Puberty and Eating Disorders- The Perfect Storm

Puberty sucks. Let’s just get that out of the way. Your body is changing, sprouting breasts and zits at the most inopportune of times. The angst of being more or less “developed” than your friends (hello, locker room comparisons!) is difficult. Then there are the psychosocial changes. Your peer relations grow much more complicated, you are expected to juggle more tasks, to figure out who you are. None of this is easy.

Mostly, researchers thought that the onset of EDs at around the time of puberty was due to psychosocial factors: not wanting to grow up, finding peer relations too complicated, the increase in body awareness and dissatisfaction. No one doubts that these can be significant factors in the development of EDs, especially if puberty tends to happen slightly earlier than average. But there’s also something about the chemical and hormonal changes of puberty that alter a person’s risk of developing an eating disorder.

In a recent paper in Hormones and Behavior, Kelly Klump reviewed what we know about puberty, eating disorders, and disordered eating. Especially in females, the surge of sex hormones seems to activate underlying genetic risk factors and alter neurochemistry. Although researchers still aren’t sure exactly what is going on, they are collecting a vast body of evidence that puberty is a particularly high risk period for EDs.

What happens at puberty?

First off, I should probably clarify things about what hormones are and what they do. Below, in all of its splendor, is estradiol, one of the estrogens (there are three: estriol, estradiol, and estrone):

estradiol

Estradiol. Image courtesy Wikimedia Commons

Ask Hollywood, and estrogen is one of those magic chemicals that make women weep at Hallmark commercials. Well, no. A slightly more accurate example is that estrogen is responsible for secondary sex characteristics in females. Okay, yes, but how does estrogen do that? Estrogens are produced by the ovaries and by adipose tissue, and they are secreted into the blood stream and travel to cells throughout the body that have receptors for them. No receptor, and it’s as if the estrogen is locked out of the house. If the cell does have a receptor, the estrogen enters the cell and heads to the nucleus. Once in the nucleus, it serves to switch genes on and off. Breast cells have estrogen receptors, and so do our brain cells. Estrogen helps to control neurotransmitter production–which can explain why some women get weepy before their periods (others of us get cranky and mean, but that’s another story).

The risks of a variety of neuropsychiatric disorders increase during puberty, of which eating disorders are only one. The prevalence of anxiety and depression appear to increase during puberty, especially in girls (Cyranowski et al., 2001). Researchers also found that early puberty and going through puberty more rapidly was associated with later anxiety and depression (Marceau et al., 2011)

In terms of ED risk, there appear to be a number of factors at work during this time period. For one, Klump found that many ED sufferers (especially those with BN and EDNOS) report showing signs of puberty at an earlier age and/or being more developed than their peers. This could obviously lead to teasing, discomfort with one’s body (especially when your friends are still sticks), and generally negative social comparisons that then lead to disordered eating. There could also be something more related to hormone exposure at an earlier age, but no one has really tested that, although there are relationships between estradiol levels and ED symptoms, but I’ll get to that later.

Klump herself also used twin studies to look at how puberty affects disordered eating (Culbert et al., 2009). Klump and colleagues looked at a set of 656 female twins, who they followed from birth through young adulthood as part of the Minnesota Twin Family Study and the Michigan State University Twin Registry. The researchers assessed for ED symptoms when the girls were between the ages of 10-15, and again when they were young adults. They found that, for twins that hadn’t yet showed signs of puberty, genetics explained very little of why some of these twins had high levels of disordered eating and the others didn’t. Instead, both individual and broader environmental factors seemed to dominate.

After puberty and into young adulthood, the opposite was true: genetics explain a much larger part of the reason why some of the twins had high levels of disordered eating and others didn’t. You can see the shift on the left-hand figure below.

puberty twins

The right-hand image showed that menarche (first menstrual period) wasn’t as a significant factor as general pubertal status. Another study (also by Klump and colleagues) shows why. It seems that the amount of estradiol in the blood seemed to rule whether genetics were the most important factor. Twins between ages 10-15 with low estradiol levels (thus not truly in puberty yet) showed little genetic effects on disordered eating while twins in the same age group but with high estradiol levels showed much higher genetic effects (Klump et al., 2010). Animal studies have shown that puberty also increases the likelihood of recurrent binge eating.

Interestingly, the hormonal effects of puberty seem to be limited to females. Studies on males have generally show much less of an influence of puberty than in women. Historically, people have cited the influence of advertising and the media as to why women have suffered from EDs at much higher rates than men. While these studies can’t (and shouldn’t) discount all effects from the media, they do show that this explanation is over-simplistic. Female sex hormones also significantly increase risk of disordered eating and eating disorders.

Other studies provide clues, too. Early puberty increases disordered eating and anxiety levels in both males and females, although it didn’t appear to increase risk-taking behavior and substance abuse.

puberty anxiety

Other studies have found links between other mental disorders and early puberty as well. So early puberty may not only directly increase disordered eating behaviors, it increases risk for other psychological problems that are strongly associated with EDs, too.

In her review article, Klump shared two main theories as to why puberty would be associated with ED risk:

Two models for how hormones and puberty affect ED risk

1. Activational. Transient effects that depend on the presence/absence of hormone

2. Organizational. Permanent effects that persist beyond the period of exposure to hormone and program later activational responses to hormone

Klump says that the evidence seems to support organizational effects since this model predicts 1) hormones organize behavior during puberty through permanent changes in brain structure/function; and 2) these changes organize the brain to respond to circulating levels of hormones in adulthood which activate and/or influence the expression of behavior.

