Hahn, Sungmin; (2025) Childhood socioeconomic position and food intake as a risk factor for eating disorders across adolescence. Doctoral thesis (Ph.D), UCL (University College London).

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Abstract

Socioeconomic position and its secondary impacts (e.g., food insecurity and dietary patterns) could be major determinants of health. However, their impact on eating disorders remains under-explored. Understanding the association between risk factors in childhood, prior to onset, and eating disorder symptoms throughout adolescence, will help inform preventative interventions. I used data from the Avon Longitudinal Study of Parents and Children. My outcomes were adolescent eating disorder symptoms (any and individual disordered eating behaviours at 14, 16, and 18 years old, weight and shape concerns at 14 and 18 years old, and body dissatisfaction at 14 years old). I examined the association between multiple socioeconomic indicators measured between 32 weeks gestation to when the child was 2/3 years old and adolescent eating disorder symptoms (Chapter 2). I investigated the association between food insecurity and other financial insecurity indicators when the child was 7 years old and adolescent eating disorder symptoms (Chapter 3). I examined how different dietary patterns at age 7 were associated with adolescent eating disorder symptoms (Chapter 4). I used multilevel logistic and linear regression and linear regression models on an imputed dataset based on participants with complete exposure data as my main analyses. All lower socioeconomic position indicators in childhood were associated with greater levels of eating disorder symptoms across adolescence, with greater financial hardship and lower parental educational attainment showing independent associations to adolescent eating disorder symptoms. Both greater levels food insecurity and other financial insecurity indicators were associated with greater levels of eating disorder symptoms across adolescence. I found little evidence that dietary patterns in childhood were associated with eating disorder symptoms. These findings indicate that lower socioeconomic position can also potentially pose as a risk factor for eating disorders. Reducing socioeconomic inequalities may also reduce the incidence eating disorders in the population.

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