Addressing equity issues to tackle disordered eating

Tackling disordered eating among rural teens might require making big-picture changes, according to a Central Michigan University medical school faculty member.

Not much is known about how prevalent disordered eating is among rural teens, said Samantha Hahn, an assistant professor in the College of Medicine. Hahn specializes in population health research, and nutrition and dietetics. There is research demonstrating the prevalence of disordered eating among teens in general, but the nature of rural life could make the risk factors that lead to disordered eating more serious.

Addressing the problem could mean attacking those risk factors at the population level.

“Change the environment and the upstream factors that cause harm, rather than putting the onus of change on the individual,” she said.

The topic has attracted very little research. Only two studies have looked at the problem, according to a paper Hahn wrote in 2022. She found that both studies were limited to high school students in specific communities approximately 30 years ago.

Hahn plans to correct that through a research project based on interviews with those who developed disordered eating as teens throughout rural mid-Michigan.

Disordered eating is more frequent among people with marginalized identities including those with a higher body weight, people of color, people who live in poverty and people in the LGBTQ+ community. Although it’s very common among girls, she said, it is also common among boys.

“People with marginalized identities are more likely to experience disordered eating, but are less likely to receive treatment,” she said. Disordered eating can manifest as fasting, binge eating, purging, use of diet or muscle-building supplements and unhealthy exercise habits, she said.

In general, rural populations have reduced access to treatment. Rural populations could also face a higher risk for disordered eating through reduced access to quality, nutritious food and certain social supports and other risk factors for disordered eating.

Part of the goal of Hahn’s research is learning which of those influences they should address – and how – to prevent eating disorders among rural teens.

Disordered eating shares a compounding relationship with another area of Hahn’s research: weight stigma. Weight stigma has a documented effect on the emotional health of those affected by it, she said. That can lead to disordered eating.

The project, funded by a grant from CMU’s Office of Research and Graduate Studies, aims to establish pilot data that could help secure funding for a more in-depth investigation.