Disordered eating behaviours and attitudes among adolescents in a middle-income country

  • Abigail N. HarrisonEmail author
  • Caryl C. B. James Bateman
  • Novie O. M. Younger-Coleman
  • Michelle C. Williams
  • Kern D. Rocke
  • Stephanie C. Clato-Day Scarlett
  • Susan M. Chang
Original Article



Adolescent-disordered eating behaviours and attitudes (DEBA) are noted to be increasing in prevalence internationally. The aim of this study was to explore the DEBAs among Jamaican adolescents and identify those adolescents most at risk.


521 high school participants (females, n = 292), ages 11–19 years, completed measures assessing socio-demographic factors, self-esteem, symptoms of anxiety and depression, behavioural factors, and anthropometry. Weight-related behaviours and attitudes were explored using the Eating Attitudes Test (EAT-26).


Thirty-one percent of participants reported engaging in at least one disordered eating behaviour, with bingeing as the most common. Female participants had significantly higher mean body mass index (p < 0.01) and mean EAT-26 score (p < 0.05) compared to males. Adolescents with EAT-26 score ≥ 20 were more desirous of being thinner (p < 0.01) and having a lighter skin complexion (p < 0.05). A greater proportion of adolescents with an EAT-26 score ≥ 20 had engaged in self-harm (p < 0.05), had smoked cigarettes (p < 0.05), had been sexually active (p < 0.01), and gave a history of sexual abuse (p < 0.01). Adolescents with overweight/obesity reported higher use of chemical weight manipulation (laxatives, diuretics, and diet pills) (p = 0.01).


Our data are consistent with the global figures showing both male and female adolescents endorsing disordered eating behaviours and attitudes (DEBAs). While this study highlights weight and shape dissatisfaction and associated DEBAs, it also raises the concern of an association with skin bleaching and elevated EAT-26 scores among Jamaican adolescents.

Level of evidence

Level V: cross-sectional descriptive study.


Adolescents Body dissatisfaction Developing country Feeding and eating disorders Skin bleaching 



This study was funded by the Caribbean Public Health Agency (CARPHA). The authors also thank the school administrators and student participants for their cooperation and help in making this study possible.

Compliance with ethical standards

Conflict of interest

The authors declare that they have no conflicts of interest.

Ethical approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and national research committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards.

Informed consent

Informed consent was obtained from all individual participants included in the study.


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Copyright information

© Springer Nature Switzerland AG 2019

Authors and Affiliations

  • Abigail N. Harrison
    • 1
    Email author
  • Caryl C. B. James Bateman
    • 2
  • Novie O. M. Younger-Coleman
    • 3
  • Michelle C. Williams
    • 1
  • Kern D. Rocke
    • 3
  • Stephanie C. Clato-Day Scarlett
    • 1
  • Susan M. Chang
    • 3
  1. 1.Department of Child and Adolescent Health, Faculty of Medical SciencesUniversity of the West Indies (UWI)MonaJamaica
  2. 2.Department of Sociology, Psychology and Social Work, Faculty of Social SciencesUWIMonaJamaica
  3. 3.Caribbean Institute for Health Research (CAIHR), UWIMonaJamaica

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