The Prevalence and Sociodemographic Correlates of Eating Disorder Symptoms in a Diverse School-Based Population

To examine the prevalence and sociodemographic distribution of eating disorder (ED) symptoms in an ethnically and socioeconomically diverse cohort of UK adolescents.

We analyzed cross-sectional data from the Born in Bradford Age of Wonder Cohort. Linear regression examined associations between sociodemographic characteristics (sex, gender identity, ethnicity, deprivation) and ED symptom scores, measured using the Eating Disorder Examination Questionnaire-Short (EDE-QS). We also estimated the prevalence of adolescents meeting the EDE-QS cut-off for elevated ED symptoms and symptom endorsement across sociodemographic groups.

The sample included 7434 (51.9% female, 59.9% ethnic minority) adolescents aged 12-15 years. One in seven girls (13.7%) and one in 20 boys (5.0%) met the EDE-QS cut-off for elevated ED symptoms. Asian (mean difference [MD]: -2.18, 95% CI: -2.77 to -1.59) and Black (MD: -1.58, 95% CI: -2.99 to -0.16) females reported lower ED symptom scores compared to White females. In contrast, Asian (MD: 0.77, 95% CI: 0.31-1.24), Black (MD: 1.49, 95% CI: 0.47-2.52), and other ethnicity (MD: 1.85, 95% CI: 0.83-2.87) males had higher symptom scores compared to White males. Gender diverse adolescents had higher ED symptom scores than cisgender adolescents (MD: 4.51, 95% CI: 3.00-6.01), as did adolescents from the most deprived areas compared to those from the least deprived areas (MD: 1.52, 95% CI: 0.75-2.29).

ED symptoms were common among UK adolescents, with marked disparities by sex, gender identity, ethnicity, and deprivation, underscoring the need for inclusive prevention strategies targeting underserved populations.