3 - (IOP 33) Prevalence of Eating Disorder Symptoms, Body Image Dissatisfaction, and Food Insecurity Among Indigenous College Students: A National and Alaskan Exploratory Examination

Eating disorders among Indigenous peoples have been largely absent from the literature, likely due to lack of representation in research studies as well as mis- or underdiagnosis. Despite this, American Indian, Alaska Native, and Native Hawaiian (AI/AN/NH, respectively) college students endorsed the highest rates of Anorexia Nervosa (OR = 2.14 compared to White students, OR= 3.74 compared to Black students) in a recent nationally representative survey (N = 426,425) (VanDyne et al., 2023). AI/AN/NH college students also endorsed the highest rates of Bulimia Nervosa, ranging from OR = 2.15 to 2.90 compared to all other groups (White, Asian, Hispanic/Latinx, Black, and Multiracial). In a different large, nationally representative sample of college students (N = 103,072), 17.4% of AI/AN students (N = 2,215) screened positive for disordered eating symptoms. Despite the growing recognition of eating disorders among AI/AN college students, existing literature is still limited; the few studies that do include AI/AN students largely focus on obesity and weight management. This study broadly aims to examine the prevalence of body image dissatisfaction (BID), eating disorder (ED) symptoms, and food insecurity among AI/AN college students using data from two nationally representative surveys, the National College Health Assessment (2023-24) and the Healthy Minds Survey (2023-24). We hypothesize that AI/AN college students will endorse BID, ED symptoms, and food insecurity at higher rates compared to other racial and ethnic groups. The second aim is to compare the prevalence of BID, ED symptoms, and food insecurity among AI/AN at the University of Alaska Anchorage (UAA). We hypothesize that AI/AN students at UAA will endorse BID, ED symptoms, and food insecurity at a rate comparable to the national average for AI/AN students and higher than other racial and ethnic groups at UAA. We predict that those who indicate recent food insecurity and BID will endorse greater restriction (including dieting), binging, and purging behaviors. We hypothesize that food insecurity will moderate the relationship between BID and ED symptoms among Native UAA students, such that those with higher rates of food insecurity and BID will report higher ED symptoms. Planned analyses will include descriptive statistics to assess prevalence rates. One-way ANOVAs will be used to compare differences in means across all racial and ethnic groups. We will run chi-squared tests to explore differences between BID, ED symptoms, and food insecurity with regard to sexual orientation and gender identity. Moderation analyses will be used to assess the moderating impact of food insecurity on the relationship between body image dissatisfaction and eating disorder symptoms. This will add to the limited literature on body image and disordered eating among AI/AN college students, as well as explore differences regarding key demographic variables as well as food insecurity in the context of Alaska, a rural and underserved state. We are preparing to collect data on up to 10,000 students at UAA (83% of the student population) in April- May 2025, including questions regarding traditional subsistence practices and cultural connectedness.