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

Abstract

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. 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. Cross-sectional nationally representative data collected from Wave III of the National Longitudinal Study of Adolescent to Adult Health (Add Health). Young adults ages 18-24 years old. 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. 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. 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.