Body mass index, disordered eating behavior, and acquisition of health information: examining ethnicity and weight-related issues in a college population

OBJECTIVE AND PARTICIPANTS: To investigate ethnic differences related to weight, the authors assessed body mass index, dysfunctional eating, receipt of health information, and perceived obstacles to healthy lifestyles of 210 ethnically diverse college women. METHODS: The authors used the Eating Attitudes Test to assess dieting, food preoccupation, and bulimic behaviors. RESULTS: The authors found no ethnic differences in body mass index or disordered eating, but African Americans were more likely than were European Americans and Latina Americans to receive nutrition information from professionals and less likely than European Americans to perceive time as an obstacle. Overall, receipt of health information from a professional was related to fewer disordered eating behaviors; however, the specific eating behavior that was reduced varied by ethnicity. CONCLUSIONS: Health professionals should reconsider traditional assumptions of disordered eating behavior as a European American problem and consider cultural appropriateness in the development of effective health programs.     

Risk Factors Associated With Overweight and Obesity in College Students

College obesity is increasing, but to the authors' knowledge, no researchers to date have evaluated risk factors in this population. Objective: The authors assessed whether abnormal eating perceptions and behaviors were associated with overweight in college students. Participants and Methods: A sample of undergraduates (N = 4,201) completed an online survey containing demographic questions and the Eating Attitudes Test-26 (EAT-26) questionnaire. The authors stratified participants into normal-weight and overweight/obese groups and evaluated physical activity, EAT-26 score, purging behaviors, and answers to selected overweight screening questions on the basis of body mass index. A modified EAT-26 score of ≥ 11 was associated with overweight (p = .016). Results: Compared with normal-weight peers, overweight participants displayed an increased fear of bingeing, preoccupation with food, desire to be thinner, and engagement in dieting behavior. Mean body mass index also increased with age and physical inactivity (p < .001). Conclusions: Because physical inactivity, disordered eating perceptions, and disordered behaviors are associated with increased rates of overweight and obesity, identification of these risk factors in obese youths may increase understanding of weight loss barriers and facilitate the treatment of adolescent obesity.     

Longitudinal Evaluation of Peer Health Education on a College Campus: Impact on Health Behaviors

Objective: The authors investigated the longitudinal impact of peer health education on the health behaviors of undergraduate students pertaining to alcohol and drug use, eating and nutrition, and sexual health. Participants: From fall 2003 to spring 2006, the authors annually administered a Web-based survey to a cohort of 2,000 randomly selected undergraduate students. Results: Students who had contact with peer health educators were significantly more likely over time than other students to report less alcohol consumption and fewer related negative consequences. Results also show that students who had contact with peer health educators initially endorsed engaging in unhealthy weight management and fat talk behaviors during their first year but decreased these unhealthy behaviors by their third year. No significant differences in sexual health behaviors were found. Conclusions: Results indicate that peer health educators play an important role in promoting healthy behaviors in the areas of alcohol and drug use and in eating and nutrition.     

Health Information-Seeking in the Digital Age

Abstract

Objective: The authors examined the sources of health information among first-year university students and whether the predictors of information-seeking varied by information source. Participants: First-year students in a required course at a midwestern public university were eligible to participate, and 82% (n = 1,060) completed the study. Methods: Students completed a survey questionnaire regarding information-seeking behaviors and Internet uses in domains including health. The authors used regression analyses to examine predictors of source-specific health information-seeking. Results: Young women are much more likely than young men to seek health information. The characteristics associated with looking online for health information are different than those for using other information sources, and students who look online for health information also report greater use of other information sources. Conclusions: Although the Internet is an important source of health information for students, health professionals should be aware that not all students equally utilize this resource.     

Risk factors associated with overweight and obesity in college students

College obesity is increasing, but to the authors' knowledge, no researchers to date have evaluated risk factors in this population. OBJECTIVE: The authors assessed whether abnormal eating perceptions and behaviors were associated with overweight in college students. PARTICIPANTS AND METHODS: A sample of undergraduates (N = 4,201) completed an online survey containing demographic questions and the Eating Attitudes Test-26 (EAT-26) questionnaire. The authors stratified participants into normal-weight and overweight/obese groups and evaluated physical activity, EAT-26 score, purging behaviors, and answers to selected overweight screening questions on the basis of body mass index. A modified EAT-26 score of > or = 11 was associated with overweight (p = .016). RESULTS: Compared with normal-weight peers, overweight participants displayed an increased fear of bingeing, preoccupation with food, desire to be thinner, and engagement in dieting behavior. Mean body mass index also increased with age and physical inactivity (p < .001). CONCLUSIONS: Because physical inactivity, disordered eating perceptions, and disordered behaviors are associated with increased rates of overweight and obesity, identification of these risk factors in obese youths may increase understanding of weight loss barriers and facilitate the treatment of adolescent obesity.     