Exactly what the estrogens do to increase ED risk isn’t clear. No one knows what genes they switch on and what effects on behavior they might have. Some have hypothesized that the earlier age of ED onset may be partially linked to earlier ages at menarche in girls.

Puberty is a very complicated time, and the research surrounding EDs and puberty is equally as complicated. Still, I hope I’ve at least given you an idea of what researchers think might be happening during this time period that seems to have a significant effect on eating disorders.

References:

Culbert, K. M., Burt, S. A., McGue, M., Iacono, W. G., & Klump, K. L. (2009). Puberty and the genetic diathesis of disordered eating attitudes and behaviors.Journal of abnormal psychology118(4), 788. doi: 10.1037/a0017207

Cyranowski, J. M., Frank, E., Young, E., & Shear, M. K. (2000). Adolescent onset of the gender difference in lifetime rates of major depression: a theoretical model. Archives of General Psychiatry57(1), 21. doi:10.1001/archpsyc.57.1.21.

Klump, K. L. (2013). Puberty as a critical risk period for eating disorders: A review of human and animal studies. Hormones and behavior64(2), 399-410. doi: 10.1016/j.yhbeh.2013.02.019

Klump, K. L., Keel, P. K., Sisk, C., & Burt, S. A. (2010). Preliminary evidence that estradiol moderates genetic influences on disordered eating attitudes and behaviors during puberty. Psychol Med40(10), 1745-53. doi: 10.1017/S0033291709992236

Marceau, K., Ram, N., Houts, R. M., Grimm, K. J., & Susman, E. J. (2011). Individual differences in boys’ and girls’ timing and tempo of puberty: Modeling development with nonlinear growth models. Developmental psychology47(5), 1389. doi: 10.1037/a0023838

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114 Responses to “Puberty and Eating Disorders- The Perfect Storm”

  1. But who are these “researchers” other than persons wanting to monger the community to earn an extra buck by medicalising a bad behaviour, aka ‘anorexia’ and or ‘bulimia’? And how do these “researchers” account for the ever-growing yoga housewife crowd who is addicted to achieving and maintaining the perfect bod and using the purge as effective method when failing at clean consumption? All of this mumbo jumbo might sound good and dandy in a “clinic” for teenagers suffering form a heartbreak and going off of the food and dieting deep end, but what does any of these magical theories have to do with real life? With adults? I offer my questions with the utmost respect because I do realise that you are probably fully vested into these “theories”, and I applaud that you seem to want to help others.

    • Clearly we disagree on pretty much everything there is to say about EDs.

      I’m vested in these theories inasmuch as there is scientific research to support them. Most of these researchers do not see patients and do not profit from EDs.

      Puberty increases ED risk from then on, across the lifespan. It’s not just teens. Onset of EDs during adulthood is exceedingly rare- most of had an ED or subclinical ED for years before they were diagnosed, relapsed, or their symptoms worsened. Most of them report ED thoughts/behaviors starting in or around puberty.

      As for what they have to do with real life, well, they have everything to do with real life. Why do some people get EDs and not others? Why do they so frequently occur during puberty?

      Diagnosing and understanding the medical aspects of anorexia and bulimia isn’t ‘medicalizing’ the problem. If it is, that’s not necessarily a bad thing if it means getting people effective treatment. Calling an ED ‘bed behavior’ trivializes the problem and contributes to the difficulty many people face in trying to get well. I’m not necessarily a big fan of the DSM. It has plenty of historic and current problems. But that doesn’t mean that the idea of a mental disorder or psychiatric illness or whatever you want to call it isn’t real.

      • To agree to disagree in our individual philosophies is a very peaceful thing to do, I think. I really like what you write because it’s smart. You are passionate. And you have experience. But your philosophy is the smart to which I do not subscribe, thus I crave to intellectually challenge it. Not much in this ED blog world prompts me to do such. “Getting EDs” sounds to me like “getting a curse” (from a magical wicked potion). EDs are not diseases, but are rather unwanted behaviours classified by ‘medical professionals’ as mental illness to absolve individuals of responsibility for their actions, rather blaming alleged illnesses. I look forward to your next post!

        • Nicole has trouble separating her own personal beliefs from scientific evidence.

          She is a dog walker – not a public health professional, womens health scholar, a doctor, a scientist, a gynecologist, a researcher, an endocrinologist or even of the understanding that this entire article is about already understood chemicals in the human body based on highly qualified and well funded peer-reviewed studies.

          She knows a few image obsessed women from yoga – so she’s totally an expert.

          • I am none of the above. But I am Nicole Marie Story, and dare I say that my strong philosophy has angered you? 😉

          • If you want to share your philosophy, you’ve probably picked the wrong place because this is a blog based on science and eating disorders. Yes, you have a strong philosophy, but the strength of your conviction does not make you right.

            If all you’re going to do is comment and disagree with pretty much everything that I stand for and not offer anything constructive, then please rethink your need to comment. We’re not going to agree, and we all know by now that you hold a very different philosophy of eating disorders than probably 99.9% of my readers and I. I welcome the open exchange of ideas, but the exchange is limited when you don’t think EDs are real or research on them is valid. I can’t offer anything in return.

          • I shall offer my opinion where I feel it is valid regardless if the blog owner can offer a compelling return argument because perhaps someone else can.

          • I’m not going to argue this further because it’s not a productive use of my time.

  2. Im not angry in the least. I am just tired of reading the same rant from you over and over again on blogs when clearly you didn’t even read the post.

