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

Abstract

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