Examining Prevalence and Presentations of Eating Disorders Across Racial/Ethnic Groups in a National, Population-Based Sample of College Students

Objective: Eating disorders (EDs) are prevalent in college students, yet limited research on EDs across racial/ethnic groups in population-based samples exists. This study aimed to examine differences in prevalence and presentations of EDs by race/ethnicity in a national college sample. Method: Students at 26 US colleges/universities (N = 29,951) completed a population-based mental health screen. Prevalence of probable anorexia nervosa (AN), clinical/subclinical bulimia nervosa (BN) or binge-eating disorder (BED) and ED risk were examined across racial/ethnic groups by gender using chi-square and Fisher's exact tests. Among those with probable EDs, ED behavior frequency, weight/shape concerns, probable psychiatric comorbidities, and psychotherapy utilization were compared across groups using chi-square, Fisher's exact tests, and one-way analyses of variance. Results: Asian women had higher AN prevalence than Black, Hispanic, and White women; AN prevalence in Black women was lower than Asian, Hispanic, Multiracial, and White women (p < 0.05). Hispanic women had higher BN/BED prevalence than Asian, Black, and White women, and higher ED risk prevalence than Asian, Multiracial, and White women (p < 0.05). Among those with EDs (N = 3929), there were no significant differences in ED behavior frequencies between any groups. White women had higher comorbid probable alcohol use disorder prevalence than Asian, Black, Hispanic, and Multiracial women (p < 0.05). Asian men had lower psychotherapy utilization than Black, Hispanic, Multiracial, and White men (p < 0.05). Discussion: Prevalence of EDs was similar across racial/ethnic groups; where differences emerged, minoritized students often had a higher prevalence. Results highlight the need for routine ED screening for all college students.