    Your personal opinion is yours alone, it does not make it a fact, or even valid. Especially since your philosophy – no matter how strongly you hold it – isn’t based in any hard fact or science. Its based on emotions which is the worst kind of philosophy to subscribe to.

    The topic at hand – correlating biological and environmental factors – which has long been accepted as shaping health and behavior is interesting. Based on your comment, you did not read one word in this article – you just gave the same rant you always do.

    • Long been accepted by whom? By medical mongering socialists and their cult members? By Carrie Arnold? By a little girl in Astoria, New York? Experience is emotion? The fact of my successful elimination of 11 years of ‘bulimia’ emotion? Ah ha!

  3. She is trying to drive traffic to her weird little blog. I’m also not going to comment on her any further.

    Very interesting article. Bookmarked!

  4. Thanks for doing this Carrie..

    I have been on other forums relating to my own medical issues, and every once in a while a person shows up just to raise heck or publicize themselves

    ..it was appropriate to block further non productive comments…we can all look at her blog if we wish…

    I have deep empathy for people that suffer ED’s. Living through my D”s ED has been incredibly difficult…your book was a godsend and we got into FBT because of it…our D is w/r after 6 months of treatment (3 in FBT) and we are not dealing with the emotional fallout, and the difficulties of parenting when every decision seems to be about life or death or the start of a relapse..

    to the point of the previous comments,

    one issue or D faces is the trivialization of her problem… comments such as “I had an eating disorder for a couple weeks” and the assumption of her peers and teachers that the issue is resolved further minimize the danger of her condition..

    The research is real. I’ve read it.

    ALL researchers have an angle and desire funds for their research…its a strawman argument to accuse the researcher of self serving studies..

  5. Thank you for this wonderful post. I am fascinated by the ED/hormone connection – I first developed anorexia smack in the middle of puberty (age 12-13), and then the illness waned for several years before cropping back up in college. Now that I am weight-restored after several years of being underweight and not having periods, my hormones have gone absolutely nuts: acne, cramps, mood swings…a second puberty, if you will. Research like this points to a lot of evidence about 1) why eating disorders are so common among adolescent girls, 2) how ED can affect so many different body systems, and 3) why the physical effects of starvation can last a LONG time.

  6. my ED started years before I went through puberty, as a really late bloomer that didn’t start til 17-18 years… and that was also the year the ED tipped from something that was just ‘there’ in the background to something that was life-threatening and anxiety and depression also went over the line from already huge problems to completely debilitating. I never looked at that period of my life (that 2-3 years) in the context of hormones before. There were so many other very serious factors for why things tipped around then – leaving an abusive home, housing instability/periods of homelessness, starting uni, a sexual assault and rape. So I assumed they were definitely the triggers.
    In hindsight, I can see hormone levels could well have contributed to how completely unable to tolerate my emotions and subject to mood swings I became, I went from being an amazingly resilient kid to an absolute mess so fast it’s scary. Feelings back then really did feel like they would kill me, I found myself contemplating suicide constantly and self harming for the first time (never having even heard of it before, and having kept it secret, not knowing it was something people actually did, just thinking that it was more proof of something horribly wrong with me.) In the beginning of this period I also experienced a period of uncontrollable binge eating – for about a year, I gained a HUGE amount of weight and felt completely out of control, stuffing myself on a several times daily basis to the point of pain, crying and rolling on my bed only to stuff myself again as soon as it eased. I found a diet, followed it, and seamlessly not only returned to my old default of restriction, but to a degree that still frightens me today.
    The weight loss cancelled out any hormones/puberty that had been happening and THINGS STARTED TO CALM DOWN. Not completely, but they became less intolerable, also I had some pretty strong coping mechanisms in place now albeit life threatening… weight loss that came with anorexia is like a volume switch being turned down for me with emotions, mood swings, flashbacks/PTSD stuff… but I wonder, could the way weight loss affected my hormone levels have contributed to that ‘volume turn down’ as well as just the fact that I was starved numb and dissociative? Every time I’ve gained weight – EVERY single time – things have become a LOT less tolerable all over again, mood swings, depression ++, anxiety ++ – could this also be to do with the increase of hormone production that comes with a higher body weight/body being refed?
    I have only had a handful of periods in my lifetime – I’m 35 – and there hasn’t seemed to be any rhyme nor reason for when they have come, but every single time it’s happened, I’ve had some major emotional crisis right in the lead up and the ED, especially the bingeing and purging part of it, has become uncontrollable. I am not predicting my period and these emotional/ED changes happening through anxiety about the period or something because I NEVER EXPECT to get it – it’s been a complete surprise every single time, leaving me shaking my head thinking “No wonder I became such a mess, it was PMS”…When you have never had measurable cycles and periods can be a year, yearS, apart – there is simply no way to predict it. I have been on hormones for my bones in the past, but on very low dosages, not enough to actually give me a period, and I usually went off them after a short while (currently not taking) because the bloating, body discomfort and mood swings were difficult to tolerate.)
    (And BTW yes, my bones are shot to hell.)
    Thank you for this blog post – it has been really, really illuminating for me. Quite a few Aha’s and Maybes going on for me.
    I also wonder if it’s hormones that decide whether someone will battle restrictive ED or bingeing and purging or bingeing? Would be very interesting to see.

