Decreased quality of life attributed to eating disorder symptoms among college students may in fact be related to comorbid depression, results of a recent analysis suggest.
Depression scores and shape concerns both accounted for significant variance in quality of life scores in the analysis. However, depression scores accounted for nearly 10% of the variance, while shape concerns accounted for less than 1%, according to graduate student Paige J. Trojanowski and associate professor Sarah Fischer, PhD, both of the department of psychology at George Mason University, Fairfax, Va.
“Considering the low base rate of eating disorders, interventions to improve student quality of life that target depression may yield more widespread results than those focused on targeting weight or eating concerns,” Ms. Trojanowski and Dr. Fischer reported in Eating Behaviors. Targeting depression might unintentionally improve quality of life in students with disordered eating or body image concerns, they added, noting that depression and eating disorders often are comorbid.
Previous studies looking at relationships between exercise, disordered eating, and quality of life have not included depressive symptoms. Thus, the investigators analyzed the relative impact of depression, eating disorder symptoms, and exercise on Quality of Life Inventory (QOLI) scores in a sample of 851 college students (mean age, about 19 years), three-quarters of whom identified as white. Most of the participants were women (n = 676).
Nearly 90% of the students reported some level of physical activity in the past month, with a mean of 885 minutes. Scores on the Beck Depression Inventory-II (BDI-II) ranged from 0 to 57, with 13.5%, 7.4% and 3.4% falling in the mild, moderate, and severe depression ranges, respectively.
A regression model developed as part of the analysis explained 28.9% of the variance in QOLI scores, Ms. Trojanowski and Dr. Fischer wrote.
Shape concern was the only symptom on the Eating Disorder Examination Questionnaire that had a significant effect on quality of life (P = .005). In addition, BDI-II scores accounted for significant variance (P less than .001).
However, only 0.77% of the total variance in QOLI scores was accounted for by unique variance in shape concern, while 9.55% was accounted for by unique variance in depressive symptoms, their analysis showed.
“While clinical level eating disorders are present on college campuses and deserve specific attention to reduce their significant negative effect on QOL in those students, these results show that depressive symptoms may have a more significant impact on the quality of life of college students at large,” they wrote.
Exercise frequency was not related to quality of life, after accounting for the contribution of eating disorder symptoms. However, exercising for mood improvement or enjoyment was significantly associated with quality of life, Ms. Trojanowski and Dr. Fischer reported. In the final model, identifying as a woman was tied to a lower quality of life.
“Future studies should examine exercising for reasons of enjoyment as a protective factor against decreased QOL in college students,” they wrote.
Limitations cited include the study’s cross-sectional design and the investigators’ reliance on self-report questionnaires.
The authors reported no conflicts of interest or research funding.
SOURCE: Trojanowski PJ et al. Eat Behav. 2018 Aug 18. doi: 10.1016/j.eatbeh.2018.08.005.