Detección de adolescentes en riesgo de presentar trastornos de la alimentación

ObjetivoAnalizar qué factores se asocian con el riesgo de presentar un trastorno de la conducta alimentaria (TCA) e identificar preguntas útiles para su detección precoz en atención primaria.DiseñoObservacional, transversal.EmplazamientoSeis centros de enseñanza de Leganés (Madrid).ParticipantesAdolescentes escolarizados de 12 a 18 años.Mediciones principalesRiesgo de presentar TCA (Eating Attitudes Test-26) y cuestionario sobre peso, talla y composición familiar, actitudes hacia la imagen corporal, el uso de servicios de salud relacionados con los TCA y antecedentes de trastorno mental.ResultadosEl 8,8% de los adolescentes está en riesgo de presentar un TCA (un 4,6% de varones y un 11,8% de mujeres). Destaca la asociación del riesgo de TCA con la edad de los varones (odds ratio [OR] = 0,76) y haber ayunado 24 h para perder peso (OR en varones = 7,44; OR en mujeres = 3,09). En las mujeres se asocia con la menarquia temprana (OR = 1,69), haber hecho dieta bajo la influencia de factores socioambientales y autoprovocarse el vómito (OR = 5,71). Preguntar respecto a los vómitos autoprovocados y al ayuno de 24 h para detectar TCA posee una especificidad y un valor predictivo negativo en torno al 95%.ConclusionesLa edad protege del riesgo de presentar TCA, más claramente en varones. En mujeres, la menarquia temprana es un factor de riesgo. Interrogar sobre los vómitos autoprovocados y el ayuno de 24 h permite descartar el TCA en mujeres.

ObjectivesTo analyse which risk factors are related to eating disorders and to identify useful questions for their early detection in primary care.DesignObservational, cross-sectional study.SettingSix secondary schools in Leganés, Madrid, Spain.ParticipantsAdolescents aged between 12 and 18 years old attending secondary school.Main measurementsRisk of suffering an eating disorder (Eating Attitudes Test-26) and questions about weight, height, family, attitudes towards body image, use of health services for eating disorders, and mental illness history.ResultsAn 8.8% of the adolescents were at risk of developing an eating disorder (4.6% male; 11.8% female). Age in males (OR=0.76) and 24-hour fasting to lose weight (OR for males =7.44; OR for females =3.09) were associated with the risk of eating disorders. Early menarche (OR=1.69), having dieted for social or environmental reasons, and self-induced vomiting (OR=5.71) were associated with eating disorders in women. The specificity and negative predictive value of asking about self-induced vomiting and 24-hour fasting in order to detect an eating disorder were around 95%.ConclusionsAge is a protective factor for eating disorders, especially in males. In women, early menarche is a risk factor. Asking about self-induced vomiting and 24-hour fasting enables eating disorders in women to be ruled out.