Marriage and Divorce Trajectories of Men and Women with Histories of Eating Disorders

Abstract

Eating disorders (ED) can have lasting effects on individual health and wellbeing. The aim of the current study was to determine the association between ED subtype and treatment on marital trajectories. The data was derived from the Utah Population Database, and the analytic sample comprised of 3196 persons previously diagnosed with an ED (between years 1995-2015) in the state of Utah, including 2,917 females and 279 males. We compared time to first marriage and time to first divorce by ED subtype (bulimia nervosa [BN], anorexia nervosa [AN], and ED not otherwise specified [EDNOS]), BMI category (underweight, normal weight, overweight, and obese), and ED-related treatment, using Cox-proportional hazard regression. Results suggested underweight BMI (relative to normal weight BMI) (Hazard Rate Ratio [HRR]=0.71, p<0.01), and having higher overall ED-related hospitalizations or outpatient visits was associated with later-age at first marriage (HRR=0.24 & HRR=0.25 respectively, p<0.001). Results indicated that BN (relative to AN) (HRR=2.16, p<0.01) and being underweight (relative to normal weight) (HRR=1.79, p<0.05) were associated with earlier-age at first divorce. Clinicians should consider relationship-based therapies for ED patients, particularly those with histories of BN.