  7. Your troll is well known and unfortunately, not capable nor interested in rationality, and for whom the extent of her reading does not extend to scholarly articles or academic sources – but to the same Ayn Rand drivel read many times over and no further than the introduction of a select few questionable books on the ‘myths’ of mental illnesses. Her philosophy is that eating disorders are ‘bad’ and ‘weaknesses’ and that you can’t be too rich or too thin or too drunk. Blocking her was a very good move. We can get back to talking about reality and she can get back to watching Sex and The City on continuous loop. 😛

  8. Fascinating study….Being a mono zygote twin…I found this personally interesting because while my twin has seemingly “recovered” from ED behaviours (we were both bulimic during university…shared much, much later due to “shame”.. as we attended different colleges in different states), I am still…alas …in the throws of a new “variant”…anorexia…which cropped up over ten years ago. I wonder why she is not in the same state as myself at times…but after reading your post I can imagine that the fact that she started puberty one year after myself…and that I am hetero while she is lesbian could account for some of it? Is it indeed possible that her “egg” was bathed in fewer female hormones …perhaps somehow “protecting” her from an increased potentiality towards facing more ED horror?…Very interesting…

  9. Oh my …I meant to write “throes” …NOT “Throws”!!…Sorry for that!

  10. This post is perfect!Thanks!
    Can I translate it to Portuguese and post it in my blog? (with the correspondente link and author)?
    (Many of my readers are Portuguese or Brazilian)

    • Sure. Can you send me a link when you’re done? I’d love to add it to the bottom of the post for my Portuguese readers!

  11. I can’t tell you how intriguing and how significant this entry is to me. As the parent of an atypical presenter ie dx at age 10….
    To learn more about the possible implications of hormone and heritability.
    If you were to ask me she was that perfect storm…pre pubertal hormone increase had the potential to activate my D’s genetic risk. Thank you for discussing this important study…………

  12. Could you please provide any information you have regarding whether anorexia during puberty merely delays pubertal development or stops it completely?

    For instance, I had anorexia for about 10 months (amenorrhea for 6-7 months) beginning when I was 15 1/2. I had already begun puberty, having experienced thelarche at 8 1/2 and menarche at 11. I stopped growing in height at 14.

    After regaining the weight (when I was 16), my breasts seemed to grow slightly larger, although that was likely due to weight gain and not pubertal development.

    Do you think I missed out on any breast growth due to my anorexia or would any changes I missed have taken place once I regained the weight? I’m confused as to whether there’s a certain timeframe during which changes must occur or if they will eventually occur, regardless of age, if you get enough weight on you.

    Thanks for reading!

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    {Enregistré en tant que favori|signet !!}, {Je aime vraiment|Je aime|Je adore votre blog {}|votre site|votre site web|votre site web}!
    |
    Way cool! Certains mêmes {|} extrêmement points valables!

    Je vous remercie de la rédaction de ce {|} {penning cette
    article|poste|écrire-up} {et|et aussi la |} plus le reste du site est
    {|} {site est également très|extrêmement|très|aussi vraiment |} vraiment bonne.
    |
    Salut, je ne crois {| Je ne pense} {ce est un excellent|ce est un grand} {Blog|site web|site web|Site}.
    Je stumbledupon il;) {Je vais|Je vais|Je vais |} {Je
    peux revenir|Retour|revoir} {nouveau |} {encore depuis que je|puisque je ai} {signet|livre marquée|livre
    marqué|enregistré en tant que favori} il.
    L’argent et la liberté {est le meilleur|est le plus grand}
    moyen de changer, vous pouvez être riche et de continuer à l’aide {|} {Guide autres personnes|autres}.
    |
    Woah! Je suis vraiment aimer {| profiter |} creuser le modèle / thème de cette place {| site web|Blog}.
    Ce est simple, mais efficace. Un grand nombre de fois où il est
    très difficile {| très difficile|contester|difficile|difficile |} dur pour obtenir que «équilibre parfait» entre
    {superbe convivialité|convivialité|convivialité} et {aspect visuel|attrait visuel|apparence}.
    Je dois dire que vous avez {| Vous avez |} vous avez fait un super
    {| amazing|très bonne|superbe|fantastique|excellente|grande} travail avec cette.
    {En outre|plus |} Aussi, le blog des charges très {|
    extrêmement|super rapide} {|} rapide pour moi sur {Safari|Internet Explorer|Chrome|Opéra|Firefox}.
    {Superbe|Exceptionnel|exceptionnelle|Excellente} Blog!
    |
    Ce sont vraiment {||en fait en fait vraiment|| véritablement} {| grands énormes|| impressionnantes merveilleux|fantastiques} {idées en ce qui concerne|concernant|à propos|sur le thème de} blogging.
    Vous avez touché certains {Nice|agréable|| bonnes exigeants} {points||
    facteurs choses} ici. Ne importe quelle manière suivre wrinting.
    |
    {Je aime|Je aime vraiment|Je aime|Je aime|Tout le monde aime ce que
    vous les gars} {sommes|sont généralement |} ont tendance à être trop.
    {Ce genre de|Ce type de|telle|Ce genre de travail intelligent et} {l’exposition|couverture|déclaration}!

