Psychological Medicine 9, 273279.CrossRefGoogle ScholarPubMed
Garner, D. M. & Garfinkel, P. E. (1980). Socio-cultural factors in the development of anorexia nervosa. Psychological Medicine 10, 647656.CrossRefGoogle ScholarPubMed
Garner, D. M., Olmsted, Bohr, Y. & Garfinkel, P. E. (1982). The Eating Attitudes Test: psychometric feature and clinical correlates. Psychological Medicine 12, 871878.CrossRefGoogle Scholar
Garner, D. M., Olmstead, M. P. & Polivy, J. (1983). Development and validation of a multidimensional eating disorder inventory for anorexia nervosa and bulimia. International Journal of Eating Disorders 2, 1534.3.0.CO;2-6>CrossRefGoogle Scholar
Gartner, A. F., Marcus, R. N., Halmi, K. & Loranger, A. W. (1989). DSM-III-R personality disorders in patients with eating disorders. American Journal of Psychiatry 146, 15851591.Google ScholarPubMed
Gross, J. & Rosen, J. C. (1988). Bulimia in adolescents: prevalence and psychosocial correlates. International Journal of Eating Disorders 7, 5161.3.0.CO;2-Q>CrossRefGoogle Scholar
Gustavson, P. A. & Bjørksten, P. (1993). Family dysfunction in asthma – a prospective study of illness development.Paper presented at the 26.Berzelius Symposium. Linkøping, Sweden.Google Scholar
Halmi, K. A., Falk, J. R. & Schwartz, E. (1981). Binge-eating and vomiting: a survey of a college population. Psychological Medicine 11, 697706.CrossRefGoogle ScholarPubMed
Harter, S. (1988). Manual for the Self-Perception Profile for Adolescents. University of Denver: Denver, Col.Google Scholar
Harding, T. P. & Lachenmeyer, J. R. (1986). Family interaction patterns and locus of control as predictors of the presence and severity of anorexia nervosa. Journal of Clinical Psychology 42, 440448.3.0.CO;2-H>CrossRefGoogle ScholarPubMed
Henderson, H. & Freeman, C. P. L. (1987). A self-rating scale for bulimics. The BITE. British Journal of Psychiatry 150, 1824.CrossRefGoogle Scholar
Herzog, D. B. (1984). Are anorexic and bulimic patients depressed? American Journal of Psychiatry 141, 15941597.Google ScholarPubMed
Holleran, P. R., Pascale, J. & Fraley, J. (1988). Personality correlates of college age bulimics. Journal of Counseling and Development 66, 378381.CrossRefGoogle Scholar
Hsu, L. K. G. & Sobkiewicz, t. A. (1991). Body image disturbance: time to abandon the concept of eating disorders. International Journal of Eating Disorders 10, 1530.3.0.CO;2-I>CrossRefGoogle Scholar
Humphrey, L. L. (1989). Observed family interactions among subtypes of eating disorders using structural analysis of social behaviour. Journal of Consulting and Clinical Psychology 57, 206214.CrossRefGoogle Scholar
International Labour Office (1990). ISCO-88 – International Standard Classification of Occupations. ILO: Geneva.Google Scholar
Jacob, T., Tennenbaum, D. L. & Krahn, G. (1987). Factors influencing the reliability and validity of observation data. In Family Interaction and Psychopathology: Theories, Methods, and Findings (ed. Jacob, T.), (pp. 297328). Plenum Press: New York.CrossRefGoogle Scholar
Johnson, C. & Flack, A. (1985). Family characteristics of 105 patients with bulimia. American Journal of Psychiatry 142, 13211324.Google ScholarPubMed
Jonas, J. M., Gold, M. S., Sweeney, D. & Pottash, A. L. C. (1987). Eating disorders and cocaine abuse: A survey of 259 cocaine abusers. Journal of Clinical Psychiatry 48, 4750.Google ScholarPubMed
Kandel, D. B. & Davies, M. (1982). Epidemiology of depressed mood in adolescents. An empirical study. Archives of General Psychiatry 39, 12051212.CrossRefGoogle Scholar
Kernberg, O. (1975). Borderline Conditions and Pathological Narcissism. Jason Aronson: New York.Google Scholar
Killen, J. D., Taylor, C. B., Telch, M. J., Robinson, T. N., Maron, D. J. & Saylor, K. E. (1987). Depressive symptoms and substance abuse among adolescent binge eaters and purgers: a defined population study. American Journal of Public Health 77, 15391541.CrossRefGoogle ScholarPubMed
