Sexual Violence, Weight Perception, and Eating Disorder Indicators in College Females

Background and Purpose: Eating disorders (EDs) are complex conditions that can develop at any point in the life course. The etiology is not fully understood, but current models highlight different pathways into EDs, intrinsic and extrinsic risk factors specific to the person, and pressures and vulnerabilities unique to differing developmental stages. College can be a time of growth and maturity; however, it is also a time where individuals engage in risky health behaviors, such as ED behaviors. Individuals engage in ED behaviors for a variety of reasons including as a way to cope with negative life experiences such as sexual violence, which is common on college campuses. Previous studies suggest a link between sexual violence and EDs, and there may also be a relationship between the types of sexual violence and ED behaviors. There is a lack of research investigating the link between severity of sexual violence and the presence of disordered eating in a college sample. The present research examined this relationship looking at different degrees of sexual violence and the presence of ED indicators in a sample of female college students.

Methods: A secondary analysis of National College Health Assessment data gathered annually at one institution from 2004-2013 was utilized. A total of 6,090 females 25 years or younger made up the final sample size. A model predicting ED indicators was tested using logistic regression analyses with multiple categorical variables representing severity of sexual violence, accuracy of body weight perceptions and an interaction between the two.

Results: Sexual violence and inaccurate body weight perception significantly predicted overall ED indicators. Further analyses examined the impact of sexual violence severity and inaccurate body weight perception on underweight status (BMI less than 18.5) and purging behaviors. Underweight status was best predicted by inaccurate body weight perception, while sexual violence best predicted purging behavior. Specifically, severe sexual violence in the past 12 months most strongly predicted purging in the past 30 days, followed by moderate, and mild sexual violence in the past 12 months.

Conclusions and Implications: Findings provide support to the relationship between disordered eating and sexual violence and suggest that individuals may be engaging in specific ED behaviors for different reasons. Sexual violence is a violent act on the body and many victims experience shame and self-blame. Some victims may cope with these feelings by punishing or harming the self, such an engaging in purging, which is a violent act on the body. The other main finding provides further evidence to the characteristics of anorexia nervosa. Many studies discuss a disturbance of body weight or shape in individuals diagnosed with anorexia nervosa. Interestingly, the inaccurate body weight perception did not show a meaningful interaction with purging behaviors or sexual violence. This may indicate that different core features of diagnoses (i.e., low weight, purging) may be triggered by different events or personality characteristics. Future research is needed in order to understand the temporal ordering of sexual violence and the presence of purging behaviors to assess appropriate intervention approaches.