Tendency Towards Eating Disorders and Associated Sex-specific Risk Factors Among University Students

Introduction: Eating disorders have frequently been reported among young adults including university students. Detailed information on the prevalence and associated gender-specific determinants of eating disorders are lacking, particularly among students in the north western region of Pakistan. The current cross-sectional study was designed to fill this gap in the literature. Methods: Total of 672 students (female: 56%, age range: 18-26 years ) were enrolled and data collected between October 2016 and December 2017. The 26 items Eating Attitude Test (EAT-26), Diet quality Index-International (DQI -I), 10 items Rosenberg's self-esteem scale (SES), Stunkard Figure Rating Scale, 19-items Pittsburgh Sleep Quality Index (PSQI) and Global Physical Activity Questionnaire (GPAQ) were used. Body composition and anthropometry were determined using standardized tools. A cut-off of >= 20 EAT-26 score was used to assess the tendency towards eating disorders (EDT). Data was analyzed using appropriate statistical tests. Results: Mean (SD) age of the respondents was 21.7 +/- 2 years. Total of 103 (15.3%) students showed EDT with no statistical difference between sexes. Students with EDT had a much lower diet quality than normal students (p<0.001). Risk factors for EDT, in female students included young age (<20 years), on-campus residency, discordant body image and poor sleep quality, while those for males were vigorous lifestyle, insufficient monthly allowance, poor sleep quality and peer pressure. Conclusions: A significant number of students showed a tendency towards an unhealthy eating attitude with some sex-specific risk factors. These students had poorer diet quality than normal students. Support to encourage healthy attitudes to eating and better diet quality could help to avert the development of clinical eating disorders.