Introduction
Eating disorders epidemiology
Comorbidity
ED in minority groups and help-seeking behaviours
Methods
Study population
Measures
Exposure
-
Do you make yourself Sick because you feel uncomfortably full?
-
Do you worry you have lost Control over how much you eat?
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Have you recently lost more than One stone (6.35 Kg) in a 3 month period?
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Do you believe yourself to be Fat even when other say you are too thin?
-
Would you say that Food dominates your life?
Psychological correlates
Psychiatric morbidity
Personality disorder
Post-traumatic stress disorder
Suicidal ideation and/or attempt
Alcohol use
Any drug use
Smoking
Help-seeking
Socio-demographic characteristics
Data analyses
Results
Sample characteristics
N (%)* | |
---|---|
Total sample | 1,645 |
Gender | |
Male | 714 (43.4) |
Female | 931 (56.6) |
Marital status | |
Single | 665 (40.3) |
Married/cohabiting | 754 (45.8) |
Divorced/separated/widowed | 226 (13.8) |
Ethnicity (N = 1,643) | |
White | 1,024 (62.4) |
Black | 362 (22) |
Asian | 60 (3.7) |
Other | 197 (12) |
Education (N = 1,626) | |
No qualification | 208 (12.8) |
GCSE/A-level | 738 (45.4) |
Degree level or above | 680 (41.8) |
BMI (N = 1,586) | |
Underweight | 39 (2.5) |
Normal weight | 708 (44.7) |
Overweight | 507 (32) |
Obese | 332 (20.9) |
Age | |
16–24 | 352 (21.4) |
25–34 | 396 (24.1) |
35–44 | 328 (19.9) |
45–54 | 252 (15.3) |
55–64 | 152 (9.2) |
65+ | 165 (10.4) |
Prevalence of disordered eating
Socio-demographic correlates
Socio-demographic characteristics |
N*** | Disordered eating |
p value** | |
---|---|---|---|---|
n
| Prevalence* (95 % CI) | |||
Total | 1,645 | 164 | 10.1 (8.6–11.8) | |
Gender | ||||
Male | 714 | 42 | 5.9 (4.3–7.9) | <0.0001 |
Female | 931 | 122 | 12.2 (10.2–14.5) | |
Marital status | ||||
Single | 665 | 74 | 11.7 (9.3–14.7) | 0.13 |
Married/cohabiting | 754 | 63 | 8.3 (6.5–10.7) | |
Divorced/separated/widowed | 226 | 27 | 11.2 (7.7–16.1) | |
Ethnicity***
| 1,643 | |||
White | 1,024 | 80 | 7.9 (6.2–9.8) | 0.001 |
Black | 362 | 46 | 12.8 (9.6–17) | |
Asian | 60 | 9 | 14.8 (7.5–27.2) | |
Other | 197 | 29 | 16.1 (11.3–22.4) | |
Education***
| 1,626 | |||
No qualification | 208 | 25 | 10.5 (7–15.4) | 0.02 |
GCSE/A-level | 738 | 87 | 12.4 (10–15.2) | |
Degree level or above | 680 | 50 | 7.4 (5.6–9.9) | |
Body mass index (BMI)***
| 1,586 | |||
Underweight | 39 | 4 | 11.4 (4.4–26.3) | 0.05 |
Normal weight | 708 | 58 | 8.2 (6.3–10.6) | |
Overweight | 507 | 48 | 9.6 (7.2–12.7) | |
Obese | 332 | 47 | 13.9 (10.4–18.3) | |
Age | ||||
16–24 | 352 | 52 | 16.1 (12.2–20.9) | 0.002 |
25–34 | 396 | 42 | 11.7 (8.6–15.6) | |
35–44 | 328 | 28 | 9.4 (6.6–13.2) | |
45–54 | 252 | 24 | 9.9 (6.7–14.5) | |
55–64 | 152 | 9 | 5.6 (2.9–10.7) | |
65+ | 165 | 9 | 5.5 (2.8–10.4) |
N
|
n
1
| Crude OR (95 % CI) |
p value | Adjusted OR2 (95 % CI) |
p value | |
---|---|---|---|---|---|---|
Total | 1,645 | 164 | ||||
Ethnicity | ||||||
White | 1,024 | 80 | 1.0 | – | 1.0 | – |
Black | 362 | 46 | 1.7 (1.2–2.6) | 0.008 | 1.2 (0.8–1.9) | 0.4 |
Asian | 60 | 9 | 2.0 (0.9–4.6) | 0.08 | 1.9 (0.9–4.6) | 0.1 |
Other | 197 | 29 | 2.3 (1.4–3.6) | 0.001 | 1.8 (1.1–3.0) | 0.02 |
