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Examining the association between onset and timing of puberty and risk of disordered eating behaviours and body dissatisfaction in young women


   Bristol Medical School

  , ,  Applications accepted all year round  Self-Funded PhD Students Only

About the Project

Rationale
Puberty is a key period for the onset of eating disorders and girls are at greater risk than boys (Klump, 2013; Harden et al. 2014. There is evidence that menarche is a risk factor for eating disorders, possibly due to associated increases in body weight (Abraham et al. 2009). There is also some evidence that girls who experience menarche earlier than their peers are at greater risk of eating disorders, but this finding is not consistent (see Klump 2013 for a review of these studies). Limitations of earlier research include cross-sectional study design, small sample sizes and inadequate adjustment for confounders. They have focussed on onset-of-menarche as a marker of puberty, whereas this project would use a range of measures to establish pubertal timing, including age at Peak Height Velocity (i.e. adolescent growth spurt). Previous work has also focussed on diagnosed eating disorders, whereas developing a better understanding of disordered eating behaviours across the spectrum may help us to prevent eating disorders more effectively. The project will go on to assess whether age at menarche is causally associated with disordered eating, using Mendelian Randomisation.

Aims & Objectives
The aim of this project is to use Avon Longitudinal Study of Parents and Children (ALSPAC) data to increase understanding of the association between puberty and eating disorders. The project will examine the following research questions:
(i) Does the risk of eating disorders and disordered eating behaviour increase following puberty?
(ii) Do girls who go through puberty earlier than their peers have an increased risk of disordered eating behaviours?
(iii) Is there a causal relationship between age at menarche and increases in disordered eating behaviour?

Methods
1. Review the literature on eating disorders and the relationship with pubertal development and identify potential confounders.
2. Obtain relevant data from ALSPAC dataset.
3. Conduct multivariable regression analysis examining the research questions. Exposure variables: time since menarche, timing of menarche (categorical: early, normative, late) and continuous (age at menarche), age at Peak Height Velocity.
Outcome variables: Self-reported disordered eating and body dissatisfaction at ages 14, 16, 18 and 24 years.
4. Use Mendelian Randomisation analysis to improve causal inference by using genetic variants that are robustly associated with timing of menarche to explore causal effects on disordered eating.

References

Klump KL. Puberty as a Critical Risk Period for Eating Disorders: A Review of Human and Animal Studies. Horm Behav. 2013; 64(2): 399–410.

Harden KP, Kretsch N, Moore SR, Mendle J. Descriptive review: hormonal influences on risk for eating disorder symptoms during puberty and adolescence. Int J Eat Disord. 2014;47(7):718-26.

Abraham S, Boyd C, Lal M, Luscombe G, Taylor A. Time since menarche, weight gain and body image awareness among adolescent girls: onset of eating disorders? J Psychosom Obstet Gynaecol. 2009;30(2):89-94.


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