Identifying factors that predict help seeking among individuals with eating disorders: Results from a nationally representative study

Abstract

Eating disorders (EDs) are characterized by the highest mortality rate of any psychiatric disorder, yet as many as 45% of individuals with EDs never receive help for their eating-related problems. There are numerous barriers to help seeking for individuals with EDs. Poor mental health literacy, perceived and actual stigma, social and racial stereotypes, cost, and attitudes toward help seeking have emerged as the most prominent barriers, whereas high ED symptom severity (e.g., high frequency of bingeing or purging), medical complications, and body image concerns have been shown to significantly promote help seeking. The present study sought to identify whether psychopathological factors (i.e., comorbidity, suicidality), social stressors (i.e., acculturative stress, discrimination, income), social cohesion factors (i.e., family cohesion, marital status, religious belongingness), and ED-specific factors (i.e., body mass index, lifetime eating disorder diagnoses) promoted help-seeking behavior in relation to EDs in a nationally representative sample (N=595; 77.8% female; 72.4% ethnic minority). Structural equation modeling was used to identify significant predictors of help seeking in individuals with EDs. Among ethnic racial minorities, body mass index (BMI) and lifetime history of binge eating disorder emerged as significant predictors of help seeking; no variables were significant predictors of help seeking among Caucasian persons. To the extent that BMI is associated with medical complications and body image concerns, these results are consistent with prior studies that have sought to understand factors that lead individuals with EDs to seek help. Findings also suggest a need for improved education and outreach to public health workers and targeted public health campaigns aimed at improving recognition of binge eating disorder as a serious condition that affects individuals in ethnic-racial minorities.