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The association of disordered eating with health-related quality of life in U.S. young adults and effect modification by gender

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Abstract

Purpose

To examine the relationship of disordered eating behaviors and eating disorder (ED) diagnosis in young adults with health-related quality of life (HRQL) and to assess the presence of effect modification by gender.

Methods

In 2013, participants (N = 9440, ages 18–31 years) in the U.S. Growing Up Today Study cohort reported use of disordered eating behaviors (dieting, diet pills, laxatives, or vomiting to control weight; binge eating with loss of control) over the past year, plus a lifetime history of ED diagnosis. The relative risk (RR) of less-than-full health (EQ-5D-5L health utility score < 1) and of any impairment (score > 1 on EQ-5D-5L dimensions) were compared across participants with and without disordered eating or ED diagnosis, using cross-sectional multivariable regression controlling for confounders. The association between HRQL and disordered eating or ED diagnosis was assessed using multivariable linear regression with the subsample reporting less-than-full health. The presence of effect modification by gender was also examined.

Results

Disordered eating behaviors and ED diagnosis were associated with significantly increased risk of less-than-full health. A significant gender interaction was found for only one variable—ED diagnosis; men who reported ever having received a diagnosis experienced worse decrements in HRQL than did women. Inclusion of BMI in estimation models revealed small attenuations. Across the weight spectrum, the presence of ED was associated with impairment across all EQ-5D-5L dimensions, except self-care.

Conclusion

Disordered eating behaviors and a lifetime history of ED diagnosis are associated with significant decrements in HRQL, but only ED diagnosis is associated with a significant effect modification by gender.

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Data sharing

The data that support the findings of this study are available from Channing Division of Network Medicine of the Brigham and Women’s Hospital. Restrictions apply to the availability of these data, which were used under license for this study. Data are available from the authors with the permission of the Channing Division of Network Medicine.

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Acknowledgements

The authors would like to thank the Growing Up Today Study (GUTS) team of investigators for their contributions to this research and the thousands of young people across the country participating in the GUTS cohort.

Funding

L.M. Hart was supported by an Endeavor Fellowship from the Australian Government Department of Education and a Postdoctoral Research Fellowship from Australian Rotary Health. A.R. Gordon was supported by F32DA042506 from the National Institute of Drug Abuse (NIDA). J.P. Calzo was supported by K01DA034753 from NIDA. S.B Austin was supported by the Leadership Education in Adolescent Health project, Maternal and Child Health Bureau, Health Resources and Services Administration Grants T71-MC00009 and T76-MC00001, the Ellen Feldberg Gordon Challenge Fund for Eating Disorders Research, and the Strategic Training Initiative for the Prevention of Eating Disorders. The funders played no role in the study design, collection, analysis or interpretation of data, in writing of the manuscript, or in the decision to submit the manuscript for publication.

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Authors and Affiliations

  1. Division of Adolescent and Young Adult Medicine, Boston Children’s Hospital, Boston, MA, USA

    Laura M. Hart, Allegra R. Gordon, Vishnudas Sarda, Jerel P. Calzo, Kendrin R. Sonneville & S. Bryn Austin

  2. School of Psychology and Public Health, La Trobe University, Kingsbury Drive, Bundoora, Melbourne, VIC, 3086, Australia

    Laura M. Hart

  3. Melbourne School of Population and Global Health, University of Melbourne, Melbourne, VIC, Australia

    Laura M. Hart

  4. Department of Pediatrics, Harvard Medical School, Boston, MA, USA

    Allegra R. Gordon, Mihail Samnaliev & S. Bryn Austin

  5. Division of Health Promotion and Behavioral Science, San Diego State University, San Diego, CA, USA

    Jerel P. Calzo

  6. Department of Nutritional Sciences, University of Michigan School of Public Health, Ann Arbor, MI, USA

    Kendrin R. Sonneville

  7. Division of General Pediatrics, Boston Children’s Hospital, Boston, MA, USA

    Mihail Samnaliev

  8. Channing Division of Network Medicine, Brigham and Women’s Hospital and Harvard Medical School, Boston, MA, USA

    S. Bryn Austin

  9. Department of Social and Behavioral Sciences, Harvard T.H. Chan School of Public Health, Boston, MA, USA

    S. Bryn Austin

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  1. Laura M. Hart
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Correspondence to Laura M. Hart.

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The authors have no conflicts of interest or financial conflicts of interest.

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The Brigham and Women’s Hospital Institutional Review Board approved this study. Informed consent was obtained from all individual participants included in the study.

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Hart, L.M., Gordon, A.R., Sarda, V. et al. The association of disordered eating with health-related quality of life in U.S. young adults and effect modification by gender. Qual Life Res 29, 1203–1215 (2020). https://doi.org/10.1007/s11136-019-02396-2

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