Prevalence and risk and protective factors related to disordered eating behaviors among adolescents: relationship to gender and ethnicity.

Purpose: To examine the current prevalence of disordered eating behaviors in a large sample of adolescents, by gender and ethnicity, and to identify gender and ethnic-specific risk and protective factors.

Methods: The study population included 81,247 9th- and 12th-graders who completed the 1998 Minnesota Student Survey, a self-report, school-based survey which included questions about disordered eating behaviors and a variety of psychosocial characteristics.

Results: Fifty-six percent of 9th-grade females and 28% of 9th-grade males report disordered eating behaviors (i.e. one or more of the following to lose or control weight: fasting or skipping meals, diet pills, vomiting, laxatives or smoking cigarettes; and binge-eating), with slightly higher rates among 12th-grade females and males, 57% and 31%, respectively. Among both genders, Hispanic and American Indian youth reported the highest prevalence of disordered eating. Risk factors for disordered eating among both males and females included cigarette smoking, appearance concerns, and alcohol use. Protective factors for both males and females were positive self-esteem, emotional well-being, school achievement, and family connectedness. While risk and protective factors were similar across gender, they differed across ethnicity particularly among females.

Conclusions: Health professionals working with youth need to be aware of the high prevalence of these subclinical disordered eating behaviors, ask appropriate screening questions, and provide resources and referral, if necessary, for youth reporting these behaviors. Knowledge of risk and protective factors can serve to guide intervention and prevention efforts, particularly as they apply across ethnicity.