Geographical clustering of eating disordered behaviors in U.S. high school students

Authors

  • Valerie L. Forman-Hoffman PhD, MPH,

    Corresponding author
    1. Center for Research on the Implementation of Innovative Strategies in Practice (CRIISP), VA Iowa City Health Care System, Iowa City, Iowa
    2. Division of General Internal Medicine, Department of Internal Medicine, University of Iowa, Iowa City, Iowa
    3. Department of Epidemiology, University of Iowa, Iowa City, Iowa
    • University of Iowa, 200 Hawkins Drive SE605-GH, Iowa City, IA 52242
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  • Cassie L. Cunningham BS

    1. Center for Research on the Implementation of Innovative Strategies in Practice (CRIISP), VA Iowa City Health Care System, Iowa City, Iowa
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  • The views expressed in this article are those of the authors and do not necessarily represent the views of the Department of Veterans Affairs

  • This article is a US Government work and, as such, is in the public domain in the United States of America.

Abstract

Objective:

The aim of this study was to determine if eating disorder behaviors geographically clustered among U.S high school students.

Method:

Our sample consisted of 15,349 high school students who responded to the 1999 Youth Risk Behavior Study (YRBS). Weight control and eating disordered behaviors under investigation included dieting, exercising, fasting, using diet pills, and purging to control weight in the last 30 days. We calculated pairwise odds ratios (PWORs) to determine the degree of within-county clustering.

Results:

Among all participants, adjusted analyses revealed that having any weight control or eating disorder symptom, severe restricting, dieting, exercising, and diet pill use each showed significant clustering (p < .05). Purging did not significantly cluster by county. The magnitude of clustering was stronger for female students than male students.

Conclusion:

The significant clustering of weight control and eating disorder behavior in U.S. high school students confirms evidence of a social contagion effect of eating disorders. © 2007 by Wiley Periodicals, Inc. Int J Eat Disord 2008

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