Changes in eating disorder symptoms and influential factors among Chinese college students: a four-wave longitudinal study

BACKGROUND: Eating disorder symptoms (EDS) have become increasingly prevalent worldwide, especially among college students. This study examines the change patterns and influential factors of EDS among college students in China. METHODS: A total of 5608 students participated in assessments conducted at four time points with 6-month intervals. The Short Form of the Eating Disorder Examination Questionnaire (EDE-QS) was used to evaluate EDS across four waves. Participants' sample characteristics, clinical variables [i.e., insomnia, depression, anxiety, and body dysmorphic disorder (BDD)], individual psychological factors (i.e., self-control) and environmental factors (i.e., family functioning, school connectedness, and cyber-victimization) were assessed. Latent growth mixture modeling was used to explore trajectories of EDS. Multivariate logistic regressions were used to examine influential factors for trajectory membership. RESULTS: Three distinct patterns of change in EDS were observed: low-decreasing (79.1%), moderate-stable (17.5%), and high-increasing (3.4%). Participants residing in urban or town areas were more likely to belong to the moderate-stable and high-increasing groups. Meanwhile, compared with the low-decreasing group, individuals in the moderate-stable group reported higher insomnia symptoms, anxiety symptoms, BDD symptoms, and cyber-victimization, as well as lower levels of family functioning, school connectedness, and self-control. Individuals in the high-increasing group scored higher on anxiety symptoms, BDD symptoms, and cyber-victimization, and lower on family functioning, school connectedness, and self-control, compared with the low-decreasing group. CONCLUSION: College students exhibited heterogeneous trajectories of EDS, underscoring the necessity for dynamic monitoring. Furthermore, individualized interventions targeting high-risk individuals based on identified influential factors represent a promising approach.