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.     

Gender Differences in the Associations Among Body Mass Index,Weight Loss,Exercise, and Drinking Among College Students

Abstract

Objective: To explore gender differences regarding weight management behaviors of college drinkers. Participants: Nationally representative sample of college students from the fall 2008 American College Health Association's National College Health Assessment II (N = 26,062 students). Methods: Structural equation modeling was used to examine potential gender differences in associations among exercise, weight loss behaviors, and alcohol use. Results: Critical ratio tests revealed that associations between exercise and weight loss behaviors were more strongly correlated among females as compared with males. For females, there was a small negative association between exercise and drinking behaviors; in contrast, for males, there was a positive relationship between exercise and alcohol use. Weight loss behaviors were positively associated with drinking for both female and male students; however, the association was significantly stronger for females. Conclusions: This investigation furthers previous research on drunkorexia and also sheds additional light on the gender-based differences in weight management behaviors of drinkers.     

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.     

Weight Loss Practices and Body Weight Perceptions Among US College Students

Objective: The authors assessed associations between body weight perception and weight loss strategies. Participants: They randomly selected male and female college students (N = 38,204). Methods: The authors conducted a secondary data analysis of the rates of weight loss strategies and body weight perception among students who completed the National College Health Assessment survey. Results: Half of respondents (50%) were trying to lose weight, although only 28% of students were overweight or obese. Also, 12% of respondents had inaccurate body weight perception. Women and men with inaccurate body weight perception were significantly more likely to engage in inappropriate weight loss strategies than were those with accurate body weight perception. Of all students attempting to lose weight, 38% used both diet and exercise. Conclusions: These data show that college students are interested in weight loss and that body weight perception plays an important role in the desire to lose weight.     

Improving body image and sexual health behaviors among college women

ABSTRACT

Objective: To conduct a pilot test to determine if the Body Project, an eating disorder prevention program, was able to reduce risky sexual behaviors. Participants: Twenty college-age women ages 18–21 (in March, 2015) who endorsed both body image dissatisfaction and previous or current sexual activity. Methods: Participants were randomized to the Body Project or psychoeducational control group, and completed baseline, post-test, and 6-month follow-up measures assessing body image concerns, eating behaviors, and sexual behaviors and attitudes. Results: An intervention manipulation check demonstrated that body image variables were in expected directions, though were not significant by group. There was a significant interaction across group and time for “unanticipated sexual encounters,” which decreased in the Body Project group. Conclusions: This pilot study supports the feasibility of using an eating disorder prevention program to reduce other risky behaviors, specifically risky sexual behaviors.     

Eating and Exercise Disorders in Young College Men

Abstract

The authors used the computerized Eating and Exercise Examination to investigate eating, weight, shape and exercise behaviors in a convenience sample of 93 male college students. One fifth of the men worried about their weight and shape, followed rules about eating, and limited their food intake. Between 9% and 12% were unhappy with their body shape, felt fat, and seriously wanted to lose weight. Exercise was important for the self-esteem of 48% of the students. Thirty-four percent were distressed when they could not exercise as much as they wanted, 27% followed rules about exercising, and 14% worried about the amount of exercise they were doing. The respondents met clinical diagnoses for objective binge eating (3%), self-induced vomiting (3%), bulimia nervosa (2%), and exercise disorders (8%). Although 9% reported disordered eating, none had sought treatment. Health professionals should be aware that eating and exercise disorders may be present in college men and that screening may help in the early identification of these problems.     

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.     

A Population-Wide Screening and Tailored Intervention Platform for Eating Disorders on College Campuses: The Healthy Body Image Program

Abstract

Objectives: This article presents a new approach to intervention for eating disorders and body image concerns on college campuses, using a model of integrated eating disorder screening and intervention. Formative data on implementation feasibility are presented. Participants: College students enrolled at 2 universities between 2011 and 2012. Methods: The Healthy Body Image program is an evidence-based screening and intervention platform, enacted via community and online resources. An online screen was used to identify students at varying levels of risk or eating disorder symptom status; responses were used to direct students to universal or targeted online interventions or further evaluation. Universal prevention programs to improve healthy weight regulation and body image culture were offered to all students. Results: Formative data from 1,551 students illustrates the application of this model. Conclusions: The Healthy Body Image program is feasible to deliver and provides a comprehensive system of screening, evidence-based intervention, and community culture change.     

