Body of evidence: Tattoos, body piercing, and eating disorder symptoms among adolescents

Objective: Tattoos and body piercing have been linked to risk-taking behaviors, including disordered eating, but the findings have come from selected samples that were at greater risk for bias due to comorbidity. This study set out to explore concurrently the prevalence of tattoos and body piercing, and eating disorder symptoms in a representative adolescent sample of a community in Sardinia, a major island in Italy. Methods: A community sample of 828 students (female, 535; male, 282; mean age=17.5±1.4 years) among those attending high school in the district of Cagliari, Italy, were invited to take the Eating Attitudes Test, the Bulimic Investigatory Test of Edinburgh, and the Body Attitudes Test, alongside a short questionnaire aimed at evaluating their resorting to body modification practices, including tattooing and body piercing. Results: Females scored higher than males at all eating disorder inventories. More males than females admitted the use of tattoos (14.5% vs. 5.4%), whereas the reverse was found for body piercing (18.4% vs. 21.3%). Tattoos among females and body piercing in both genders were statistically associated with eating disorder measures related to bulimia symptoms. On the whole, the degree of association was modest. Conclusions: Tattoos and body piecing should be seen as desires to show a subject's identity rather than as a marker of psychopathology. Greater health education, however, is needed in the wake of the growing popularity of these body modification practices. © 2006 Elsevier Inc. All rights reserved.