Objective Examine substance use, depression, self-esteem, and suicidality by eating disorder (ED) classifications among nonclinical youth. Method A school-based sample of 4,746 youth completed anthropometric measures and Project EAT survey items matched to DSM-IV ED criteria. Logistic regression analyses and general linear models compared three threshold (AN, BN, or BED), two subthreshold (binge-eating and/or compensatory behaviors not meeting ED diagnosis, or body image disturbance without disordered eating) and one asymptomatic ED classifications. Results Subthreshold and threshold classifications reported lower self-esteem and greater substance use, depression, suicidal ideation/attempts than asymptomatic youth. The BED group had higher depressive mood, and BED and BN had lower self-esteem, than the subthreshold groups. Odds ratios for suicidality were highest among the BN group and lowest among the body image disturbance group. Discussion Subthreshold and threshold classifications are associated with compromised health, suggesting the importance of addressing the continuum of weight/shape concerns and disordered eating behaviors within prevention and treatment interventions.
- eating disorders
- substance use