“Drunkorexia”: Understanding eating and physical activity behaviors of weight conscious drinkers in a sample of college students

Objective: Behaviors of weight conscious drinkers (BWCD) include disordered eating, excessive physical activity (PA), and heavy episodic drinking. Considering that approximately 25% of the college students report BWCD, it is important to investigate what characteristics increase the likelihood of college students engaged in BWCD for both moderate and vigorous PAs. Participants: A total of 510 college students were recruited from a large, public southeastern university. Methods: Participants completed a cross-sectional survey during the spring 2015 semester. Results: Of 510 respondents, 11.2% reported moderate PA-based BWCD and 14.7% reported vigorous PA-based BWCD. Weight loss intention, BMI and Greek affiliation predicted both moderate and vigorous BWCD. Conclusions: Study findings suggest that Greek-affiliated students and students with weight loss intentions might be at an increased risk for BWCD. Along with promoting lower levels of alcohol consumption, college practitioners should consider discussing issues of weight and body image with college students as they relate to maladaptive drinking behavior.     

Classroom Approach for Managing Dietary Restraint,Negative Eating Styles,and Body Image Concerns Among College Women

Objective: In this exploratory study, the authors evaluated the impact of an elective college course on dieting levels, eating styles, and body image among college women. Participants: Participants were a convenience sample of 29 self-selected female students at a western university who were mostly white, normal-weight seniors with significant dieting experience. Methods: The authors used valid and reliable instruments to collect data both before and after testing. An instructor conducted the program in an undergraduate course that met twice weekly for 15 weeks. Theory-based lessons focused on resisting media pressure, modifying dietary restraint, eating in response to hunger (intrinsic eating), and achieving healthy body image. Dependent variables included intrinsic eating, dieting involvement, emotional eating, body image, and self-esteem. Results: A comparison of pretest and posttest scores identified significant improvements for most measures. Conclusions: A theory-driven elective course implemented within a college setting may improve women's eating styles and body image.     

Perceived Stress,Energy Drink Consumption,and Academic Performance Among College Students

Abstract

Objective: This study explored relationships regarding perceived stress, energy drink consumption, and academic performance among college students. Participants: Participants included 136 undergraduates attending a large southern plains university. Methods: Participants completed surveys including items from the Perceived Stress Scale ¹ Cohen, S, Kamarck, T and Mermelstein, R. 1983. A global measure of perceived stress. J Health Soc Behav, 24: 385–396. [Crossref], [PubMed], [Web of Science ®] , [Google Scholar] and items to describe energy drink consumption, academic performance, and demographics. Results: Positive correlations existed between participants’ perceived stress and energy drink consumption. Participants’ energy drink consumption and academic performance were negatively correlated. Freshmen (M = 0.330) and sophomores (M = 0.408) consumed a lower number of energy drinks yesterday than juniors (M = 1.000). Males reported higher means than females for selected energy drink consumption items. Statistically significant interactions existed between gender and year in school for selected energy drink consumption items. Conclusions: Results confirm gender differences in energy drink consumption and illuminate a need for education regarding use of energy drinks in response to perceived stress.     

Associations Between Physical Activity and Health-Related Factors in a National Sample of College Students

Abstract

Objective: To examine associations between meeting the current moderate to vigorous physical activity (MVPA) recommendation and health-related factors in a national sample of college students. Participants: Participants (N = 67,861) completed the National College Health Assessment II during the Fall 2008/Spring 2009 academic year. Methods: Hierarchical binary logistic regression was used to examine the contribution of 19 variables in explaining whether or not participants met the MVPA recommendation. Results: Meeting the MVPA recommendation was associated with several protective factors among college students, including adequate daily fruit and vegetable consumption, positive perception of general health, healthy body mass index, consistent seatbelt use, not smoking cigarettes, less perceived depression, and adequate sleep. In addition, meeting the MVPA recommendation was also significantly associated with a few risky behaviors including binge drinking, physical fighting, and multiple sexual partners. Conclusions: College student PA interventions should consider also addressing fruit/vegetable consumption and binge drinking.     

