Prevalence and Correlates of Disordered Eating Among Alaska Youth: Results From the 2023 Alaska Youth Risk Behavior...

Despite the ongoing youth mental health crisis and reports of spiking eating disorder rates, especially in rural and underserved areas, epidemiologic data on these patterns remain scarce. To help address this gap, the objectives of our study were to document the prevalence of key disordered eating behaviors in a representative sample of youth from Alaska (a state with a vast geographic area and significant rural and remote populations), examine differences across sociodemographic subgroups, and identify mental health correlates.

Participants were those from the 2023 Alaska Youth Risk Behavior Survey, a cross-section of traditional (n = 1129) and alternative (n = 418) high school students in grades 9-12. We estimated weighted proportions of youth reporting past-month binge eating or unhealthy weight control behaviors (UWCBs), overall and by grade, sex/gender, race/ethnicity, and weight status; we then fit a series of logistic models to quantify associations between each outcome and indicators of mental distress and substance use.

Approximately one-half of Alaska youth engaged in disordered eating in 2023, with female youth, racial/ethnic minority youth, and youth of higher weight status having inequitably higher prevalence. Youth who reported depression, anxiety, suicide ideation or attempts, alcohol use, e-cigarette use, or other substance misuse had significantly higher odds of both binge eating and UWCBs; conversely, cigarette use was not associated with either outcome.

These findings collectively underscore the urgent need to include eating disorders within broader conversations regarding the ongoing youth mental health crisis, especially as it pertains to impacts on rural areas of the US. Ongoing surveillance at the state and federal levels, enhanced screening, and large-scale prevention efforts are warranted to address this growing public health threat.