Exploring the Relationship between Eating Disorders and Sexual Assault Among College-Enrolled Males

Background and Purpose: Eating disorders and sexual assault occur at high rates among college-enrolled females and thus research, prevention, and treatment efforts have primarily focused on this population. However, new research continues to show that college-enrolled males experience eating disorders at rates of between 3%-5.5%. Similarly, males made up 17% of sexual assault victimizations among college students between 1995-2013 and college-enrolled males have higher rates of experiencing a sexual assault compared to non-college-enrolled males. Previous research has investigated and found a positive association between eating disorders and sexual assault victimization among college-enrolled women, however this relationship has not been directly studied among college-enrolled males. Therefore, this study aimed to explore the association between a self-reported 12-month history of a sexual assault and screening positive for an eating disorder among college-enrolled males. 

Methods: Data and Sample: A secondary data analysis was conducted using the 2017-2018 Healthy Minds Study. The analytic sample included a representative sample of over 11,500 cisgender males currently enrolled in college. 

Statistical Analysis: Guided by an emotion regulation framework, the analysis was conducted using hierarchal logistic regression models to estimate the effects of screening positive for an eating disorder using the SCOFF scale and reporting a sexual assault in the previous 12-months. Age, race/ethnicity, sexual orientation, degree program, relationship status, residence, alcohol and illicit drug use in the previous 30 days, and screening positive for anxiety and depression were controlled for in the analysis.

Results: Findings indicate that 16% (n=2,337) screened positive for an eating disorder and 4% (n=698) reported a sexual assault within the previous 12 months. Hierarchal logistic regression findings indicate that college-enrolled cisgender males who screened positive for an eating disorder, compared to those who did not, had greater odds of reporting a sexual assault within the previous 12 months (OR=1.38, p<.01). College-enrolled cisgender males who screened positive for an eating disorder, compared to those who did not, also had greater odds of identifying as a sexual minority (OR=1.82, p<.001), as Hispanic (OR=1.30, p<.01) or Asian (OR=1.55, p<.001), screening positive for depression (OR=2.46, p<.001) and anxiety (OR=1.73, p<.001), and reporting illicit drug use in the previous 30 days (OR=1.20, p<.01). Age, degree program, residence, relationship status, and alcohol use were not significantly associated with screening positive for a positive eating disorder in this analysis.

Conclusions and Implications: Findings from this study indicate that eating disorders and sexual assault victimization occur at surprising rates among college-enrolled cisgender males. Furthermore, this study is the first known to explore and find a positive association between these two factors among this population. Proper assessment, diagnosis, and psychological treatment of eating disorders remains a crucial for a positive prognosis. Therefore, utilizing these findings, social workers can be particularly aware of the increased risk of eating disorders among college-enrolled cisgender males who have experienced a sexual assault, screened positive for depression and anxiety, used illicit drugs, as well as those who identify as a sexual minority, Hispanic, or Asian.