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Use of appearance- and performance-enhancing drugs and substances is associated with eating disorder symptomatology among U.S. college students

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Abstract

Purpose

Body ideals for both men and women are continuing to emphasize muscularity and leanness, which has resulted in the high prevalence of appearance- and performance-enhancing drugs and substances (APEDS) use, particularly among young men. Overall, little research has investigated the individual associations between specific APEDS use and eating disorder symptomatology, including among the high-risk population of young adult college students, which was the aim of this study.

Methods

Data from the 2020–2021 Healthy Minds Study (N = 7394) were analyzed. Five indicators of lifetime APEDS use were assessed, and a cumulative sum score was constructed. Eating disorder symptomatology was assessed via the SCOFF questionnaire. A total of 14 modified Poisson regression analyses were estimated to determine the association between APEDS use and a positive eating disorder screen among women and men.

Results

Lifetime use of protein supplements and diuretics or water pills were associated with a positive eating disorder screen among both women and men, while use of non-steroid synthetic muscle enhancers was associated with a positive eating disorder screen among men and creatine supplement use was associated with a positive eating disorder screen among women. The risk of a positive eating disorder screen was highest among men who reported use of five APEDS in their lifetime.

Conclusions

Lifetime use of APEDS is associated with eating disorder symptomatology among a national sample of U.S. college and university students. Prevention and intervention efforts are needed to address the link between these potentially harmful behaviors.

Level of evidence

Level V, cross-sectional descriptive study.

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Availability of data and materials

The Healthy Minds Study is available to researchers. Please visit http://healthymindsnetwork.org for more information.

Code availability

Not applicable.

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Funding

JMN is supported by the National Institutes of Health (K08HL159350) and the American Heart Association (CDA34760281). No funding was used to support this research.

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Authors and Affiliations

  1. Factor-Inwentash Faculty of Social Work, University of Toronto, 246 Bloor Street W, Toronto, ON, M5S 1V4, Canada

    Kyle T. Ganson

  2. School of Psychology, The University of Sydney, Sydney, NSW, Australia

    Mitchell L. Cunningham

  3. Department of Psychiatry and the Behavioral Sciences, University of Southern California, Los Angeles, CA, USA

    Stuart B. Murray

  4. Department of Pediatrics, University of California, San Francisco, San Francisco, CA, USA

    Jason M. Nagata

Authors
  1. Kyle T. Ganson
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  2. Mitchell L. Cunningham
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  3. Stuart B. Murray
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  4. Jason M. Nagata
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Contributions

KTG conceptualized the study, conducted the statistical analyses, and drafted an initial manuscript. MC, SBM, and JMN provided conceptual contributions and reviewed and edited the manuscript. All authors approved of the final manuscript as submitted.

Corresponding author

Correspondence to Kyle T. Ganson.

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Conflict of interest

All authors declare no conflicts of interest.

Research involving human participants

Healthy Minds Study was approved by the Health Sciences and Behavioral Sciences Institutional Review Board at the University of Michigan and all participating institutions. This study is exempt from research ethics approval given the data is publicly available and unidentifiable.

Informed consent

Informed consent was obtained from all individual participants included in the study.

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Ganson, K.T., Cunningham, M.L., Murray, S.B. et al. Use of appearance- and performance-enhancing drugs and substances is associated with eating disorder symptomatology among U.S. college students. Eat Weight Disord 27, 2245–2250 (2022). https://doi.org/10.1007/s40519-022-01364-z

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  • DOI: https://doi.org/10.1007/s40519-022-01364-z

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