King, M. (1988). Eating disorders in a general practice population: prevalence, characteristics and follow-up at 12 to 18 months. Psychological Medicine, suppl. 14.Google Scholar
Lakin, J. A., Steen, S. N. & Oppliger, R. A. (1991). Eating behaviors, weight loss methods and nutrition practices among high school wrestlers. Journal of Community Health Nursing 7, 223233.CrossRefGoogle Scholar
Lavik, N. J., Clause, S. E. & Pedersen, W. (1991). Eating behaviour, drug use, psychopathology and parental bonding in adolescents in Norway. Acta Psychiatrica Scandinavica 84, 387390.CrossRefGoogle ScholarPubMed
Ledoux, S., Choquet, M. and Manfredi, R. (1993). Associated features for self-reported binge eating among male and female adolescents. Journal of Adolescence 16, 7591.CrossRefGoogle Scholar
Magnusson, D., Stattin, H. & Allen, V. L. (1985). Biological maturation and social development: a longitudinal study of some adjustment processes from mid-adolescence to adulthood. Journal of Youth and Adolescence 14, 267283.CrossRefGoogle Scholar
Marrazzi, M. A. & Luby, E. D. (1986). An auto-addiction opoid model of chronic anorexia nervosa. International Journal of Eating Disorders 5, 191208.3.0.CO;2-I>CrossRefGoogle Scholar
Minuchin, S., Rosman, B. L. & Baker, L. (1978). Psychosomatic Families. Anorexia Nervosa in Context. Harvard University Press: Cambridge, Mass.CrossRefGoogle Scholar
Mumford, D. B., Whitehouse, A. M. & Platts, M. (1991). Sociocultural correlates of eating disorders among asian schoolgirls in Bradford. British Journal of Psychiatry 158, 222228.CrossRefGoogle Scholar
Nylander, I. (1971). The feeling of being fat and dieting in a school population: epidemiologic, interview investigation. Acta Socimedica Scandinavia 3, 1726.Google Scholar
Orbach, S. (1978). Fat is a Feminist Issue. Berkley: New York.Google Scholar
Owens, R. G. & Slade, P. D. (1987). Running and anorexia nervosa: an empirical study. International Journal of Eating Disorders 6, 771775.3.0.CO;2-V>CrossRefGoogle Scholar
Parker, G., Tupling, H. & Brown, L. B. (1979). A parental bonding instrument. British Journal of Medical Psychology 52, 110.CrossRefGoogle Scholar
Patton, G. C. (1988). The spectrum of eating disorder in adolescence. Journal of Psychosomatic Research 32, 579598.CrossRefGoogle ScholarPubMed
Paxton, S. J., Wertheim, E. H., Gibbons, K., Szmuckler, G I., Hillier, L. & Petrovich, J. L. (1991). Body image satisfaction, dieting beliefs, and weight loss behaviors in adolescent girls and boys. Journal of Youth and Adolescence 20, 361379.CrossRefGoogle ScholarPubMed
Petersen, A. C. & Crockett, L. (1985). Pubertal timing and grade effects on adjustment. Journal of Youth and Adolescence 14, 191206.CrossRefGoogle ScholarPubMed
Pole, R., Waller, D. A., Stewart, S. M. & Parkin-Feigenbaum, L. (1988). Parental carving vs. overprotection in bulimia. International Journal of Eating Disorders 7, 601606.3.0.CO;2-8>CrossRefGoogle Scholar
Pope, H. G., Champoux, R. F. & Hudson, J. I. (1987). Eating disorder and socioeconomic class. Anorexia and bulimia in nine communities. Journal of Nervous and Mental Disease 175, 620623.CrossRefGoogle ScholarPubMed
Rastam, M. & Gillberg, C. (1991) The family background in anorexia nervosa: a population based study. Journal of the American Academy of Child and Adolescent Psychiatry 30, 283289.CrossRefGoogle ScholarPubMed
Rosenberg, M. (1979). Conceiving the Self. Basic Books: New York.Google Scholar
Rost, W., Neuhans, M. & Florin, I. (1982). Bulimia nervosa: sex role attitude, sex role behavior, and sex role-related locus of control in bulimiarcxic women. Journal of Psychosomatic Research 26, 403408.CrossRefGoogle ScholarPubMed
Russell, J. D., Kopec-Schrader, E., Rey, J. M. & Beumont, P. J. V. (1992). The Parental Bonding Instrument in adolescent patients with anorexia nervosa. Acta Psychiatrica Scandinavica 86, 236239.CrossRefGoogle ScholarPubMed