The College Health Advisor and the College Age Adoptee

Abstract

Eating disorders are among the most common psychopathologies on college campuses. Research on ethnic differences in eating disorder symptoms and prevalence has resulted in conflicting conclusions. Some studies find that particular ethnic groups have a higher prevalence of a symptom; others find that members of that ethnic group have a lower prevalence of the same symptom. The authors explored the role of body mass index (BMI), one potential confound. They used a reliable measure of eating disorder symptoms to assess differences between Hispanic, Asian, and non-Hispanic White college women from two separate samples. After controlling for BMI, ethnic differences in eating disorder symptoms of concern about weight and shape disappeared, but differences in restrained eating remained. Inconsistent findings in the ethnic-difference literature on eating disorders may result from systematic group differences in BMI. Implications for college health programs, counseling, and case finding are discussed.     

Appropriate Terminology for the Alcohol,Eating, and Physical Activity Relationship

Abstract

“Drunkorexia” merges prior literature identifying positive relationships between (a) alcohol use/abuse and disordered eating/eating disorders, (b) alcohol use/abuse and physical activity, and (c) disordered eating/eating disorders and physical activity. The term, highlighting an individual's proactive and/or reactive weight management behaviors (ie, disordered eating, physical activity) in relation to alcohol consumption, originated in news editorials and has recently gained recognition via use in scholarly publications. The purpose of this commentary is to recommend discontinuing use of the term “drunkorexia” due to (a) inconsistent definitions of drunkorexia across investigations, (b) drunkorexia being a misnomer, and (c) the medical community's lack of recognition/acceptance of drunkorexia. Because the behaviors encompassed by drunkorexia are of concern to researchers and health professionals, future investigations are still warranted. However, until a medically recognized term/phrase is accepted, scholars should utilize more appropriate characterizations such as “weight-conscious drinkers,” “weight management behaviors of drinkers,” or “Eating Disorders Not Otherwise Specified” (Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, Text Revision).     

College Health Professionals and Academic Librarians: Collaboration for Student Health

College health professionals must find new ways of educating students on finding and evaluating consumer health information, specifically in the online environment. Librarians are trained as information professionals; however, librarians at general academic libraries are not taking a lead role in providing consumer health information. Objective: The authors' purpose in this research was to determine the health information resource needs of college and university students and provide a model for collaboration between college health professionals and academic librarians. Participants and Methods: The authors compared data from a national survey on college health (N = 54,111) with their own results from a survey of general academic librarians (N = 17) to create recommendations for synching students' reported health information needs with librarians' resources. Results: Although the Internet was students' second most-often consulted health information source, they ranked the believability of online health information above only television. In the librarian survey, although 12 respondents indicated that health information provision is a library's responsibility, the majority (n = 11) believed their library's consumer health outreach to be passive. Conclusions: The authors offer recommendations for partnerships between college healthcare professionals and academic librarians to better provide this information to students.     

An Examination of Influences on Body Dissatisfaction Among Asian American College Females: Do Family,Media, or Peers Play a Role?

Abstract

Objective: The etiology of body dissatisfaction and its correlates (eg, disordered eating) among ethnic minorities is generally unknown. The purpose of this study was to replicate the tripartite model of influence in an Asian American college female sample in order to examine this relationship. Participants: Participants were 80 undergraduate Asian American females between the ages of 18 and 25. Methods: Participants completed a survey that included the Tripartite Influence Scale, Body Parts Satisfaction Scale, and Sociocultural Attitudes towards Appearance Questionnaire–3. Results: Mediation analyses indicated that thin-ideal internalization fully mediated the relationship between media influence and body dissatisfaction and partially mediated the relationship between peer influence and body dissatisfaction. Family influence did not significantly predict body dissatisfaction. Conclusions: Asian American college females experience body dissatisfaction through mechanisms that have not been examined in detail. These factors must be considered when creating targeted health promotion strategies and developing best practices for eating disorder assessment and treatment protocols at university health centers.     