    Gardez les superbes {||formidables très bons grands|||bonnes impressionnants fantastiques|||excellents étonnantes|merveilleuse} fonctionne gars que je ai incorporé {|| ajoutée|inclus} vous
    les gars à {| mon|notre || mon record personnel|mon propre} blogroll.
    |
    {Howdy|Salut il|Salut|Salut|Bonjour |} Hey! Quelqu’un dans mon|{groupe Facebook Myspace} {partagé cette place|site web} avec
    nous alors je suis venu {lui donner un look|regarder par-dessus|jetez un oeil|check it
    out}. Je suis définitivement {profitant |} aimer
    l’information. Je suis {livre-marquage|bookmarking}
    et sera tweeting cela à mes disciples! {Terrific|Magnifique|Grande|Fantastique|exceptionnelle|Exceptionnel|Superbe|Excellente}
    {blog et merveilleuse|terrible|brillante|amazing|grande|excellente|fantastique|exceptionnelle|superbe}
    {style et le design|design et le style|conception}.
    |
    {Je aime|Je aime vraiment|Je aime|Je aime|Tout le
    monde aime ce que vous les gars} {sommes|sont généralement |} ont tendance à être trop.
    {Ce genre de|Ce type de|telle|Ce genre de travail intelligent
    et} {l’exposition|couverture|déclaration}! Gardez les superbes {||formidables très bons
    grands|||bonnes impressionnants fantastiques|||excellents étonnantes|merveilleuse} fonctionne gars que je
    ai {Incorporated|ajout|inclus} vous les gars à {| mon|notre|mon personnelles|mon} propre blogroll.

    |
    {Howdy|Salut il|Salut|Salut|Bonjour|Hey}-vous l’esprit {déclarant
    |} partager la plateforme blog, vous êtes {travailler
    avec|aide}? Je recherche {| planification |} va commencer mon propre blog {dans un avenir proche|dès} mais je vais avoir un {dure|difficile|hard} {temps de prendre une décision|sélection|choisir |} décider entre BlogEngine / WordPress /
    B2evolution et Drupal. La raison pour laquelle je demande, ce est parce que votre {design et le style|conception|layout} semble différente, alors la plupart des blogs et je
    suis à la recherche de quelque chose de complètement unique {|} uniques.
    PS {Mes excuses|Apologies|Désolé} {pour obtenir |}
    étant hors-sujet, mais je ai dû demander! |
    {Howdy|Salut il|Salut|Salut|Bonjour|Hey} cela vous dérangerait de me laisser
    savoir qui {hébergeur|société d’hébergement|hébergeur}
    vous {utilisant|travailler avec|aide}? Je ai chargé votre blog en 3 {complètement différents |} {différents navigateurs Internet|navigateurs|navigateurs}
    et je dois dire ce blog charge beaucoup plus rapide {|}, puis plus vite.
    Pouvez-vous suggérer {|} recommandent un bon {hébergement Internet|hébergement|hébergement} {fournisseur à un honnête|raisonnable
    |} juste prix? {Merci beaucoup|Kudos|Vive|Merci|Merci beaucoup |} Merci, je
    l’apprécie! |
    {Je aime|Je aime vraiment|Je aime|Tout le monde aime} {il quand les gens|lorsque les individus|quand les gens|quand les gens se réunissent} {|} se réunir et de partager
    des opinions {||| Regardé pensées idées}. Grande {Blog|site web|Site}, {keep
    it up|continuer le bon travail|rester avec elle}! |
    Merci pour le bon augure {|} writeup bonne. Il était en fait un amusement compte il.
    Regardez bien avancée pour {|} ajouté plus agréable de vous!
    {En passant |} Cependant, comment pouvons {|} pourrions-nous communiquer?
    |
    {Howdy|Salut il|Salut|Bonjour|Hey} voulais juste vous donner un heads-up rapide.
    Les textes {|} mots dans votre {contenu|poste|Article}
    semblent être en cours d’exécution hors de l’écran dans {Ie|Internet Explorer|Chrome|Firefox|Safari|Opéra}.
    Je ne sais pas si ce est une forme {|} formatage question ou quelque chose
    à voir avec {navigateur|navigateur Internet|navigateur} {compatibilité
    mais je pensais|figuré} je poste pour vous laisser savoir.

    Le style et le design {| design et le style|montage|conception}
    fière allure si! Je espère que vous obtenez le problème {|} {problème résolu|résolus|fixe} bientôt.
    {Kudos|Vive|Merci beaucoup|Merci} |
    Ce est un sujet {ce est|ce est|qui est} {près de|proche de mon cœur …} {Vive|Merci beaucoup|Meilleurs voeux|Prenez soin|Merci}!

    {Où |} Exactement là où sont vos coordonnées si? |
    Ce est très {faciles|simple|simple|| sans problème effort} pour découvrir toute {sujet|importe} le
    {net|web} par rapport à {livres|manuels},
    que je ai trouvé ce {article|poste|morceau de écrit|paragraphe} {à ce site|site web|Site|page Web}.

    |
    Votre site de {| site web|Blog} ont une page de contact?
    Je vais avoir un moment difficile {| problèmes|ennuis} localiser,
    mais, je aimerais envoyer {|} shoot-vous un {e-mail|email}.
    Je ai quelques idées créatives {| recommandations|suggestions |} idées pour
    votre blog, vous pourriez être intéressé audience.
    De toute façon, une grande place {| site web|Blog} et
    je ai hâte de le voir développer {| améliorer|Développer |}
    croître au fil du temps. |
    {Hola|Salut|Salut|Bonjour|Salutations}! Je ai {suivais|lecture} {votre site|site web|site
    web|blog|Blog} {pour longtemps|un moment |}
    maintenant un certain temps et a finalement obtenu la bravoure {|} courage d’aller de l’avant et vous
    donner un cri de {New Caney|Kingwood|Huffman|Porter|Houston|Dallas|Austin|Lubbock|Humble|Atascocita}
    {Tx|Texas}! Je voulais juste vous dire {| mention |} dire garder le fantastique {| excellente|grande|bonne}
    {emploi|travaux}! |
    Salutations de {Idaho|Carolina|Ohio|Colorado|Floride|Los Angeles|Californie}!
    Je suis {ennuyer à mourir|Bored to Death |} ennuyer au travail alors je ai décidé d'{vérifier|navigation} {votre site|site web|Blog} sur
    mon iPhone pendant la pause déjeuner. Je apprécie {| vraiment|amour} {la connaissance|info|informations} {vous présente|offrir} ici et ne peut pas attendre
    de prendre un coup d’oeil quand je rentre à la maison. Je {choqué|étonné|surpris} {comment rapide|rapide} votre
    blog chargé sur mon portable {| téléphone portable|téléphone} ..
    Je ne suis même pas en utilisant le WiFi, juste 3G ..
    Quoi qu’il en soit {|} Quoi qu’il en soit, {génial|amazing|très bonne|superbe|bien|merveilleuse|fantastique|excellente|grande} {site|Blog}!
    |
    Son {comme vous|telle que vous lisez} {|} apprendre mon esprit {|} pensées!
    Vous semblez {|} {apparaissent à comprendre|savoir|à saisir} {tellement|beaucoup} {environ|à propos de cette}, {comme vous|telle que vous l’écriviez} {livre|e-book|Guide|ebook|e} livre en elle ou quelque chose.

