Male College Students with Eating Disorder Symptoms Had the Highest Cannabis Use Disorder Rates

What the researchers found

About one-third (32.4%) of the sample screened positive for an eating disorder. Screening positive was associated with cannabis use frequency and cannabis use disorder symptoms, but not alcohol outcomes. Sex moderated the cannabis use disorder association: male students who screened positive for eating disorders had the highest cannabis use disorder symptoms, a counterintuitive finding given that eating disorders are more common in females.

Why it matters

Eating disorders in males are often underdiagnosed and undertreated. The finding that male students with eating disorder symptoms have particularly high cannabis use disorder rates suggests that screening for one condition should prompt assessment for the other, especially in male college students.

The numbers in context

N=471 college students. 32.4% screened positive for eating disorder. Females more likely to screen positive for ED. Males more likely to screen positive for alcohol or cannabis use disorder. ED associated with cannabis frequency and CUD symptoms (not alcohol). Sex moderated ED-CUD relationship: males with positive ED screen had highest CUD symptoms.

How the study worked

Cross-sectional study of 471 college students recruited for a study on high-risk drinking (regular pregaming required). Eating disorder screening, alcohol use disorder, and cannabis use disorder assessments were completed, with sex-stratified analyses.

What this study cannot tell us

Sample selected for high-risk drinking (pregaming), which may not represent all college students. Cross-sectional design cannot determine directionality. Self-report measures. Cannot determine whether cannabis use is a cause, consequence, or co-occurring condition with eating disorders.

How to read the evidence

Moderate evidence from a reasonably sized college sample, though limited by selection for high-risk drinking and cross-sectional design.

When this study was published

2025 study examining the intersection of eating disorders and cannabis use in college students.

The bigger picture

Eating disorders and substance use disorders share common mechanisms including impulsivity, emotion regulation difficulties, and reward processing. This study suggests cannabis, rather than alcohol, may be the substance most closely linked to disordered eating in college populations, particularly among males.

Questions still open

• Are male students using cannabis to manage appetite or body image concerns related to their eating disorder? Does cannabis use worsen or alleviate eating disorder symptoms? Would integrated treatment addressing both conditions improve outcomes?

Common questions

Read the original research

Alcohol use disorder, cannabis use disorder, and eating disorder symptoms among male and female college students.

The American journal on addictions, 34(1), 40-49

Citation

Pedersen, Eric R; Shute, Ireland M; Buch, Keegan D; Fitzke, Reagan E; Berry, Katherine A; Tran, Denise D; Murray, Stuart B. (2025). Alcohol use disorder, cannabis use disorder, and eating disorder symptoms among male and female college students.. The American journal on addictions, 34(1), 40-49. https://doi.org/10.1111/ajad.13634

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