Overweight people are more likely to have an eating disorder, but are less likely to be treated
When people think about eating disorders, they typically think of thin people – usually women. However, this is forgetting the most common eating disorder in society today: binge eating disorder.
Now, a new study reminds us that, despite the stereotypes, overweight or obese individuals are more likely to show signs of disordered eating behaviors compared to normal weight or underweight individuals. In most cases, these disordered eating behaviors (DEBs) were signs of binge eating disorder.
In the study, published in the Journal of General Internal Medicine, researchers found a higher rate of DEBs among young adults 18- to 24-years-old compared with those who were underweight or normal weight.
More so, those who were obese were more than 2.4 times more likely to engage in DEBs such as unhealthy weight control practices and binge eating, the team of researchers led by Jason M. Nagata, MD., wrote. This group showed the highest rate of DEBs compared to all weight categories.
Troublingly, this information does not translate to increased treatment or awareness of eating disorders among the overweight or obese. In fact, overweight and obese individuals were half as likely to receive a clinical diagnosis for an eating disorder from a healthcare provider compared to both those who were normal or overweight.
“Using a large nationally representative data source, we found that disordered eating behaviors are actually three times more common in young adults with obesity than those who are underweight,” explained Nagata and his colleagues from the University of California San Francisco.
Nagata also noted that these behaviors were more common among men than some previously believed, as 15% of the young men in the study who were obese or overweight reporting DEBs.
“Clinicians should be aware that disordered eating behaviors occur in young adults with overweight or obesity,” Nagata recommended. “They should ask if, and how, young people are trying to lose weight, and discourage unsafe practices such as vomiting, fasting, or non-prescribed weight loss medications.”
In the report, the group explained that DEBs account for some of the most critical criteria for diagnosing an eating disorder, including behaviors like binge eating, vomiting, fasting, or skipping meals.
The findings did support many past estimates of eating disorder prevalence. For example, young women were more likely to engage in these behaviors compared to men, and LGBT individuals were more likely to report DEBs than heterosexual peers. Interestingly, the report found that those with less education were also less likely to participate in DEBs compared to those who had more than a high school education.
For the study, the team used data from Wave III of the National Longitudinal Study of Adolescent to Adult Health study, which included data from 14,322 young adults who participated in face-to-face interviews on weight control behaviors.