Drive for thinness in adolescents predicts greater adult BMI in the Growth and Health Study cohort over 20 years

OBJECTIVE: In youth, a preoccupation with weight and the desire to be thinner, or drive for thinness, might persist into adulthood and predict reward-based compulsive eating and greater weight status. METHODS: A total of 623 women were enrolled from a prospective cohort study starting at 10 years old and assessed up to 20 years later. Drive for thinness was measured five times during adolescence. In adulthood (mean age = 39.5), drive for thinness, reward-based eating drive, and BMI were measured. RESULTS: Structural equation modeling found cumulative adolescent drive for thinness predicted higher scores for both adult drive for thinness and reward-based eating drive. Youth drive for thinness was not directly associated with adult BMI but rather indirectly through adult drive for thinness. Reward-based eating drive was not associated with adult BMI. CONCLUSIONS: Drive for thinness during the critical developmental years may exert long-term effects on adulthood eating behaviors tied to greater weight gain, potentially reflecting an important early target of intervention.