# Eating disorder symptoms are prospectively associated with higher BMI percentile in male early adolescents

## TL;DR

The study finds that eating disorder symptoms in early male adolescents are linked to higher BMI percentile increases over one year.

## Contribution

The study reveals sex-specific associations between eating disorder symptoms and BMI changes in early adolescence.

## Key findings

- Binge eating symptoms in males were significantly linked to higher BMI percentile increases.
- Fear of weight gain in males was strongly associated with increased BMI percentile.
- Many eating disorder symptom associations were significant only in males, not in the overall sample.

## Abstract

To investigate sex differences in prospective associations between eating disorder (ED) symptoms and changes in body mass index (BMI) percentile in early adolescence.

This prospective study used survey data from 7111 participants aged 10–12 years at Year 1 from the Adolescent Brain Cognitive Development (ABCD) Study—a diverse, national sample of adolescents from 21 sites across the United States (US). Multivariable linear regression models were used to assess the prospective associations between ED symptoms at Year 1 and BMI percentile at Year 2, adjusting for covariates and BMI percentile at Year 1. Effect moderation was explored in sex-stratified models.

Sex modified the relationship between ED symptoms and changes in BMI percentile. Having binge eating symptoms (B = 3.65, 95% CI 1.80–5.51, p <0.001), distress related to binge eating (B = 2.79, 95% CI 0.05–5.53, p = 0.046), inappropriate compensatory behaviors (B = 6.39, 95% CI 2.16–10.62, p = 0.005), and fear of weight gain (B = 5.26, 95% CI 3.18–7.33, p < 0.001) at Year 1 were significantly associated with higher BMI percentile at Year 2 among males. In the overall sample, distress related to binge eating (B = 2.09, 95% CI 0.40–3.69, p = 0.017) was significantly associated with a higher BMI percentile 1 year later; the interaction by sex was not statistically significant.

ED symptoms were associated with higher BMI percentiles 1 year later in early adolescents, although sex-stratified findings revealed that many associations were significant only for males. Clinicians caring for early adolescents should consider evaluating for ED symptoms as potential risk factors for elevated weight.

Level III: Evidence obtained from well-designed cohort or case–control analytic studies.

The online version contains supplementary material available at 10.1007/s40519-026-01824-w.