Schuessler, K. F. (1982). Measuring Social Life Feelings. Jossey-Bass: San Francisco.Google Scholar
Scott, D. (1983). Alcohol and food abuse: some comparison. British Journal of Addiction 78, 339349.CrossRefGoogle Scholar
Shedler, J. & Block, J. (1990). Adolescent drug use and psychological health. American Psychologist 45, 612630.CrossRefGoogle ScholarPubMed
Selvini-Paluzzoli, M. (1974). Self-starvation: From Individuation to Family Therapy in the Treatment of Anorexia Nervosa. Aronson: New York.Google Scholar
Silbereisen, R. K. & Noack, P. (1988). On the constructive role of problem behaviour in adolescence. In Person in Context (ed. Bolger, N.), pp. 152180. Cambridge University Press: Cambridge.Google Scholar
Silverstone, P. H. (1990). Low self-esteem in eating disordered patients in the absence of depression. Psychological Reports 67, 276278.CrossRefGoogle Scholar
Slade, P. D. (1985). A review of body-image studies in anorexia nervosa and bulimia nervosa. Journal of Psychiatric Research 19, 255–26.CrossRefGoogle ScholarPubMed
Slade, P. D., Dewey, M. E., Kiemle, G. & Newton, T. (1990). Update on SCANS: a screening instrument for identifying individuals at risk for developing an eating disorder. International Journal of Eating Disorders 9, 583584.3.0.CO;2-A>CrossRefGoogle Scholar
Striegel-More, R., Silberstein, L. & Rodin, L. (1986). Towards an understanding of risk factors for bulimia. American Psychologist 41, 246263.CrossRefGoogle Scholar
Tobin-Richards, M. H., Boxer, A. M. & Petersen, A. C. (1983). The psychological significance of pubertal change: sex differences in perceptions of self during early adolescence. In Girls at Puberty: Biological and Psychosocial Perspectives (ed. Brooks-Gunn, J. and Petersen, A. C.), pp. 127154. Plenum Press: New York.CrossRefGoogle Scholar
Waller, G., Calam, R. & Slade, P. (1989). Eating disorders and family interaction. British Journal of Clinical Psychology 28, 285286.CrossRefGoogle ScholarPubMed
Weight, L. M. & Noakes, T. D. (1987). Is running an analogue of anorexia? A survey of the incidence of eating disorders in female distance runners. Medical Science and Sports Exercise 19, 213217.Google Scholar
Wells, J. E., Coope, P. A., Gabb, D. C. & Pears, R. K. (1985). The factor structure of the Eating Attitude Test with adolescent schoolgirls. Psychological Medicine 15, 141146.CrossRefGoogle ScholarPubMed
Whitaker, A., Davies, M., Shaffer, D., Johnson, J., Abrams, S., Walsh, B. T. & Kalikov, K. (1989). The struggle to be thin: a survey of anorexic and bulimic symptoms in a non-referred adolescent population. Psychological Medicine 19, 143163.CrossRefGoogle Scholar
Wichstrøm, L. & Kvernmo, S. (1994). The Young in Finnmark Study. Unpublished raw data. The Research Council of Norway's Centre for Youth Research: Oslo.Google Scholar
Willi, J. G., Giacometti, G. & Limacher, B. (1990). Update on the epidemiology of anorexia nervosa in a defined region in Switzerland. American Journal of Psychiatry 147, 15141517.Google Scholar
Williams, P., Hand, D. & Tarnopolsky, A. (1982). The problem of screening for uncommon disorders – a comment on the Eating Attitudes Test. Psychological Medicine 12, 431434.CrossRefGoogle ScholarPubMed
Williamson, D. A., Kelley, M. L., Davis, C. J., Ruggiero, L. & Blouin, D. C. (1985). Psychopathology of eating disorders: A controlled comparison of bulimic, obese, and normal subjects. Journal of Consulting and Clinical Psychology 53, 161166.CrossRefGoogle ScholarPubMed
Yates, A. J., Leehay, K. & Shisslak, C. M. (1983). Running – an analogue of anorexia? New England Journal of Medicine 308, 251255.CrossRefGoogle ScholarPubMed
Yates, W. R., Sieleni, B., Reich, J. & Brass, C. (1989). Comorbidity of bulimia nervosa and personality disorder. Journal of Clinical Psychiatry 50, 5759.Google ScholarPubMed
Zweben, J. E. (1987). Eating disorders and substance abuse. Journal of Psychoactive Drugs 19, 181192.CrossRefGoogle ScholarPubMed