It is unfortunate that Jennifer Jones and colleagues1 did not discuss the results of 2 previously published surveys of maladaptive eating attitudes among school-aged Canadians. In 1982 my colleagues and I surveyed 5150 male and female students aged 12 to 20 years, using the original 40-question Eating Attitudes Test (EAT-40).2 Of the 2404 female students we surveyed, 22.3% scored 30 or above on the EAT-40, suggesting that they had significant concerns about their weight and exhibited maladaptive eating behaviours. When this information is combined with self-reported weights, it can be speculated that close to 1% of these female students could have been suffering from anorexia nervosa and 6% from bulimia nervosa. High EAT scores were dramatically more common for students older than 12 years than for younger girls, a finding that is similar to the results of Jones and colleagues.
In 1993, we surveyed francophone and anglophone students in the urban Montreal region using the EAT-26 questionnaire.3 Of the 181 female students aged 11 to 18 years, 14.2% scored 20 and above, which matches the results reported by Jones and colleagues. This suggests that the prevalence of disordered eating attitudes and behaviours has not increased, but neither has it decreased.
Despite increased awareness among health care workers and the public of the dangers of dieting, girls continue to value thinness. We have traditionally associated this attitude with the values of Western culture. However, a recent study in Iran that showed a similar prevalence of disordered eating attitudes challenges this assumption.4 Could it be that self-induced emaciation is in fact common among women around the globe and related to more universal stresses such as inequities in social power and poverty rather than a fear of fat? This possibility adds support to the recommendation by Jones and colleagues that prevention programs should target self-esteem and encourage girls to express their thoughts and feelings.
References
- 1.Jones JM, Bennett S, Olmsted MP, Lawson ML, Rodin G. Disordered eating attitudes and behaviours in teenaged girls: a school-based study. CMAJ 2001;165(5):547-52. [PMC free article] [PubMed]
- 2.Leichner P, Arnett J, Rallo J, Srikameswaran S, Vuliano B. An epidemiologic study of adaptive eating attitudes in the Canadian school age population. Int J Eat Disord 1986;5(6):969-85.
- 3.Leichner P, Steiger H, Puentes-Neuman G, Perreault M, Gottheil N. Validation d'une échelle d'attitudes alimentaires auprès d'un population québecois francophone. Can J Psychiatry 1994; 39:49-54. [DOI] [PubMed]
- 4.Abdollahi P, Mann T. Eating disorder symptoms and body image concerns in Iran: comparisons between Iranian women in Iran and in America. Int J Eat Disord 2001;30(3):259-68. [DOI] [PubMed]