Eating disorder symptoms among undergraduate and graduate students at 12 U.S. colleges and universities

•No gender difference in use of compensatory behaviors was observed.•Elevated ED symptoms were seen among sexual minority males.•Weight status emerged as the most consistent predictor of eating disorder symptoms.•Students with overweight/obesity were at highest risk for eating disorder symptoms.

Objectives: We sought to estimate the prevalence of eating disorder symptoms in a large sample of U.S. college students and variations therein across student characteristics.Methods: Participants were 9713 students from 12 colleges and universities participating in the Healthy Bodies Study. We used gender-stratified logistic regression to estimate bivariate correlates of elevated eating disorder symptoms, past-month objective binge eating, and past-month compensatory behaviors across student characteristics including age, degree-level, sexual orientation, race/ethnicity, first-generation status, citizenship, academic and extracurricular characteristics, and weight status. Eating disorder outcomes were based on the Eating Disorder Examination Questionnaire.Results: We observed higher prevalence of objective binge eating among females relative to males (49% versus 30%, p < 0.001), but similar prevalence of compensatory behaviors (31% versus 29%). Weight status was the most consistent predictor of eating disorder risk with significantly more symptoms seen among individuals with overweight and obesity. When compared to individuals with a healthy weight, those with overweight had greater eating disorder risk (males OR = 3.5; females OR = 2.0), binge eating (males OR = 2.1; females OR = 1.9), and use of compensatory behaviors (males OR = 1.5; females OR = 1.3).Conclusions: This study suggests smaller gender difference in prevalence of eating disorder symptoms than previously reported and identifies students with overweight/obesity as salient targets for campus-based eating disorder screening and early intervention efforts.