Disparities in eating disorder symptoms and mental healthcare engagement prior to and following the onset of the COVID-19 pandemic: Findings from a national study of US college students

Kelly A Romano; Sarah K Lipson; Ariel L Beccia; Paula A Quatromoni; Jose Murgueitio

doi:10.1002/eat.23869

Disparities in eating disorder symptoms and mental healthcare engagement prior to and following the onset of the COVID-19 pandemic: Findings from a national study of US college students

Int J Eat Disord. 2023 Jan;56(1):203-215. doi: 10.1002/eat.23869. Epub 2022 Dec 8.

Authors

Kelly A Romano¹, Sarah K Lipson², Ariel L Beccia³, Paula A Quatromoni⁴, Jose Murgueitio⁵

Affiliations

¹ Department of Psychology, Virginia Consortium Program in Clinical Psychology, Norfolk, Virginia, USA.
² Boston University School of Public Health, Department of Health Law Policy and Management, Boston, Massachusetts, USA.
³ Division of Adolescent and Young Adult Medicine, Boston Children's Hospital, Boston, Massachusetts, USA.
⁴ Department of Health Sciences, College of Health and Rehabilitation Sciences: Sargent College, Boston University, Boston, Massachusetts, USA.
⁵ Department of Psychology and Neuroscience, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA.

Abstract

Objective: Early COVID-19 eating disorders (EDs) research used regionally restricted samples with little sociodemographic diversity. The present study aimed to address these research gaps by examining whether pandemic-related changes in ED symptoms and mental healthcare prevalence differed for historically marginalized groups within a national sample of US college students.

Method: Participants included 242,906 US college students (M_age = 23.45, SD = 7.04; M_BMI = 25.28, SD = 5.91) who completed the repeated cross-sectional multi-institute Healthy Minds Study between January 2019 and May 2021. Moderated logistic regressions examined whether pandemic-related changes in individuals' likelihoods of exhibiting current probable ED, reporting lifetime ED diagnoses, and-among individuals with current probable ED-mental healthcare engagement differed for diverse gender, sexual, and racial/ethnic identity groups, and by body mass index (BMI) and financial stress.

Results: There were increases of 5% and 12% in individuals' likelihoods of exhibiting current probable ED and symptomatic individuals' mental healthcare engagement, respectively, pre- to post-COVID-19 onset, but no pandemic-related changes in lifetime ED diagnosis prevalence. There were also important variations in these time-trends for different marginalized groups. For example, individuals identifying as genderqueer/gender nonconforming and lesbian exhibited increasing ED symptoms pre- to post-COVID-19 onset, and individuals with current probable ED and higher BMIs were increasingly likely to receive mental healthcare. Associations between financial stress, and the ED and mental healthcare outcomes did not change over time.

Discussion: These findings provide insight into groups of US college students that experienced disproportionate ED burden during the pandemic at the population level, and directions for research and interventions that warrant consideration.

Keywords: disordered eating; eating disorders; mental health; young adults.

Publication types

Research Support, N.I.H., Extramural
Research Support, Non-U.S. Gov't

MeSH terms

Adult
COVID-19* / epidemiology
Cross-Sectional Studies
Feeding and Eating Disorders* / diagnosis
Feeding and Eating Disorders* / epidemiology
Feeding and Eating Disorders* / therapy
Female
Humans
Mental Health Services*
Pandemics
Students
Young Adult

Abstract

Publication types

MeSH terms

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