BMI | ||||||
Underweight | 39 | 4 | 1.3 (0.4–3.8) | 0.6 | 1.6 (0.5–4.8) | 0.3 |
Normal weight | 708 | 58 | 1.0 | – | 1.0 | – |
Overweight | 507 | 48 | 1.2 (0.8–1.7) | 0.4 | 1.5 (0.9–2.2) | 0.07 |
Obese | 332 | 47 | 1.7 (1.1–2.6) | 0.01 | 2.1 (1.3–3.4) | 0.002 |
Disordered eating and behavioural and psychological outcomes
Correlates |
N
|
n
1
| Crude OR (95 % CIs) |
p value | Adjusted OR2 (95 % CIs) |
p value |
---|---|---|---|---|---|---|
Total | 1,645 | 164 | ||||
Alcohol use disorders identification test (AUDIT) | ||||||
No hazard | 1,305 | 124 | 1.0 | – | 1.0 | – |
Hazardous | 265 | 27 | 1.3 (0.8–2.1) | 0.3 | 1.7 (1.0–3.0) | 0.05 |
Hazardous and harmful | 75 | 13 | 2.4 (1.3–4.6) | 0.007 | 2.9 (1.4–6.1) | 0.003 |
Smoking status | ||||||
Non-smoker | 502 | 53 | 1.0 | – | 1.0 | – |
Current | 704 | 76 | 1.1 (0.7–1.6) | 0.8 | 1.2 (0.7–1.8) | 0.5 |
Ex-smoker | 439 | 35 | 0.7 (0.5–1.2) | 0.2 | 1.1 (0.6–1.8) | 0.8 |
Primary diagnosis | ||||||
No diagnosis | 1,212 | 76 | 1.0 | – | 1.0 | – |
Non-specified neurotic disorder | 108 | 15 | 2.3 (1.3–4.2) | 0.006 | 2.1 (1.1–3.9) | 0.02 |
Anxiety/mood/anxiety + mood disorder | 325 | 73 | 4.1 (2.8–5.9) | <0.0001 | 4.1 (2.7–5.9) | <0.0001 |
Any drug use last year | ||||||
No | 1,286 | 120 | 1.0 | – | 1.0 | – |
Yes | 359 | 44 | 1.4 (1.0–2.1) | 0.05 | 1.6 (1.1–2.5) | 0.03 |
Standardised assessment of personality-abbreviated scale (SAPAS) | ||||||
No | 1,411 | 109 | 1.0 | – | 1.0 | – |
Yes | 234 | 55 | 3.4 (2.4–4.9) | <0.0001 | 3.2 (2.1–4.8) | <0.0001 |
Post-traumatic stress disorder (PTSD) | ||||||
No | 1,562 | 139 | 1.0 | – | 1.0 | – |
Yes | 83 | 25 | 4.7 (2.8–7.7) | <0.0001 | 4.5 (2.7–7.6) | <0.0001 |
Suicide attempt or ideation | ||||||
No | 1,290 | 101 | 1.0 | – | 1.0 | – |
Yes | 355 | 63 | 2.4 (1.7–3.5) | <0.0001 | 2.5 (1.7–3.6) | <0.0001 |
Disordered eating and service use
Outcome indicator | SCOFF negative | SCOFF positive |
p value | Crude OR (95 % CI) |
p value | Adjusted OR1 (95 % CI) |
p value | ||
---|---|---|---|---|---|---|---|---|---|
n
| Prevalence (95 % CI) |
n
| Prevalence (95 % CI) | ||||||
Sought help | |||||||||
No | 942 | 62.6 (59.9–65.3) | 53 | 31.8 (24.5–39.9) | 1.0 | 1.0 | |||
No, though I should have | 314 | 21.6 (19.4–24) | 52 | 31.9 (25.1–39.5) | <0.0001 | 2.9 (1.9–4.4) | <0.0001 | 2.1 (1.3–3.3) | 0.002 |
Yes | 225 | 15.7 (13.8–17.8) | 59 | 36.3 (29.1–44.3) | 4.6 (3.1–7.1) | <0.0001 | 3.2 (1.9–5.2) | <0.0001 | |
Seen a GP | |||||||||
No | 1,319 | 88.6 (86.7–90.3) | 119 | 72.6 (64.9–79.1) | <0.0001 | 1.0 | 1.0 | ||
Yes | 162 | 11.4 (9.7–13.2) | 45 | 27.4 (20.9–35.1) | 2.9 (1.9–4.4) | <0.0001 | 2.9 (1.9–4.4) | <0.0001 | |
Seen a therapist | |||||||||
No | 1,387 | 93.7 (92.2–94.9) | 143 | 86.9 (80.6–91.5) | 0.002 | 1.0 | 1.0 | ||
Yes | 94 | 6.3 (5.1–7.8) | 21 | 13.1 (8.6–19.5) | 2.2 (1.3–3.7) | 0.003 | 2.5 (1.5–4.2) | 0.001 | |
Seen a mental health specialist | |||||||||
No | 1,459 | 98.4 (97.6–94.7) | 155 | 94.7 (90–97.2) | 0.001 | 1.0 | 1.0 | ||
Yes | 22 | 1.6 (1–2.4) | 9 | 5.3 (2.8–9.9) | 3.5 (1.6–7.9) | 0.003 | 3.2 (1.4–7.1) | 0.005 | |
ED diagnosis | |||||||||
N/A | 1,255 | 84.8 (82.8–86.6) | 105 | 64 (56.3–71.1) | <0.0001 | ||||
No | 215 | 14.6 (12.9–16.5) | 47 | 29.5 (22.8–37.3) | |||||
Yes | 1 | – | 7 | 4.4 (2.1–8.9) |