Disparities in eating disorder diagnosis and treatment according to weight status, race/ethnicity, socioeconomic background, and sex among college students

ObjectiveEating disorders (EDs) present a significant threat to the health of adolescents and young adults, yet remain under‐diagnosed and under‐treated at a population‐level. EDs have historically been thought to afflict “skinny, white, affluent girls” (the SWAG stereotype). As such, higher‐weight individuals, racial/ethnic minorities, those from socioeconomically disadvantaged backgrounds, and males may not recognize their need for treatment, may not be properly screened for EDs, and/or may not be referred to treatment.MethodUsing large‐scale survey data from the healthy bodies study, we examined variations in prevalence of perceived need for ED treatment, ED diagnosis, past‐year ED treatment, and treatment barriers according to weight status, race, socioeconomic background, and sex among undergraduate and graduate students with symptoms of an ED (N = 1,747).ResultsAmong students with symptoms of an ED, 30.7% perceived a need for treatment, 10.5% had received a diagnosis, and 13.6% had received treatment in the past year. Individual characteristics were highly associated with perceived need, diagnosis, and past‐year treatment. Females were more likely than males to perceive a need for treatment (OR = 1.97), to be diagnosed (OR = 4.66), and to be treated (OR = 1.64) for their ED symptoms. Socioeconomic background was associated with perceived need for treatment and past‐year treatment, with students from affluent backgrounds having higher odds of perceiving need (OR = 1.52) and of receiving treatment (OR = 1.89) compared with their non‐affluent peers.DiscussionAt a population‐level, the unmet need for ED treatment disproportionately affects certain groups. Stereotypes about who develops EDs could contribute to disparities in ED treatment and outcomes.Peer Reviewedhttps://deepblue.lib.umich.edu/bitstream/2027.42/144703/1/eat22846_am.pdfhttps://deepblue.lib.umich.edu/bitstream/2027.42/144703/2/eat22846.pd