Adverse Childhood Experiences and Disordered Eating Behaviors in Adolescence: Differences by Gender

Abstract Eating disorders often develop during adolescence. Disordered eating behaviors (DEBs) such as skipping meals, binging, and purging are less severe but still lead to significant health problems. Adverse childhood experiences (ACEs) are linked to various maladaptive behaviors, including DEBs, but gender-specific relationships are less understood. The purpose of this study is to explore the link between various types and measurements of ACEs and DEBs among adolescents, examining gender-specific differences. Data from the 2022 National Survey of Children’s Health (NSCH), involving a nationally representative sample of 21,573 adolescents aged 11 to 17, was used. DEBs were assessed based on parent reports of binge eating, purging, and use of diet pills. Fourteen ACEs were measured in a variety of ways, including categorized into economic hardships, violence exposure, family hardships, and discrimination. Logistic regressions modeled DEBs by ACE measures, controlling for covariates. Bivariate and multivariate analyses were stratified by gender. Each additional ACE increased odds of DEBs by 33% (OR = 1.33, p < .01), with no significant gender differences in cumulative effects. However, specific ACEs had gender-differentiated impacts: food insecurity increased odds among females (OR = 2.55, p < .01), while violence increased odds for males (OR = 3.14, p < .01). Body image concerns and obesity were more strongly associated with DEBs in females, whereas higher family income was significant for males. Findings highlight the need for gender-sensitive prevention and intervention strategies, addressing household stressors and promoting healthy family dynamics for females, and focusing on coping mechanisms and emotional expression for males.