Endometriosis risk varies between purging behaviours and binge eating among teens

Adolescents with self-induced vomiting appear to have a higher likelihood of subsequent endometriosis diagnosis, whereas those with binge eating have a lower likelihood, as shown in a study.

The study included 11,773 female participants from the Growing Up Today Study (1996–2021). Frequency of binge eating, laxative use, and self-induced vomiting over the past year was self-reported on repeated questionnaires during follow-up. The main outcome was physician-diagnosed endometriosis, which was also self-reported.

Over 25 years of follow-up, endometriosis occurred in 269 participants (2.3 percent), 190 of which were laparoscopically confirmed. Thirty-two percent of participants had a history of binge eating, 14 percent had a history of self-induced vomiting to lose weight, and 9 percent had a history of using laxatives to lose weight.

Participants who cumulatively reported self-induced vomiting more than monthly during follow-up had a more than threefold greater odds of a laparoscopically confirmed endometriosis diagnosis compared with those who had no such history (adjusted odds ratio [aOR], 3.07, 95 percent confidence interval [CI], 1.74–5.40).

Similarly, participants who reported weekly or more frequent self-induced vomiting at least once during follow-up had higher odds of a laparoscopically confirmed endometriosis diagnosis compared with those who reported never vomiting (aOR, 2.41, 95 percent CI, 1.40–4.12).

Cumulative exposure to binge eating during follow-up was not associated with laparoscopically confirmed endometriosis. However, the odds were 52 percent lower among participants who reported the highest ever engagement in binge eating of weekly or more vs those who reported less than weekly binge eating (aOR, 0.47, 95 percent CI, 0.25–0.90).

Laxative use showed no strong association with endometriosis diagnosis.