Early puberty and early sexual activity are associated with bulimic-type eating pathology in middle adolescence

Purpose: To examine the associations between early pubertal timing and early advanced sexual development with bulimic-type eating pathology in middle adolescents. Methods: A total of 19,321 boys and 19,196 girls aged 14-16 years (mean age 15.3 years, standard deviation 0.59) responded to the School Health Promotion Study, a class-room survey among Finnish adolescents about health, health behavior, and school experiences. Bulimic-type eating pathology was assessed with a questionnaire formulated according to the fourth edition of the Diagnostic and Statistical Manual for Mental Disorders IV (DSM-IV) criteria. Pubertal timing was assessed by self-reported age at menarche or oigarche. Statistical methods were used chi-square and logistic regression. Results: Bulimic-type eating pathology among girls was associated with early menarche, early sexual experiences, and increasing age. Among boys, onset of ejaculations at the normative age was protective for bulimic-type eating pathology, and the risk was elevated among very early and late maturers. Early sexual experience was associated with bulimic-type eating pathology. Conclusion: To prevent bulimia nervosa and to create opportunities for early intervention, attention should be paid to early maturing girls and off-time maturing boys, as well as those with early onset of sexual activity. (C) Society for Adolescent Medicine, 2001.