    {Je pense|Je me sens|Je crois que vous} {| que vous simplement|que vous venez}
    {pouvait |} peut faire avec une certaine {|} {quelques-uns%|pc|pour
    cent} au {force|pression|lecteur|puissance} {le message maison|Accueil}
    {un peu|un peu}, {Toutefois |} {mais autre que |} au lieu de cela, ce est {|} {ce est une grande|merveilleuse|fantastique|magnifique|excellente}
    blog. {Un grand|Un excellent|Un fantastique} lire.
    {Je vais|Je vais certainement} {|} certainement être de
    retour. |
    Je ai visité {multiples|beaucoup|plusieurs|divers} {Sites|sites|sites web|pages web|blogs}
    {mais|sauf|cependant} l’audio {qualité|fonction} pour les chansons audio {de courant|Actuel|existante} à ce {site|site web|Site|page Web} {est vraiment|effectivement|en fait|véritable |}
    {véritablement merveilleuse|merveilleuse|excellente|fabuleuse|superbe}.

    |
    {Howdy|Salut il|Salut|Bonjour}, je ai lu votre blog {occasionnellement|de temps
    à autre} et je possède un semblable et je étais juste curieux {|} demandais si vous obtenez beaucoup de spam {commentaires|réponses|} commentaires|remarques?
    Si oui, comment avez-vous empêchez {| réduire|stop
    |} protéger contre elle, un plugin ou ce que
    vous pouvez {conseiller|proposer|recommandez}? Je reçois
    tellement dernièrement, il me rend folle {| folle|folle} {de sorte que toute
    l’assistance|aide |} soutien est très apprécié.
    |
    Salutations! {Très utile|Très utile} {des conseils dans ce|dans ce
    cas particulier} {article|après}! {Ce sont les|Ce est la} {petits changements qui font|qui rendront|| qui produisent qui feront}
    {les plus grandes|| les plus grands plus grands|les plus importants|les plus importants changements}.
    {Merci beaucoup|Merci|Un grand merci pour le
    partage}! |
    {Je ai vraiment je ai vraiment|||Je ai sérieusement I absolument} {amour votre blog|votre site|votre site ..} {Très
    belles|Excellent|Pleasant|Grande} couleurs et thème. Avez-vous {créez|Développement|faire|construire} {ce
    site|ce site|ce site Web|ce site étonnant}
    vous-même? Se il vous plaît répondre que je me suis à la recherche de {| essayant
    de|planification à|voulant|espérant|tenter de créer {} ma propre|mon propre|mon propre personnel}
    {Blog|site web|Site} et {aimerait à|vouloir|aimerait}
    {savoir|apprendre |} savoir où vous avez obtenu ce à partir ou
    {ce que le|exactement ce que le|juste ce que le thème} {est
    appelé|nommé}. {Merci|Merci beaucoup|Merci|Vive|apprécions|Kudos}!

    |
    {Salut il|Bonjour il|Howdy}! Ce poste {| article|blog}
    {ne pouvait |} ne pouvait pas être écrit {mieux |} beaucoup mieux!

    {Lisant|Regarder|Passer par|En regardant à travers} {ce message|article} me rappelle mon colocataire précédente!
    Il {toujours|constamment|continuellement} {gardé parle|prêcher sur ce}.
    {Je vais|Je|Je vais|Je vais très certainement avant} {|} {envoyer cet article|cette information |} ce
    poste lui. {Jolie-vous|assez sûre} {il|il va|il va}
    {avoir une bonne|avoir une très bonne|ont une grande} lire.
    {Merci pour|Merci pour|Merci beaucoup de|je vous apprécie pour}
    partage! |
    {Wow|Whoa|Incredible|étonnantes}! Ce blog regards exactement {|} tout comme mon vieux!
    Ce est sur un {complètement|entièrement|totalement différente} {sujet|sujet} mais il a peu près la même mise en page
    {|} mise en page et la conception. {Excellent|Magnifique|Grande|exceptionnelle |} Superbe
    choix de couleurs! |
    {Il est|Il ya certainement} {|} {certainement beaucoup à|beaucoup
    à} {connaître|apprendre|découvrir} {ce sujet|sujet |} question. {Je aime|Je adore|Je aime
    vraiment} {tous les|tous les points {} vous
    avez fait|que vous avez fait|que vous avez fait}.

