(PS14-8) Substance Use for Eating Disorder-related Avoidance Among College Students

Substance use and eating disorders (EDs) are frequently elevated among college students, and students with EDs are more likely to report substance use relative to their peers without EDs (Qeadan et al., 2023). According to the American College Health Association (2022), alcohol was the most commonly used substance by college students, followed by cannabis, nicotine products, hallucinogens, and prescription stimulants. Additionally, 92% of college students used caffeine in the past year (Mahoney et al., 2019). Elevated substance use among people with EDs (Calero-Elvira et al., 2009; Qeadan et al., 2023) may be partly due to the use of substances as a method of appetite suppression (Claudino, Hay, & Lima, 2018). However, there is minimal research investigating ED-related motivations for substance use across a variety of substances. 

The present study (1) analyzed the frequency of substance use for ED-related motivations in a sample of college students and (2) examined the frequency of substance use for ED-related motivations in individuals with EDs compared to individuals without EDs. Participants were 336 college students (M = 19.76, SD = 3.25) who completed online questionnaires in which they were asked about their eating behaviors and use of alcohol, cannabis, nicotine, caffeine, and stimulants for ED-related motivations, including avoiding eating, avoiding feeling hungry, and avoiding having thoughts about weight, shape, body, or food intake. Probable ED status was established using a clinical cutoff of 16 from the Clinical Impairment Assessment (CIA; Bohn et al., 2008) questionnaire. We conducted four Chi-square tests to analyze the frequency of substances used for ED-related motivations among participants with EDs compared to participants without EDs. 

Results indicated that caffeine was the most commonly used substance for ED-related avoidance in participants with EDs (caffeine = 36%, nicotine = 9%, alcohol = 6.5%, cannabis = 6%) and people without EDs (caffeine = 23%, nicotine = 4%, alcohol = 3%, cannabis = 4%). Chi-square analyses revealed that people with EDs were more likely to use caffeine (χ² = 43.92, df = 1, p < .001), nicotine (χ² = 22.44, df = 1, p < .001), alcohol (χ² = 14.82, df = 1, p < .001), and cannabis (χ² = 5.66, df = 1, p < .001) as a method of avoidance than individuals without EDs. There were insufficient participants who endorsed ED-related motivations for using stimulants to analyze the data.

Results suggest that college students with EDs are more likely to use substances as an ED-related avoidance technique than college students without EDs. Further, caffeine is the most commonly used substance for ED-related avoidance motivations among students with and without EDs. This study is the first to characterize the frequency of ED-related avoidance by using substances in people with and without EDs. These findings indicate the need for further research to characterize ED-related substance use motivations and associations with ED pathology, which could shape intervention development for co-occurring EDs and harmful substance use.