Attention-deficit hyperactivity disorder symptomatology,binge eating disorder symptomatology,and body mass index among college students

Abstract

Objective: To explore the relationship between symptoms of attention-deficit hyperactivity disorder (ADHD), symptoms of binge eating disorder, and body mass index (BMI) among students at a southern university. Participants: Two hundred seventy-seven college students. Methods: Between January 31, 2013 and March 27, 2013, participants completed the Adult ADHD Self-Report Scale (ASRS) Screener and the Binge Eating Scale (BES) in addition to permitting researchers to measure their height and weight. Results: Higher ASRS scores, higher BMIs, and lower BES scores were observed among men. Among both men and women, BES scores were positively correlated with BMI and ASRS scores; however, the correlation between ASRS and BMI was not significant. Conclusion: Binge eating disorder symptomatology was associated with increased ADHD symptomatology and a higher BMI among both men and women. Among students presenting with obesity or ADHD, screening for binge eating may assist with the identification of problematic eating behaviors.     

Differences in Dietary Patterns Among College Students According to Body Mass Index

Objective and Participants: The authors surveyed 557 undergraduate students aged 18-56 years to assess weight status, health behaviors, and dietary variety. Methods: They used body mass index (BMI) to divide students into 4 weight categories: underweight (BMI < 19 kg/m²), healthy weight (19 kg/m² to 24.99 kg/m²), over-weight (25 kg/m² to 29.99 kg/m²), and obese (> 30 kg/m²). Results: Approximately 33% of respondents were overweight or obese, and 8% were underweight. Among the weight categories, the authors observed significant differences in diet (eg, cheese, pork, lamb, veal and game, fish, green leafy vegetables, other vegetables, and the cumulative total of all meats). Overall, 33% of the students consumed 1 fruit in 3 days. The authors found no differences among the weight categories related to eating fatty, sugary snacks. Conclusions: College administrators should create health promotion and skill-building programs to improve students' diet variety.     

Drunkorexia: Understanding the Co-occurrence of Alcohol Consumption and Eating/Exercise Weight Management Behaviors

Abstract

Objective: Examine the co-occurrence of alcohol consumption, physical activity, and disordered eating behaviors via a drunkorexia perspective. Participants: Nationally representative sample (n = 22,488) of college students completing the Fall 2008 National College Health Assessment. Methods: Hierarchical logistic regression was employed to determine if physical activity and disordered eating behaviors uniquely predicted binge drinking, while controlling for age, race, gender, year in college, Greek membership, and place of residence. Results: Physical activity and disordered eating made unique, statistically significant contributions. Moreover, including physical activity and disordered eating behaviors allowed for the correct classification of an additional 431 cases (ie, binge drinkers) over and above the predictive ability of the covariate-only model. Conclusions: Findings corroborate prior research indicating highly active college students are more likely to binge drink than their nonactive peers, and highlight the potential of a drunkorexia perspective in explaining the counterintuitive alcohol–activity association among college students.     

Two distinct mediated pathways to disordered eating in response to weight stigmatization and their application to prevention programs

ABSTRACT

Objective: Disordered eating behaviors among undergraduate women are common and, thus, are an important public health concern. Weight stigmatization, stress, and social withdrawal are often associated with disordered eating behaviors; however, it is unclear whether stress and social withdrawal act as mediators between weight stigmatization and disordered eating. By testing specific pathways to disordered eating, theory-driven prevention programs can be implemented. Methods: Self-reported surveys were administered to 217 undergraduate women during the Fall 2014 semester. Results: There were 2 distinct mediational pathways in response to weight stigmatization. Stress partially mediated the path between weight stigmatization and emotional eating (38%), whereas social withdrawal partially mediated the path between weight stigmatization and dietary restraint (44%). Conclusions: Stress and social withdrawal mediate the relationship between weight stigmatization and disordered eating. The results of this study identified potentially critical risk factors that, if addressed, may improve outcomes of campus-based disordered eating programs for women.     

Female Collegiate Athletes: Prevalence of Eating Disorders and Disordered Eating Behaviors

Objective: The authors assessed the prevalence of pathogenic eating and weight-control behaviors among female college athletes, using a psychometrically valid measure. Participants: Participants were 204 college athletes (M age = 20.16 years, SD = 1.31 years) from 17 sports at 3 universities. On average, they participated in their sport for 10.88 years (SD = 16.68 years) and on their college team for 2.10 years (SD = 1.03 years). Methods: Participants completed a demographic and weight background questionnaire, Questionnaire for Eating Disorder Diagnoses, and the Bulimia Test-Revised. Results: The authors classified participants as eating disordered (n = 4, 2.0%), symptomatic (n = 52, 25.5%), and asymptomatic (n = 148, 72.5%). Few participants engaged in binge eating; most used exercise, as opposed to vomiting, dieting, laxatives, or diuretics, to control their weight. Conclusions: Female athletes suffer from eating disorders, and most experience symptom levels that are subclinical but problematic.     

