In its first research snapshot of the year, the Utah Women & Leadership Project at Utah State University released papers Thursday examining eating disorders among women in Utah.

The research and report team included Maya Miyairi, Sara Boghosian and Sadie Wilde.

As described by the research team, eating disorders are “behavioral conditions characterized by severe and persistent disturbance in eating behaviors and associated distressing thoughts and emotions.”

They frequently co-occur with other mental health disorders, such as mood disorders, anxiety disorders, obsessive compulsive disorders and substance abuse problems, as well as neurodevelopmental disorders such as autism spectrum disorder and attention-deficit/hyperactivity disorder, the research states.

“LGBTQ+ individuals are also more vulnerable,” according to the three-member research team. Importantly, they wrote, eating disorders “are recognized as one of the most fatal mental illnesses in the US.”

A recent U.S. study estimated that between 2018 and 2019, one person died from an eating disorder every 51.5 minutes. The report projected that 28.8 million Americans will suffer from an eating disorder at some point in their lifetime, and women were found to be two times more likely to have an eating disorder than men.

Given the mortality risk, higher rates among women and the predicted prevalence of eating disorders in Utah, the UWLP sought to better understand what may be affecting this public health crisis in the state.

The various types of eating disorders include anorexia nervosa (referred to as anorexia), bulimia nervosa (bulimia), binge-eating disorder or BED, avoidant restrictive food intake disorders or ARFID, other specified feeding or eating disorders, abbreviated OSFED, pica and rumination-regurgitation disorders.

In addition to the classifications, other eating disorder behaviors, such as orthorexia and compulsive exercise, have been recognized.

According to the UWLP research, which compared the results of two national studies, one looking at data from 2001-2003 and another analyzing data from 2012-2013, “the prevalence of anorexia was slightly higher during the most recent period (except among men), but the prevalence of bulimia and BED was lower.”

Representing 69.2% of cases, OSFED was found to be the most prevalent eating disorder in Utah, according to the UWLP study, compared to bulimia (26.3%) and anorexia (26.2%).

Weight was found to play a role in eating disorders, referred to as EDs in the UWLP report, though it was noted that people of any weight could develop such a condition.

“Research has shown that individuals who are overweight or obese have an increased risk of disordered eating behaviors,” the research snapshot states.

Statewide epidemiological data about Utahns diagnosed with an eating disorder are very limited, the report says, but several recent publications provide some indication of ED trends.

The UWLP research cited a 2018 report provided by local mental health authorities in Utah, which indicated that 0.2% of their clients age 18 and older were diagnosed with eating disorders.

Another study, analyzing data from the Utah Population Database covering the years 1995-2015, found that among a sample of 4,606 people ages 12-55 with a known eating disorder, nearly 91% were female.

Per the UWLP report, the Utah Department of Health and Human Services found that between 2011 and 2013, 4.0% of female students and 1.4% of male students met criteria for being underweight and having disordered eating behaviors.

“These criteria were associated with higher rates of depression, suicidal ideation, bullying, and violence,” the research team concluded. “According to a 2019 report from the American College Health Association: National College Health Assessment for Utah State University, more female students were diagnosed or treated by a mental health professional for anorexia or bulimia than male students. The report from USU also found that more female students (5.8%) were diagnosed with EDs than male (0.6%) or trans/gender-nonconforming (4.5%) students. Of the females diagnosed with an ED, only 44.8% had sought help from a healthcare provider or mental health professional within the last 12 months.”

Risk factors and triggers for eating disorders vary for each woman, the UWLP reported, but those often include negative media influences or body image dissatisfaction. External factors such as military service and sport participation also are considered risk factors.

“Media and social media exposure, involvement in certain activities, experiencing life events such as marriage and childbearing, and trauma can impact the development and trajectory of EDs,” the snapshot reports. “EDs are often associated with other mental health challenges, and the increased risk of suicidality is particularly concerning. Emerging from the pandemic, data showed increased ED-related needs and decreased care; it will be important to monitor ED prevalence and health care access trends.”

The UWLP research paper states that mental illness, including eating disorders, is progressively detrimental to a person’s well-being if left untreated.

“It is necessary to improve ED prevention and treatment initiatives in Utah and implement evidence-based prevention programs in Utah schools,” the research concludes. “Additionally, coordinated efforts are needed to track prevalence in the state. Taking these essential steps will improve the mental health and physical wellbeing of girls and women throughout Utah, which will strengthen their impact in their homes, communities, and in our state.”

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