Characterizing eating disorder diagnosis and related outcomes by sexual orientation and gender identity in a national sample of college students
Anne Claire Grammer, Melissa M Vázquez, Ellen E Fitzsimmons-Craft, Lauren A Fowler, Gavin N Rackoff, Natasha A Schvey, Sarah Ketchen Lipson, Michelle G Newman, Daniel Eisenberg, C Barr Taylor, Denise E Wilfley, Anne Claire Grammer, Melissa M Vázquez, Ellen E Fitzsimmons-Craft, Lauren A Fowler, Gavin N Rackoff, Natasha A Schvey, Sarah Ketchen Lipson, Michelle G Newman, Daniel Eisenberg, C Barr Taylor, Denise E Wilfley
Abstract
Objective: In a national sample of college students, the current study aimed to: 1) examine differences in probable diagnoses of EDs (i.e., anorexia nervosa (AN), clinical/subthreshold bulimia nervosa (BN), or binge eating disorder (BED)) and weight and shape concerns by sexual orientation and gender identity, and 2) examine differences in ED chronicity and probable comorbid psychiatric diagnoses by sexual orientation and gender identity.
Method: Students across nine U.S. universities completed an online screener for DSM-5 clinical or subthreshold ED diagnoses, comorbid depression and anxiety disorders, and self-reported ED chronicity. Self-reported sexual orientation and gender identity were also collected. Tukey-corrected logistic and linear regressions examined differences in outcomes separately by sexual orientation and gender identity, adjusting for age, race, and ethnicity.
Results: A total of 8,531 students (24% sexually diverse (SD); 2.7% gender diverse (GD)) were studied. Students who identified as bisexual or other sexual orientation reported significantly greater odds of a probable ED diagnosis and greater elevations in weight and shape concerns compared to heterosexual students. Cisgender female students and GD students reported significantly greater odds of a probable ED diagnosis and greater elevations in weight and shape concerns compared to cisgender male students. Some SD students and GD students who met criteria for probable EDs were also more likely to report chronic ED symptoms and probable comorbid psychiatric diagnoses compared to heterosexual students and cisgender males, respectively.
Discussion: Some SGD students may be at heightened risk for EDs, highlighting the need to identify mechanisms that contribute to disparities.
Trial registration: ClinicalTrials.gov NCT04162847.
Keywords: College students; Comorbidities; Eating disorders; Sexual and gender diverse.
Conflict of interest statement
Declaration of competing interest
All authors declare no potential conflicts of interest. The opinions and assertions expressed herein are those of the author(s) and do not necessarily reflect the official policy or position of the Uniformed Services University or the Department of Defense.
Copyright © 2021 Elsevier Ltd. All rights reserved.
Source: PubMed