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Eat Behav. 2017 Apr;25:74-80. doi: 10.1016/j.eatbeh.2016.03.019. Epub 2016 Mar 29.

Universal prevention efforts should address eating disorder pathology across the weight spectrum: Implications for screening and intervention on college campuses.

Author information

1
Department of Medicine, The University of Chicago, Chicago, IL, USA. Electronic address: akass@medicine.bsd.uchicago.edu.
2
Lantern, San Francisco, CA, USA; Department of Psychiatry, Stanford University School of Medicine, Stanford, CA, USA.
3
Department of Psychiatry, University of Pittsburgh, Pittsburgh, PA, USA.
4
Department of Psychology, Washington University in St. Louis, St. Louis, MO, USA.
5
Department of Psychiatry, Washington University School of Medicine, St. Louis, MO, USA.
6
Department of Pediatrics, University of California, San Diego, San Diego, CA, USA.
7
Department of Psychiatry, Stanford University School of Medicine, Stanford, CA, USA.
8
Department of Psychiatry, Stanford University School of Medicine, Stanford, CA, USA; Center for mHealth, Palo Alto University, Palo Alto, CA, USA.
9
Department of Psychology, Washington University in St. Louis, St. Louis, MO, USA; Department of Psychiatry, Washington University School of Medicine, St. Louis, MO, USA.

Abstract

PURPOSE:

Given shared risk and maintaining factors between eating disorders and obesity, it may be important to include both eating disorder intervention and healthy weight management within a universal eating disorder care delivery program. This study evaluated differential eating disorder screening responses by initial weight status among university students, to assess eating disorder risk and pathology among individuals with overweight/obesity versus normal weight or underweight.

METHODS:

1529 individuals were screened and analyzed. Screening was conducted via pilot implementation of the Internet-based Healthy Body Image program on two university campuses.

RESULTS:

Fifteen percent of the sample had overweight/obesity. Over half (58%) of individuals with overweight/obesity screened as high risk for an eating disorder or warranting clinical referral, and 58% of individuals with overweight/obesity endorsed a ≥10-pound weight change over the past year. Compared to individuals with normal weight or underweight, individuals with overweight/obesity were more likely to identify as Black, endorse objective binge eating and fasting, endorse that eating disorder-related concerns impaired their relationships/social life and made them feel badly, and endorse higher weight/shape concerns.

CONCLUSIONS:

Results suggest rates of eating disorder pathology and clinical impairment are highest among students with overweight/obesity, and targeted intervention across weight categories and diverse races/ethnicities is warranted within universal eating disorder intervention efforts. Integrating eating disorder intervention and healthy weight management into universal prevention programs could reduce the incidence and prevalence of eating disorders, unhealthy weight control practices, and obesity among university students.

KEYWORDS:

Eating disorder risk; Intervention; Obesity; Overweight; Screening

PMID:
27090854
PMCID:
PMC5042805
DOI:
10.1016/j.eatbeh.2016.03.019
[Indexed for MEDLINE]
Free PMC Article

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