UC research reveals complex roots of disordered eating in college students

New research with University of Cincinnati connections debunks the standard assumption of disordered eating and proposes more personalized attention.

“The study highlights how complex disordered eating can be and emphasizes the need for personalized mental health care,” says study co-author Rose Marie Ward, PhD, a UC psychology researcher.

There is a common misconception that eating disorders predominantly affect white, affluent, teenage girls. Disordered eating, however, is far more demographically widespread with multiple causes, Ward explains.  

In fact, according to the National Eating Disorders Association, young adults have the highest prevalence of eating disorders.

To better understand and treat disordered eating among young adults, a multi-institutional research team conducted a study among college students.

The study, which appears in the Journal of Eating Disorders, identified five distinct patterns of disordered eating behaviors among college students ages 18-24 — ranging from mild to severe — each tied to different levels of anxiety, distress tolerance and alcohol use.

The research team looked at the health survey data of 1,362 college students and discovered that not all students who struggle with eating do so in the same way.

According to the study, one group, which made up nearly 8% of the students, stood out for having both high levels of anxiety and severe disordered eating. This group, of which approximately 70% identified as women, also showed high scores across all other psychological risk factors, suggesting they face multiple, compounding mental health challenges.

“This finding is important because it shows that anxiety plays a major role in the most severe cases of disordered eating,” says Ward.

Another surprising discovery, she says, was a group representing nearly 10% of the sample — mostly male students — who engaged in excessive exercise and “muscle-building behaviors.”

This group reported some of the lowest levels of anxiety and emotional distress. The study found that this profile resembles what some have labeled “drunkorexia” or “food alcohol disruption,” where individuals use food and fitness behaviors to compensate for or balance out heavy drinking.

“These results show that disordered eating isn’t one-size-fits-all,” Ward explained, as some students are using food, exercise or alcohol in ways that may seem healthy on the surface but reflect deeper issues.

The study also shows that some harmful behaviors — like excessive exercising — can be overlooked, especially in populations that may not show signs of typical emotional distress.

“Our findings challenge the idea that disordered eating only exists in extreme or obvious forms,” says lead author Elizabeth Claydon, an assistant professor in the Department of Social & Behavioral Sciences at the West Virginia University School of Public Health.

“By recognizing the full range of behaviors and their psychological roots, we can create more effective, customized support systems for students,” says Claydon.

In addition to Ward, co-authors are Rachel Geyer, Miami University (Oxford, Ohio), and Donovan Weekley, West Virginia University (Morgantown, West Virginia).