ArticleHealth & place2026
Individual, school, and neighborhood influences on disordered eating behaviors in adolescence and eating disorders in young adulthood.
Article in Health & place, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
objectiveThis study explores the simultaneous influence of adolescent individual, school, and neighborhood factors on weight-related behaviors during adolescence and eating disorder (ED) diagnoses in young adulthood.
methodUsing data from the National Longitudinal Study of Adolescent to Adult Health (Add Health), a nationally representative U.S. cohort, and cross-classified multilevel logistic regression models, we examine associations between adolescent school and neighborhood contexts and sociodemographic factors and the likelihood of reporting currently trying to lose weight and engaging in disordered eating behaviors in the last 7 days (e.g., dieting, vomiting, use of diet pills or laxatives) in adolescence, and ED diagnosis by young adulthood.
resultsIn adolescence (N = 18,640; age mean = 15.6 years), 34.4% reported trying to lose weight and 13.9% reported disordered eating behaviors. Female sex and Hispanic ethnicity were associated with higher odds of trying to lose weight, while female sex and higher parental education were associated with higher odds of disordered eating behaviors, with small contextual-level contributions. In young adulthood (N = 13,713; age mean = 21.9 years), 2.1% reported an ED diagnosis. Female sex, White non-Hispanic race/ethnicity, engaging in weight-related behaviors, and lower BMI in adolescence were associated with a greater likelihood of young adulthood ED diagnosis. Contextual contributions were small, with greater variation explained by the school level. DISCUSSION: Findings highlight a significant role of individual sociodemographic factors in adolescent weight-related behaviors and subsequent risk of ED diagnoses. Although school and neighborhood contexts explained a small proportion of variation, their contributions highlight the importance of multilevel prevention approaches.
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