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.     

Weight and Weight-Related Behaviors Among 2-Year College Students

Abstract

Objectives and Participants: The purpose of this article is to describe weight indicators and weight-related behaviors of students enrolled in 2-year colleges, including sex differences. Methods: During Fall 2011 and Spring 2012, 441 students from 3 Minnesota community colleges enrolled in the Choosing Healthy Options in College Environments and Settings (CHOICES) Study and completed baseline assessments. Participants completed a baseline survey evaluating eating and activity patterns, sleep, and stress and measures of height, weight, waist circumference, and body fat. Results: Participants were primarily female (68%), white (73%), with a mean age of 22.8 years, and 66.2% reporting an annual income < $12,000. Almost half (47%) were overweight or obese. Young males appeared to engage the most in risky health behaviors and had higher levels of overweight or obesity, compared with young females. Conclusions: Findings confirm the need for innovative interventions targeting this understudied and underserved young adult population.     

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.     

Racial/ethnic differences in body weight perception among U.S. college students

Objective: To examine racial/ethnic differences in weight perception by sex among U.S. college students. Participants: a national sample (N = 70,267) of college students selected from 2- and 4-year postsecondary institutions (N = 62) during the Fall semester from 2011 to 2014. Methods: This is a secondary data analysis using 4 years of American College Health Association-National College Health Assessment IIb data. Sex-stratified multinomial logistic regression was performed to investigate racial/ethnic differences in body weight perception. Results: Compared with non-Hispanic whites, non-Hispanic black men and women were more likely to underestimate their body weight (p < .01). Asian men and women were more likely to overestimate their body weight than non-Hispanic whites (p < .001). Conclusions: Weight-related interventions should take into account racial/ethnic differences in body weight perception.     

My Student Body: Effects of an Internet-Based Prevention Program to Decrease Obesity Among College Students

Abstract

Objective: To determine the impact of My Student Body (MSB)–Nutrition, an Internet-based obesity prevention program for college students. Participants: Three hundred and twenty ethnically diverse undergraduate students were randomly assigned to 1 of 3 conditions: MSB-Nutrition program, an on-campus weight management course, and a comparison group. Methods: Students completed baseline and follow-up surveys regarding their nutrition and physical activity behaviors, self-efficacy, stress, attitudes, and body weight. Results: Compared with the on-campus course and a comparison group, the MSB-Nutrition program increased fruit and vegetable consumption, reduced stress, and increased fruit and vegetable self-efficacy but had no significant effect on students’ exercise self-efficacy, exercise behavior, or weight loss. Conclusions: The MSB-Nutrition program was effective in changing students’ nutrition behaviors but had no effect on physical activity behaviors or weight loss. Suggestions for improving Internet-based interventions aimed at decreasing obesity rates among college students are offered.     

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.     

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.     

Body image,self-esteem,and behavioral risk for chronic disease among college students: Additional evidence for integrated prevention

Abstract

Objective: To examine associations between two body image constructs (body appreciation and body satisfaction) and five health behaviors (diet, physical activity, weight management, tobacco exposure, and alcohol intake) associated with risk for chronic disease, controlling for self-esteem. Participants: Three hundred and forty-four college students enrolled at a large, public university in the southeastern US. Methods: Students completed an online survey composed of measures of body appreciation, body satisfaction, self-esteem, and frequency of engagement in preventive health behaviors. Hierarchical linear regression models were used to assess relationships between constructs. Results: Body appreciation, but not body satisfaction or self-esteem, significantly and positively predicted engagement in diet-, physical activity-, and weight-related health behaviors. No associations were found for substance use outcomes. Conclusions: Results illuminate health risks among college students and provide additional evidence to support the development of holistic preventive interventions that simultaneously address aspects of mental and physical health among college students.