    |
    {Vous avez fait|Vous avez fait|Vous avez fait} {certains décents|| bons très bons points, il}.
    Je ai regardé {|} {vérifié sur internet|sur le web|sur le net}
    {pour plus d’info|pour plus d’informations|en savoir plus|en savoir plus|Pour plus d’informations} sur la question et a trouvé la plupart des individus {| la plupart des gens}
    iront avec vos vues sur ce site {| ce site|ce site}. |
    {Salut|Bonjour|Salut il|Quoi de neuf}, {je connecte sur|vérifier|lire} {votre nouvelle stuff|blogs|Blog} {régulièrement|Comme chaque semaine|jour|sur une base régulière}.
    Votre {contes|écriture|humoristique} {style est génial|spirituelle},
    {garder de faire ce que vous faites|le bon travail|it
    up}! |
    Je ai tout simplement {|} {juste ne pouvait pas|ne pouvait pas laisser} {| départ|aller} {votre site|site
    web|site web} {avant|avant} {suggérant que je vraiment|extrêmement |} {effectivement apprécié|} {aimé
    la norme|habituel} {informations|info} {une personne|un individu} {approvisionnement|fournir}
    {pour votre|sur votre|dans votre|à vos visiteurs} {|} invités?
    Est {va |} va être {back|nouveau} {fréquemment|régulièrement|incessamment|régulièrement|sans
    cesse|souvent|continu} {pour|à} {vérifier sur|vérifier|inspecter|enquêter sur recoupement} les
    nouveaux messages |
    {Je voulais|je avais besoin|Je veux |} Je ai besoin de vous remercier pour cette grande {| excellente|fantastique|merveilleuse|bien |} très bonne
    lecture !! I {définitivement|certainement|absolument} {bénéficié|aimé} {chaque peu de|peu} il.

    {Je ai|Je ai|Je ai} {vous signet|livre marqué|marque-page|enregistré
    en tant que favori} {de vérifier|regarder} {nouvelle trucs que vous|choses que
    vous publiez} … |
    {Salut|Bonjour|Salut il|Quoi de neuf}, je voulais
    juste mention {| dire |} vous dire, je ai apprécié {| aimé |} aimé cette {article|poste|blog}.
    Ce était inspirant {| drôle|pratique|utiles}. Continuez à poster!
    |
    {Salut il|Bonjour}, {Je aime lire tous|travers} {votre article|poste|article après}.
    I {comme|voulu} Pour écrire un petit commentaire pour vous soutenir.
    |
    I {toujours|constamment|chaque fois} passé ma demi-heure à lire ce {Blog|blog|Web|site web|site web}
    s ‘{articles|messages|articles ou commentaires|contenu} {quotidienne|quotidienne|chaque jour|tout
    le temps} {avec une tasse |} tasse de café. |
    I {toujours|pour tous les temps|tout le temps|constamment|chaque fois}
    envoyé cette {Blog|blog|Web|site web|site web} après page tous mes {amis|associés|contacts}, {car|puisque|en|pour la raison que si} aiment lire {alors|après|suivant|suite} {mes amis|liens|contacts} aussi.

    |
    Mon {codeur|programmeur |} développeur tente de persuader {|} me convaincre de passer à
    .net de PHP. Je ai toujours détesté l’idée en raison des dépenses {|} coûts.
    Mais il ne tryiong moins. Je me sers de {type Movable|WordPress}
    {sur un certain nombre de|| une variété de nombreux|| divers} plusieurs sites Web pour environ un an et je
    suis nerveux {| anxieux|inquiet|concernée} sur le passage à une autre plateforme.
    Je ai entendu {fantastiques|| très bons excellents|grands |} bonnes choses à propos de blogengine.net.
    Est-il possible que je peux {transfert|importation} {wordpress tout mon contenu |} messages en elle?
    {Tout type de |} Toute aide serait vraiment {|} grandement
    apprécié! |
    {Bonjour|Salut|Bonjour il|Salut il|Howdy|Bonne journée}!
    Je aurais juré que je ai été à {|} {visité ce
    blog|ce site Web|ce site|ce site|votre blog} avant, mais après {parcourant|passer par|regardant} {partie de la|quelques-uns de la|nombre des messages} {|} articles je ai réalisé que ce est nouveau pour moi.
    Quoi qu’il en soit {| Quoi qu’il en soit|Néanmoins|Peu}, {Je suis définitivement |} {certainement heureux|plu|ravis} {Je ai trouvé|Je ai
    découvert|je suis tombé sur|je suis tombé sur}
    et je serai {bookmarking|livre -marking} et {contrôle de
    retour souvent|régulièrement|souvent}! |
    {Terrific|Grande|Magnifique} {article|travaux}! {Ce est|Ce est} {le type de|le genre de} {informations|info} {qui
    sont censées|qui sont censés|qui devrait être partagée {}
    autour de la |} {travers le web|Internet|filet }. {Disgrace|Honte} {sur les chercher {|} recherche
    moteurs|Google} pour {maintenant non|non|plus} {positionnement ce poste|soumettre|Publier|conditionnés} {supérieure|plus}!
    Come On Over et {TALK OVER avec|discuter avec|demander conseil à|Visite|consulter} {mon site|site web|site web}.
    {Merci|Merci} =) |
    Heya {je suis |} je suis pour la première fois ici.
    Je suis tombé sur {|} trouvé ce conseil et je trouve
    cela vraiment {|} vraiment utile et il m’a aidé beaucoup {|}
    beaucoup. Je espère que de donner quelque chose en retour et {} aide|aide les autres
    comme vous a aidé {|} aidé moi. |
    {Salut|Bonjour|Salut il|Bonjour il|Howdy|Salutations},
    {Je pense|Je crois|Je ne crois|Je ne pense|Il
    n’y a pas de doute que} {votre site|votre site|votre
    site web|votre blog} {pourrait être|peut être|pourrait être|pourrait éventuellement être} {ayant
    navigateur|navigateur internet|navigateur Web} {compatibilité questions|problèmes}.
    {Quand je|Chaque fois que je} {regarde votre|jeter un oeil à votre} {site|site web|Site|Blog} dans Safari, il semble bien {mais quand|cependant quand|cependant, si|cependant, quand} ouverture
    {dans Internet Explorer|IE|IE}, {a|Il est obtenu} certaines questions se chevauchent.
    {Je viens|Je ai simplement|Je ai simplement} {voulais vous donner un|vous
    fournir un} têtes Quick Up! {Autre que cela|En dehors de cela|En outre|Mis à part cela},
    {fantastique|merveilleuse|grande|excellente} {Blog|site web|Site}!
    |
    {Une personne|Quelqu’un|Quelqu’un} {nécessairement|essentiellement} {prêter main|aide |} aider à faire {sérieux|| significative
    gravement|sévèrement} {articles|messages} {Je voudrais|Je pourrais|je avais} Etat .
    {Ce est |} Ce est le premier {|} toute première fois que je fréquentais votre {page Web|site web page}
    et {ce point|jusqu’ici|jusqu’ici|jusqu’à maintenant}? I {étonné|surpris} avec {la recherche
    |} analyse que vous faites pour créer des {|} {faire cette réelle|ce particulier}
    {après|envoyer|publier|mettre en place} {incroyable|amazing |} extraordinaire.
    {Grande|Magnifique|Fantastique|Magnifique|Excellente} {tâche|processus|activité|emploi}!
    |
    Heya {je suis|je suis} pour {primaire |} la première fois ici.
    Je suis tombé sur {|} trouvé ce conseil et je {à trouver|trouver|trouver} {Il vraiment |} {vraiment utiles |} utiles et il m’a aidé beaucoup {|} beaucoup.
    {Je espère|Je espère|Je espère} {pour donner|offrir|de fournir|de présenter quelque
    chose} {|} {une chose back|nouveau} et {aide|aide} {d’autres comme vous|tels que vous} {aidé|aidé} moi.

