Gender Identity Moderates the Association Between Alcohol Use and Eating Disorder Risk in U.S. College and University...

Area of Science:

• Psychiatry
• Public Health
• Addiction Medicine

Background:

• Alcohol use disorder (AUD) and eating disorders (EDs) are prevalent among college students.
• Existing research indicates an association between AUD and EDs, but patterns across gender identities, especially for transgender and gender-expansive (TGE) individuals, remain unclear.

Purpose of the Study:

• To investigate the relationship between the severity of alcohol use and the prevalence of eating disorder symptoms.
• To examine whether this association differs based on gender identity, including cisgender men, cisgender women, and TGE individuals.

Main Methods:

• Utilized data from a US national sample of 21,623 college students via the Healthy Minds Study.
• Assessed alcohol use severity using the Alcohol Use Disorder Identification Test (AUDIT) scores and eating disorder screening via the SCOFF tool.
• Employed logistic regression with interaction terms for gender identity and alcohol involvement, using marginal standardization for predicted prevalence.

Main Results:

• The prevalence difference for positive eating disorder screens between non-drinkers and severe AUD was largest for TGE individuals (43.3%), followed by cisgender women (25.3%) and cisgender men (16.8%).
• A monotonic association was observed for cisgender women.
• A threshold effect was noted for cisgender men and TGE individuals, with increased eating disorder prevalence only at moderate to severe AUD levels.

Conclusions:

• Patterns of association between alcohol involvement and eating disorders differ significantly across gender identities in college students.
• Findings emphasize the necessity for gender identity-sensitive prevention and treatment strategies for co-occurring AUD and EDs.
• Targeted interventions are crucial to address the unique comorbidity patterns observed in TGE populations.