A Description of Disordered Eating Behaviors in Latino Males

Abstract

Objective: To explore disordered eating and eating disorders (EDs) in Latino males. Participants: Participants are 722 male college students from a larger prevalence study conducted in the University of Puerto Rico system. Methods: Participants were selected from a list of sections of required courses for first-year students on each campus. Self-report instruments were used to explore ED symptoms (the Eating Attitudes Test [EAT-26] and the Bulimia Test–Revised [BULIT-26-R] and the Beck Depression Inventory depression (BDI). Results: Overall, 2.26% scored above the cut-off point on the BULIT-R and 5.08% score above the cut-off point on the EAT-26. Of the males, 4.43% reported sufficient frequency and severity to approximate DSM-IV criteria for bulimia nervosa. Depression symptomatology was found in those who scored above the cut-off point on both instruments of EDs. Conclusion: College health practitioners should be aware of disordered eating in Latino males and include them in efforts to detect disordered eating behaviors in college students.     

Racial/Ethnic Disparities in Health: The Role of Lifestyle,Education, Income,and Wealth

Abstract

This article addresses the persistent relationship between race/ethnicity, SES, health-related lifestyle behaviors, and self-reported health using data from the 1995 National Health Interview Survey and its topical supplements. Through a series of models, we found that both SES (education, income, home ownership, and house and business monetary value) and health-related lifestyle behaviors (physical activity, nutrition awareness, and smoking) contribute to racial/ethnic disparities in self-reported health. Further, the impact of education on smoking behavior and self-reported health differs by race/ethnicity, with non-Hispanic whites receiving greater health benefits from education than African Americans and Hispanics. Although SES and lifestyle behaviors are indirect paths through which race/ethnicity affects health, the relationship between SES and health also is shaped by racial/ethnic status.     

College Students and the Diagnosis of Attention Deficit Hyperactivity Disorder

Abstract

Background: When H1N1 emerged in 2009, institutions of higher education were immediately faced with questions about how best to protect their community from the virus, yet limited information existed to help predict student preventive behaviors. Methods: The authors surveyed students at a large urban university in November 2009 to better understand how students perceived their susceptibility to and the severity of H1N1, which preventive behaviors they engaged in, and if policies impacted their preventive health decisions. Results: Preventive health behavior messaging had a mixed impact on students. Students made simple behavior changes to protect themselves from H1N1, especially if they perceived a high personal risk of contracting H1N1. Although policies were instituted to enable students to avoid classes when ill, almost no student self-isolated for the entire duration of their illness. Conclusions: These findings can help inform future decision making in a university setting to best influence preventive health behaviors.     

Normative Beliefs as Risk Factors for Involvement in Unhealthy Weight Control Behavior

Objective: The authors' aim in this study was to determine, after adjustment for the effects of body mass index and sociodemographic measures, whether sex-specific weight control norms would have significant independent relationships with the weight control behavior of college women and men. Participants: The authors used an anonymous questionnaire to assess a sample of 470 college students, aged 18 to 26 years, attending either a 2- year community college or a 4-year public university. Methods: To calculate body mass index, the authors objectively measured the height and weight of each participant. They conducted separate discriminant function analyses for women and men. Results: The discriminant function analyses clearly indicated that weight control norms of same-sex, close friends were the best discriminators of involvement in weight control. Conclusions: The findings indicate that perceived peer norms may be important but overlooked risk factors for engaging in unhealthy weight control practices. The authors discuss the implications of these findings in the context of student health promotion.     

Predicting 1-Year Change in Body Mass Index Among College Students

Objective: Despite beliefs about weight gain in college, few researchers have evaluated this phenomenon. Participants: Participants were 18- to 31-year-old students at a midwestern university. The dependent variable was body mass index (BMI) change. Methods: The authors extracted predictor variables from a Health Risk Appraisal. These included clinical, medical history, medical usage, medications, pain or chronic conditions, perceptual measures, and behavioral factors. The authors performed an ordinal regression technique separately by gender. Results: No predictors were significant for men. Women in the BMI gain group were (1) more likely to consume alcohol, use maladaptive coping behaviors, eat foods low in fiber, and consume caffeine; and (2) less likely to be stress-free, to eat cruciferous vegetables, and to refrain from eating high-cholesterol foods. Conclusions: The lack of research on predictors of and interventions for reducing BMI gain among college students warrants more research.