Eating disorders risk potentiates high suicide risk in LGBTQIA+ university students

Suicide is the fourth leading cause of death in young people aged 15 to 29 years, the average age of those enrolled in undergraduate programs. Students who are part of sexual and gender minorities have a higher prevalence of past-year suicide attempts (5-10 %) than observed in studies with the general college population (0.6-1.3 %). The presence of even one eating disorder symptom can increase the odds of suicidal ideation by up to 70 %, while a higher number of symptoms increases the chances of suicide attempted by up to 11 times in university students. The DSM-5, highlights the importance of assessing for suicide ideation and behaviors, as well as other risk factors for suicide, specifically in individuals with anorexia nervosa or bulimia nervosa. The aim of this study was to investigate whether eating disorder risk potentiates high suicide risk in LGBTQIA+ university students.

This cross-sectional study used Eating Attitudes Test-26 (EAT-26) and Bulimic Investigatory Test of Edinburgh (BITE) to assess the presence of eating disorder symptoms and risk in 2,831 students from twenty-eight Brazilian universities. The Mini International Neuropsychiatric Interview - module C (MINI-C) was used to determine suicide risk.

Eating disorder risk was identified in 807 (28.5 %) participants; highly disordered eating patterns and presence of binge eating in 637 (22.5 %); and high suicide risk in 821 (29.0 %). LGBTQIA+ students (n = 1,405; 46.6 %) are more likely to have high suicide risk (PR: 1.92; 95%CI [1.68; 2.19], p<0.001). This risk is further increased for those with a positive EAT-26 (PR: 3.56; 95%CI [2.98; 4.26], p<0.001) or BITE (PR: 3.53; 95%CI [2.99; 4.18], p<0.001) screen for eating disorder risk compared to non-LGBTQIA+ students with a negative screen for eating disorder risk.

These findings highlight the need for prevention and intervention efforts regarding eating disorder and suicide in LGBTQIA+ students at universities.