A latent class analysis to empirically describe eating disorders through developmental stages

Int J Eat Disord. 2014 Nov;47(7):762-72. doi: 10.1002/eat.22308. Epub 2014 Jun 9.


Objectives: The current standards for classifying eating disorders were primarily informed by adult, clinical study populations, while it is unknown whether an empirically based classification system can be supported across preadolescence through young adulthood. Using latent class analyses, we sought to empirically classify disordered eating in females from preadolescence to young adulthood, and assess the association between classes and adverse outcomes.

Method: Latent class models were fit using observations from the 9,039 girls participating in the growing up today study, an on-going cohort following participants annually or biennially since 1996 when they were ages 9-14 years. Associations between classes and drug use, binge drinking, and depressive symptoms were assessed using generalized estimating equations.

Results: Across age groups, there was evidence of six classes: a large asymptomatic class, a class characterized by shape/weight concerns, a class characterized by overeating without loss of control, and three resembling full and subthreshold binge eating disorder, purging disorder, and bulimia nervosa. Relative prevalences of classes varied across developmental stages, with symptomatic classes increasing in prevalence with increasing age. Symptomatic classes were associated with concurrent and incident drug use, binge drinking, and high depressive symptoms.

Discussion: A classification system resembling broader definitions of DSM-5 diagnoses along with two further subclinical symptomatic classes may be a useful framework for studying disordered eating among adolescent and young adult females.

Keywords: binge eating disorder; classification; eating disorder; eating disorder not otherwise specified; latent class analysis; purging disorder.

Publication types

  • Research Support, N.I.H., Extramural

MeSH terms

  • Adolescent
  • Adult
  • Binge-Eating Disorder / classification
  • Binge-Eating Disorder / psychology
  • Body Weight
  • Child
  • Depression / psychology
  • Feeding and Eating Disorders / classification
  • Feeding and Eating Disorders / psychology*
  • Female
  • Humans
  • Hyperphagia / classification
  • Hyperphagia / psychology
  • Prevalence
  • Substance-Related Disorders / psychology
  • Young Adult