Binge eating and purging in first‐year college students: Prevalence, psychiatric comorbidity, and academic performance

Abstract

Background Binge eating and purging behaviors (BPB) are common among college students, but evidence is scant on prevalence and associations of BPB with mental health problems and objective academic performance. This study aims to investigate: (a) 12‐month prevalence of BPB among college first‐year students, (b) comorbidity patterns of BPB with various mental health problems, and (c) the association of BPB with objective academic functioning. Methods Using data from the Leuven College Surveys (Belgium), as part of the World Mental Health Surveys International College Student initiative, we cross‐sectionally assessed 12‐month BPB and mental health problems among college first‐year students (n = 4,889; response rate = 73.2%) at the beginning of the academic year. Objective measures of academic functioning (final grades, expressed in academic year percentage “AYP” [0–100%] and academic failure) were obtained from administrative records at the end of the academic year. Results Twelve‐month prevalence of BPB was 7.6% (7.3%binge eating and 1.0%purging), with higher rates among females than males. Bivariate models showed an association between BPB and numerous mental health problems (ORs = 3.4–18.4). Multivariate models showed associations with non‐suicidal self‐injury, post‐traumatic stress, internalizing/externalizing problems and suicidal ideation. After controlling for sociodemographic characteristics and comorbid mental health problems, BPB were still associated with lower AYP (−4.1 to −11.2% range) and elevated odds of academic year failure (ORs = 1.4–4.2). Conclusions BPB (especially binge eating) are relatively common and associated with mental health problems, comparatively low academic performance, and higher risk of academic failure among college first‐year students. Further study is needed to examine the causal dynamics underlying these associations.

Eating Disorders among College Students in France: Characteristics, Help-and Care-Seeking

“…Trigueros et al reported that academic performance and grading pressure could generate maladaptive consequences for food consumption [28]. Another study found an association between bulimic EDs and hyperphagic EDs with low academic performance, and a higher risk of academic failure among first-year college students [29].…”

Exploring the use of individualised patient‐reported outcome measures in eating disorders: Validation of the Psychological Outcome Profiles

“…More specifically, Serra et al. (2020) found that binge/purge behaviours were associated with lower academic performance and higher risk of academic failure in first‐year university students. Given that the literature has previously identified all these concerns as relevant to ED patients, and some specifically to emerging adult ED patients, it follows that these concerns should be measured during treatment if they are relevant to an individual.…”

“…Finally, university students with an ED reported that the illness hindered their ability to focus on academic responsibilities (Goldschen et al, 2019), and interference with life roles (e.g., ability to focus on studies) has been found to be a facilitator of help-seeking in emerging adults (Potterton et al, 2020). More specifically, Serra et al (2020) found that binge/ purge behaviours were associated with lower academic performance and higher risk of academic failure in firstyear university students. Given that the literature has previously identified all these concerns as relevant to ED patients, and some specifically to emerging adult ED patients, it follows that these concerns should be measured during treatment if they are relevant to an individual.…”

Non-Suicidal Self-Injury and Eating Disordered Behaviors: An Update on What We Do and Do Not Know

“…Apart from the physical risk and societal burden associated with these behaviors, there is growing evidence that NSSI and ED behaviors may also negatively impact the psychosocial development of young people. Researchers have linked NSSI and/or ED behaviors with future risk of mental health problems (especially depression) [ 33 ••, 90 ], impaired family functioning [ 91 , 92 ], decreased emotion regulation capabilities [ 67 ], identity issues [ 93 , 94 ], lower self-esteem and quality of life [ 95 , 96 ], stigma [ 97 , 98 ], and academic failure [ 99 , 100 ]. Hence, much could be learned from future investigations that adopt a broader developmental framework in which risk factors, NSSI and ED behaviors/disorders, and developmental tasks (e.g., identity formation, graduating, and finding work) might influence each other reciprocally throughout adolescence and (emerging) adulthood.…”