The overall aim of this thesis was to examine the development and prediction of disturbed eating attitudes in girls aged 7–20 years. The four studies are part of a seven-year longitudinal project including 1279 girls in several age groups (7, 9, 11, 13, 15 years at inclusion) and their parents.

Study I showed that among girls aged 11 and 13 years, in addition to a positive relation between disturbed eating attitudes and age, eating attitudes, higher BMI than peers, a less healthy relation to family, and fathers’ eating attitudes, predicted disturbed eating attitudes two years later. Study II demonstrated that girls aged 9–15 years, who wished to be thinner dieted more often, thought that they would be more popular if they were thinner, were skipping meals more often and had a higher BMI, over five years, compared with the girls without such a wish. Study III demonstrated an increasing trend in the wish to be thinner and dieting attempts between the ages of 9 and 18 years. Motives for wishing to be thinner were, e.g., “to feel better about yourself” and “to correspond to the societal ideal”. A majority of the girls adopted healthy weight control practices, but unhealthy and extreme methods were also used. In Study IV, among girls aged 9 and 13 years, a wish to be thinner, fathers’ eating attitudes and mothers’ perfectionism contributed most to the prediction of disturbed eating attitudes seven years later. Protective factors were low BMI and more healthy eating attitudes moderated by high self-esteem, and low-to-medium degree of perfectionism.

In conclusion a wish to be thinner, higher BMI than peers, girls’ and fathers’ disturbed eating attitudes, mothers’ perfectionism and a less healthy relation to family predict the development of disturbed eating attitudes in girls. Low BMI and more healthy eating attitudes especially influenced by high self-esteem, and a low-to-medium degree of perfectionism protect against it. The “thin-ideal” is internalized early in girls and it is important to take a critical stand against the thinness ideal in our society, especially in families, and schools.