Original article
Body Image Dissatisfaction and the Adrenarchal Transition

https://doi.org/10.1016/j.jadohealth.2018.05.025Get rights and content

Abstract

Background

Puberty marks a transition in risk for body image disturbance and disordered eating. Yet few studies have examined these symptoms across puberty and none have examined links with adrenarche, the earliest phase in the pubertal hormonal cascade.

Method

Levels of adrenal androgens (dehydroepiandrosterone, dehydroepiandrosterone sulphate, and testosterone) were measured in a population-based study of 8- to 9-year-old children (516 males and 621 females). Body dissatisfaction was measured using the Kids’ Eating Disorder Scale Silhouettes. Covariates included body mass index, age, and socioeconomic status.

Results

There were significant associations between adrenal androgen levels and greater body dissatisfaction in both males and females. Specifically, females with more advanced levels of dehydroepiandrosterone and testosterone relative to peers, and males with more advanced levels of testosterone relative to peers, reported greater body dissatisfaction. However, after adjusting for covariates, hormones levels were no longer associated with body dissatisfaction, and only higher body mass index had a clear association with body dissatisfaction.

Conclusions

The adrenarchal transition brings a heightened risk for body dissatisfaction. Whether this arises from the neuroendocrine effects of adrenal androgens or as a reaction to the greater body mass that accompanies adrenarche requires further exploration.

Section snippets

Participants and procedure

Participants were drawn from the first wave of the Childhood to Adolescence Transition Study, a longitudinal study of health and wellbeing across the pubertal transition. A full study protocol for Childhood to Adolescence Transition Study has been published [23]. In brief, a stratified random sample was selected comprising 43 primary schools (Government, Catholic, and Independent strata) in metropolitan Melbourne, Australia. All grade three students (fourth year of formal schooling) were

Results

Of the 1,239 children recruited, 73 were excluded because they did not have at least one adrenal hormone measure, 14 were excluded due to missing body dissatisfaction or covariate measures, and 15 were excluded because they were outside the 8–9 year age range. All participants within the age range were included regardless of self- or parent-reported maturation status. The final sample comprised 1,137 (92%) participants, consisting of 621 females and 516 males with a mean age of 8.97years

Discussion

Children who were more advanced in adrenarche compared to peers had higher rates of body image dissatisfaction. Specifically, females with more advanced levels of DHEA and testosterone relative to peers, and males with more advanced levels of testosterone relative to peers, reported greater body dissatisfaction. However, after the inclusion of covariates, only BMI was significantly associated with body dissatisfaction. Given data used for these analyses were cross-sectional, it is not possible

Acknowledgments

We would like to thank all of the families and schools who participated in this study, and the staff and volunteers involved in data collection and processing at the Centre for Adolescent Health and MCRI.

Financial Support

This research was supported by a project grant from Australia's National Health and Medical Research Council (NHMRC #1010018). MCRI research is supported by the Victorian Government's Operational Infrastructure Program. Dr Hughes is supported by a grant from the Baker Foundation. Dr Mundy is partially supported by a grant from the Invergowrie Foundation. Professor Wake is supported by a NHMRC Senior Research Fellowship (#1046518). Professor Patton is supported by a NHMRC Senior Principal

References (40)

  • F McNicholas et al.

    The impact of self-reported pubertal status and pubertal timing on disordered eating in Irish adolescents

    Eur Eat Disord Rev

    (2012)
  • Ullsperger JM, Nikolas MA. A meta-analytic review of the association between pubertal timing and psychopathology in...
  • Abraham S, Boyd C, Lal M, et al. Time since menarche, weight gain and body image awareness among adolescent girls:...
  • RH Striegel-Moore et al.

    Exploring the relationship between timing of menarche and eating disorder symptoms in black and white adolescent girls

    Int J Eat Disord

    (2001)
  • KP Harden et al.

    Descriptive review: Hormonal influences on risk for eating disorder symptoms during puberty and adolescence

    Int J Eat Disord

    (2014)
  • KL Klump et al.

    Preliminary evidence that estradiol moderates genetic influences on disordered eating attitudes and behaviors during puberty

    Psychol Med

    (2010)
  • EA Crone et al.

    Understanding adolescence as a period of social-affective engagement and goal flexibility

    Nat Rev Neurosci

    (2012)
  • S Shapiro et al.

    Fear of fat, disregulated-restrained eating, and body-esteem: Prevalence and gender differences among eight- to ten-year-old children

    J Clin Child Psychol

    (1997)
  • LD Dorn et al.

    Puberty and its measurement: A decade in review

    J Res Adol

    (2011)
  • IM Goodyer et al.

    Possible role of cortisol and dehydroepiandrosterone in human development and psychopathology

    Br J Psychiatry

    (2001)
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    Conflicts of interest: The authors report no financial interests or potential conflicts of interest.

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