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Prevalence and Correlates of Disordered Eating Behaviors Among Young Adults with Overweight or Obesity

  • Jason M. Nagata
  • Andrea K. Garber
  • Jennifer L. Tabler
  • Stuart B. Murray
  • Kirsten Bibbins-Domingo
Original Research

Abstract

Background

Clinical and community samples indicate that eating disorders (EDs) and disordered eating behaviors (DEBs) may co-occur among adolescents and young adults at a weight status classified as overweight or obese.

Objective

To determine the prevalence of EDs and DEBs among young adults at a weight status classified as overweight or obese using a nationally representative sample and to characterize differences in prevalence by sex, race/ethnicity, sexual orientation, and socioeconomic status.

Design

Cross-sectional nationally representative data collected from Wave III of the National Longitudinal Study of Adolescent to Adult Health (Add Health).

Participants

Young adults ages 18–24 years old.

Main Measures

ED diagnosis and DEBs (self-reported binge eating or unhealthy weight control behaviors including vomiting, fasting/skipping meals, or laxative/diuretic use to lose weight). Covariates: age, sex, race/ethnicity, sexual orientation, weight status, and education.

Key Results

Of the 14,322 young adults in the sample, 48.6% were at a weight status classified as overweight or obese. Compared to young adults at a weight status classified as underweight or normal weight, those at a weight status classified as overweight or obese reported a higher rate of DEBs (29.3 vs 15.8% in females, 15.4 vs 7.5% in males). Logistic regression analyses demonstrated that odds of engaging in DEBs were 2.32 (95% confidence interval 2.05–2.61) times higher for females compared to males; 1.66 (1.23–2.24) times higher for Asian/Pacific Islander compared to White; 1.62 (1.16–2.26) times higher for homosexual or bisexual compared to heterosexual; 1.26 (1.09–1.44) times higher for high school or less versus more than high school education; and 2.45 (2.16–2.79) times higher for obesity compared to normal weight, adjusting for all covariates.

Conclusions

The high prevalence of DEBs particularly in young adults at a weight status classified as overweight or obese underscores the need for screening, referrals, and tailored interventions for DEBs in this population.

KEY WORDS

obesity eating disorders anorexia nervosa bulimia nervosa binge eating weight control behaviors young adult 

Notes

Acknowledgments

Thanks to Nicole Capdarest-Arest for help with literature searches. This research uses data from Add Health, a program project directed by Kathleen Mullan Harris and designed by J. Richard Udry, Peter S. Bearman, and Kathleen Mullan Harris at the University of North Carolina at Chapel Hill, and funded by grant P01-HD31921 from the Eunice Kennedy Shriver National Institute of Child Health and Human Development, with cooperative funding from 23 other federal agencies and foundations. Special acknowledgment is due Ronald R. Rindfuss and Barbara Entwisle for assistance in the original design. Information on how to obtain the Add Health data files is available on the Add Health website (http://www.cpc.unc.edu/addhealth). No direct support was received from grant P01-HD31921 for this analysis.

Funding Information

Jason Nagata is a Fellow in the Pediatric Scientist Development Program (K12HD000850-33). This project was supported by grants from the American Academy of Pediatrics (AAP), the American Pediatric Society (APS), and the Norman Schlossberger Research Fund from the University of California, San Francisco. A.K.G. was supported by NIH 5R01HD082166-02. S.B.M was supported by K23 MH115184.

Compliance with Ethical Standards

The University of North Carolina Institutional Review Board approved all Add Health study procedures, and the University of California, San Francisco Institutional Review Board deemed this specific project exempt. Written informed consent was obtained from each subject.

Conflict of Interest

The authors declare that they do not have a conflict of interest.

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Copyright information

© Society of General Internal Medicine 2018

Authors and Affiliations

  • Jason M. Nagata
    • 1
  • Andrea K. Garber
    • 1
  • Jennifer L. Tabler
    • 2
  • Stuart B. Murray
    • 3
  • Kirsten Bibbins-Domingo
    • 4
    • 5
  1. 1.Division of Adolescent and Young Adult Medicine, University of CaliforniaSan FranciscoUSA
  2. 2.Department of Sociology and AnthropologyUniversity of Texas Rio Grande ValleyEdinburgUSA
  3. 3.Department of PsychiatryUniversity of CaliforniasSan FranciscoUSA
  4. 4.Department of Epidemiology and BiostatisticsUniversity of CaliforniaSan FranciscoUSA
  5. 5.Department of MedicineUniversity of CaliforniaSan FranciscoUSA

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