    |
    {Bonjour|Salut|Bonjour il|Salut il|Howdy|Bonjour |} Hé là!
    {Je viens|Je ai simplement} {aimerais|vouloir|souhaiter} {Vous donner|vous une offre} {} énormes|big coup de pouce
    pour le {|} {pour votre grande|excellente} {info|informations} {Vous avez|vous avez|vous avez
    ici} {|} ici sur ce post. {Je serai|Je serai|Je suis} {revenir
    à|retour à} {votre blog|votre site|votre site|votre site web pour plus d’} bientôt.
    |
    Je ai toujours {| tout le temps|chaque fois} {utilisé pour lire|étude} {article|poste|morceau de l’écriture|paragraphe} dans des journaux, mais maintenant que je
    suis un utilisateur de {Internet|Internet|net} {so|ainsi |} donc à partir de maintenant je
    utilise net pour {articles|messages|articles ou commentaires|contenu}, grâce à Internet.
    |
    Votre manière {| Méthode|moyens|Mode} de {décrivant|expliquant|révélateur} {tout|tout|le tout dans ce} {article|poste|morceau de l’écriture|paragraphe} {est vraiment|effectivement|en fait|vraiment|véritablement} {nice|agréable|bien|fastidieux}, {tout|tous} {peut|être en mesure
    de|être capable de facilement} {| sans difficulté|effort|simplement} {comprendre|savoir|être conscient de ce} ,
    Merci beaucoup. |
    {Salut|Bonjour} il, {Je ai trouvé|Je ai découvert} votre {Blog|site
    web|site web|Site} {au moyen de|via|par l’utilisation de|par voie de} Google {en même temps que|tout|même si|tout}
    {chercher|recherche} un {similaire|comparables|liés}
    {sujet|matières|sujet}, votre {site|site web|site web} {arrivé ici|venaient} en place, il {regarde|apparaît|semble|semble être|semble être comme} {bien|grande}.

    {Je ai|Je ai} signet dans mes favoris Google.
    {Bonjour |} Salut là, tout simplement {|} {simplement transformé en|devint|a|devenir|changé dans} {conscient
    de|alerte} {votre blogue|blog} {travers|par|via Google},
    {et a trouvé |} et trouve que ce est {|} {ce est vraiment |} vraiment instructif.
    {Je suis|Je suis} {va|va} {attention|soyez prudent} pour Bruxelles.
    {Je vais|Je vais apprécier} {|} {être reconnaissants si
    vous|devriez-vous|lorsque vous|dans le cas où vous|au cas où vous|pour ceux qui|si
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  1. Puberty and Eating Disorders- The Perfect Storm | ED Bites | Bulimia 10 | Bulimia 10 - October 14, 2013

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  2. News You Can Use – October 15-22 2013 « Eating Disorder Pro - October 16, 2013

    […] Puberty and Eating Disorders – The Perfect Storm – In a recent paper in Hormones and Behavior, Kelly Klump reviewed what we know about puberty, eating disorders, and disordered eating. Especially in females, the surge of sex hormones seems to activate underlying genetic risk factors and alter neurochemistry. Although researchers still aren’t sure exactly what is going on, they are collecting a vast body of evidence that puberty is a particularly high risk period for Eating Disorders. Learn More. […]