Research Article: Socioeconomic Correlates of Eating Disorder Symptoms in an Australian Population-Based Sample

Date Published: January 31, 2017

Publisher: Public Library of Science

Author(s): Brittany Mulders-Jones, Deborah Mitchison, Federico Girosi, Phillipa Hay, Susana Jiménez-Murcia.


Recent research has challenged the stereotype that eating disorders are largely limited to young, White, upper-class females. This study investigated the association between indicators of socioeconomic status and eating disorder features.

Data were merged from cross-sectional general population surveys of adults in South Australia in 2008 (n = 3034) and 2009 (n = 3007) to give a total sample of 6041 participants. Multivariate logistic regressions were employed to test associations between indicators of socioeconomic status (household income, educational level, employment status, indigenous status and urbanicity) and current eating disorder features (objective binge eating, subjective binge eating, purging, strict dieting and overvaluation of weight/shape). Eating disorder features occurred at similar rates across all levels of income, education, indigenous status, and urbanicity (p > 0.05). However, compared to working full-time, not working due to disability was associated with an increased risk of objective binge eating (odds ratio (OR) = 2.30, p < 0.01) and purging (OR = 4.13, p < 0.05), engagement in home-duties with an increased risk of overvaluation of weight/shape (OR = 1.39, p < 0.05), and unemployment with an increased risk of objective binge eating (OR = 2.02, p < 0.05) and subjective binge eating (OR = 2.80, p < 0.05). Furthermore, participants with a trade or certificate qualification were at a significantly increased risk of reporting strict dieting compared to participants without a tertiary qualification (OR = 1.58, p <0.01). Limitations included the small numbers of indigenous participants (n = 115) and participants who reported purging (n = 54), exclusion of excessive exercise (which is associated with eating disorders, particularly in males), and the conduct of interviews by laypersons. Overall, symptoms of eating disorders are distributed equally across levels of socioeconomic status. This study highlights the need for universal access to specialised services, to train healthcare workers in the detection and diagnosis of eating disorders in diverse subgroups, and to combat barriers to help-seeking experienced by people who do not conform to the demographic stereotype of an eating disorder. The increased prevalence of various eating disorder features in those who are not working could be addressed by providing support to help sufferers join the workforce, or engage in meaningful social or community activities to improve resilience against the development of eating disorders.

Partial Text

Eating disorders (EDs) are characterised by disturbances in eating and feeding behaviours with accompanying psychological concerns that pertain to eating and body image. The primary clinical entities outlined in the fifth edition of the Diagnostic and Statistical Manual of Mental Disorders are anorexia nervosa (AN), bulimia nervosa (BN) and binge eating disorder (BED) [1].

In order to determine the socioeconomic and socio-geographic distribution of disordered eating, this study examined the association between indicators of SES and the endorsement of ED features. Overall, the study found rates of ED features to be comparable across indices of SES. In particular, no association between ED features and household income or indigenous status emerged. Whilst analysis of the remaining indicators of SES–educational level, employment status and urbanicity–did yield some impact on the prevalence of ED features, the overall trend still indicated that EDs were universally experienced, irrespective of SES. This study is thus further evidence against the historical view that EDs are diseases exclusive to the wealthy [9].




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