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School demographics affect risk for eating disorders

Attending a school with a higher proportion of females and having university-educated parents were associated with increased risk for eating disorders.

“Eating disorders have an enormous effect on the lives of young people who suffer from them — it is important to understand the risk factors so that we can address them,” Helen Bould, MA, BMBCh, MRCPsych, of the University of Oxford, said in a press release. “For a long time, clinicians in the field have noted that they seem to see more young people with eating disorders from some schools than others, but this is the first empirical evidence that this is the case.”

To assess variance in eating disorder rates among schools, researchers conducted multilevel analysis of register-based, record-linkage data for 55,059 Swedish females who finished high school in 2002 to 2010.

The 5-year cumulative incidence of eating disorder diagnosis at age 16 to 20 years was 2.4%.

With each 10% increase in proportion of girls at a school, the odds ratio for ED was 1.07 (95% CI, 1.01-1.3; P = .018), when adjusting for individual risk factors.

With each 10% increase in the proportion of children with at least one parent with post-high school education, the odds ratio for eating disorders was 1.14 (95% CI, 1.09-1.19; P < .0001).

Researchers predicted the probability of developing eating disorders was 1.3% at a school with 25% girls where 25% of parents had post-high school education, compared with 3.3% at a school with 75% girls where 75% of parents had post-high school education.

“Unfortunately, this study can't tell us what it is about schools that affects the rates of eating disorders. It might be an unintentional effect of the aspirational culture of some schools that makes eating disorders more likely [or] it might be that eating disorders are contagious and can spread within a school,” Bould said in the release. “On the other hand, it could be that some schools are better than others at identifying eating disorders in their students and ensuring they get diagnosed and treated.” – by Amanda Oldt

Disclosure: The researchers report no relevant financial disclosures.