Eating attitudes in English secondary school students: influences of ethnicity, gender, mood, and social class

OBJECTIVE: To examine the effects of ethnicity, gender, socioeconomic position, self-esteem, and emotion on eating attitudes in adolescents. METHOD: Questionnaire survey of 722 students in two English schools, using Eating Attitude Test-26 (EAT), Rosenberg Self-Esteem Scale, and Angold vMood and Feeling instruments. RESULTS: EAT scores were significantly higher for Asians and Muslims and for mixed-race subjects than for White or African Caribbean subjects (p =.003). Adjusted odds ratios for having a very high EAT score (>20) were 2.4 (95% confidence interval [CI] 1.0-6.0) in Asians and Muslims and 2.9 (95% CI 1.3-18.6) in mixed-race subjects, compared with White subjects. Having only one parent employed was also independently associated with a very high EAT score, compared with having both parents employed. Similar associations were found for a moderately high EAT score (>10) and for a combination of low self-esteem and high EAT score. Low self-esteem and depressed mood were independently associated with a high EAT score. DISCUSSION: Ethnicity, socioeconomic position, self-esteem, and depression, but not gender, were independently associated with eating attitudes. Effects of cultural and socioeconomic stresses on eating disorders may be mediated through depressed mood and low self-esteem.