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Risk of eating disorders, changes in salivary cortisol concentrations and nutritional status of adolescents

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Eating and Weight Disorders - Studies on Anorexia, Bulimia and Obesity Aims and scope Submit manuscript

Abstract

Purpose

The imposition of the thin body as an ideal of beauty and the changes that occur in adolescence lead to a constant concern with adolescents’ body weight, putting them at risk for eating disorders. Thus, the study sought to investigate associations between eating disorders and salivary cortisol concentrations, nutritional status and depressive symptoms in female adolescents with bulimia.

Methods

A cross-sectional study was carried out with 1435 adolescents aged 10–19 years. The Bulimic Investigatory Test of Edinburgh (BITE) and Body Shape Questionnaire (BSQ) questionnaires were used. A follow-up study was conducted from a random selection of female adolescents diagnosed with Bulimia Development and Well-Being Assessment—(DAWBA) to assess associations with salivary cortisol concentrations and nutritional status.

Results

The prevalence of body dissatisfaction among adolescents with symptoms of bulimia was 37%. There was a significant difference between salivary cortisol and bulimia (Risk Group = 0.33 ± 0.20 μg/100 ml, Diagnostic Group = 0.44 ± 0.21 μg/100 ml p = 0.040), and correlation positive between the risk of bulimia with symptoms of depression (0.355 p = 0.002) and with Body Mass Index (0.259 p = 0.028). High concentrations of salivary cortisol in bulimic adolescents may be associated with hyperactivity of the hypothalamic–pituitary–adrenal axis and depressive symptoms.

Conclusions

Nutritional status indicators cannot be used alone for the diagnosis of bulimia, since cortisol levels seem to be a reliable parameter in the identification of bulimia, provided they are used with other diagnostic criteria.

Level III

Evidence obtained from cross-sectional study.

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Data availability

All data and materials support the published statements and meet field standards.

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Acknowledgements

The authors are grateful to the Coordenação de Aperfeiçoamento de Pessoal de Nível Superior -Brazil (CAPES) for funding this study, the researchers of the Eating Behavior Group of the Federal University of Pernambuco (UFPE) and the adolescents who participated in the study.

Funding

This study was financed in part by the Coordenação de Aperfeiçoamento de Pessoal de Nível Superior-Brazil (CAPES).

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Authors and Affiliations

  1. Graduate Program in Neuropsychiatry and Behavioral Sciences, Federal University of Pernambuco (UFPE), Av. da Engenharia, 186-298 - Cidade Universitária, Recife, Pernambuco, 50740-600, Brazil

    Laércio Marques da Luz Neto, Tiago Coimbra Costa Pinto, Everton Botelho Sougey, Weslley Álex da Silva Dionisio, Alisson Vinicius dos Santos & Rosana Christine Cavalcanti Ximenes

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  1. Laércio Marques da Luz Neto
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  2. Tiago Coimbra Costa Pinto
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  3. Everton Botelho Sougey
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  4. Weslley Álex da Silva Dionisio
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  5. Alisson Vinicius dos Santos
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  6. Rosana Christine Cavalcanti Ximenes
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Contributions

All authors made substantial contributions to the preparation of this study. LM da LN: responsible for the project design and planning, supervision of research execution, data acquisition and manuscript writing. TCCP: responsible for the idealization and planning of the project and supervised execution of the research. EBS responsible for designing and planning the project, supervising the execution of the survey, data interpretation and statistical analysis. WÁ da SD responsible for writing the manuscript. AV dos S responsible for writing the manuscript. RCCX responsible for data interpretation, statistical analysis and manuscript writing.

Corresponding author

Correspondence to Weslley Álex da Silva Dionisio.

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Conflict of interest

The authors declare no competing financial and non-financial interests.

Ethical approval

This study was approved by the Institutional Review Board/Research Ethics Committee of the Federal University in Pernambuco, Brazil.

Consent to participate

As these were adolescents, the consent of the guardians was collected together with the consent of the young people before the application of assessment instruments.

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All authors contributed to the critical review of the manuscript and gave their final approval for the publication of the manuscript.

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da Luz Neto, L.M., Pinto, T.C.C., Sougey, E.B. et al. Risk of eating disorders, changes in salivary cortisol concentrations and nutritional status of adolescents. Eat Weight Disord 27, 2415–2423 (2022). https://doi.org/10.1007/s40519-022-01382-x

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