title: Universal prevention efforts should address eating disorder pathology across the weight spectrum: Implications for screening and intervention on college campuses.
abstract: Given shared risk and maintaining factors between eating disorders and obesity, it may be important to include both eating disorder intervention and healthy weight management within a universal eating disorder care delivery program. This study evaluated differential eating disorder screening responses by initial weight status among university students, to assess eating disorder risk and pathology among individuals with overweight/obesity versus normal weight or underweight.
  
  
  
  1529 individuals were screened and analyzed. Screening was conducted via pilot implementation of the Internet-based Healthy Body Image program on two university campuses.
  
  
  
  Fifteen percent of the sample had overweight/obesity. Over half (58%) of individuals with overweight/obesity screened as high risk for an eating disorder or warranting clinical referral, and 58% of individuals with overweight/obesity endorsed a ≥10-pound weight change over the past year. Compared to individuals with normal weight or underweight, individuals with overweight/obesity were more likely to identify as Black, endorse objective binge eating and fasting, endorse that eating disorder-related concerns impaired their relationships/social life and made them feel badly, and endorse higher weight/shape concerns.
  
  
  
  Results suggest rates of eating disorder pathology and clinical impairment are highest among students with overweight/obesity, and targeted intervention across weight categories and diverse races/ethnicities is warranted within universal eating disorder intervention efforts. Integrating eating disorder intervention and healthy weight management into universal prevention programs could reduce the incidence and prevalence of eating disorders, unhealthy weight control practices, and obesity among university students.
authors.affiliation: Department of Medicine, The University of Chicago, Chicago, IL, USA. Electronic address: akass@medicine.bsd.uchicago.edu.
authors.forename: Andrea E
authors.initials: AE
authors.lastname: Kass
authors.affiliation: Lantern, San Francisco, CA, USA; Department of Psychiatry, Stanford University School of Medicine, Stanford, CA, USA.
authors.forename: Megan
authors.initials: M
authors.lastname: Jones
authors.affiliation: Department of Psychiatry, University of Pittsburgh, Pittsburgh, PA, USA.
authors.forename: Rachel P
authors.initials: RP
authors.lastname: Kolko
authors.affiliation: Department of Psychology, Washington University in St. Louis, St. Louis, MO, USA.
authors.forename: Myra
authors.initials: M
authors.lastname: Altman
authors.affiliation: Department of Psychiatry, Washington University School of Medicine, St. Louis, MO, USA.
authors.forename: Ellen E
authors.initials: EE
authors.lastname: Fitzsimmons-Craft
authors.affiliation: Department of Pediatrics, University of California, San Diego, San Diego, CA, USA.
authors.forename: Dawn M
authors.initials: DM
authors.lastname: Eichen
authors.affiliation: Department of Psychiatry, Washington University School of Medicine, St. Louis, MO, USA.
authors.forename: Katherine N
authors.initials: KN
authors.lastname: Balantekin
authors.affiliation: Department of Psychiatry, Stanford University School of Medicine, Stanford, CA, USA.
authors.forename: Mickey
authors.initials: M
authors.lastname: Trockel
authors.affiliation: Department of Psychiatry, Stanford University School of Medicine, Stanford, CA, USA; Center for mHealth, Palo Alto University, Palo Alto, CA, USA.
authors.forename: C Barr
authors.initials: CB
authors.lastname: Taylor
authors.affiliation: Department of Psychology, Washington University in St. Louis, St. Louis, MO, USA; Department of Psychiatry, Washington University School of Medicine, St. Louis, MO, USA.
authors.forename: Denise E
authors.initials: DE
authors.lastname: Wilfley
mesh_terms: D000293:Adolescent; D001828:Body Image / Q000523:psychology; D001835:Body Weight; D001068:Feeding and Eating Disorders / Q000453:epidemiology / Q000517:prevention & control* / Q000523:psychology; D005260:Female; D006801:Humans; D056865:Ideal Body Weight; D020407:Internet; D008297:Male; D008403:Mass Screening / Q000379:methods*; D009765:Obesity / Q000453:epidemiology; D050177:Overweight / Q000453:epidemiology; D010865:Pilot Projects; D012307:Risk Factors; D013334:Students / Q000523:psychology* / Q000706:statistics & numerical data*; D013851:Thinness / Q000453:epidemiology; D014495:Universities; D055815:Young Adult
keywords: Eating disorder risk; Intervention; Obesity; Overweight; Screening