Eating Disorders in University Students and Their Relationship with Body Image
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Abstract
University students are a population at particular risk for developing eating disorders, influenced by body image dissatisfaction and lifestyle factors. Despite this, little is known about how eating disorder risk relates to objective body composition measures and perceived body image in this group. The aim was to assess the risk of developing eating disorders in university students using the SCOFF questionnaire and correlate the findings with body composition and body image perception. A total of 500 students, both male and female, aged 18 to 30 years old, were evaluated anthropometrically using the InBody 270 device. Body image perception was assessed using Stunkard’s silhouettes, and participants completed the five-question SCOFF questionnaire. A high prevalence of eating disorders risk (44 %) was observed, with a significant association with sex (chisquare, p < 0.01), as women showed a higher frequency of risk (63 %). Individuals at risk of EDs had higher weight, BMI, body fat, and lower muscle mass (t-test, p = 0.001, p = 0.000, p = 0.0001, and p = 0.01, respectively). A significant relationship was also found between eating disorder risk and body image dissatisfaction (chi-square, p < 0.0001). Risk analysis revealed that females are 2.5 times more likely to develop eating disorders, and body image dissatisfaction increases this risk by fourfold. The most common condition identified was binge eating disorder, affecting 63 % of at-risk individuals. The high frequency of eating disorders observed among university students is notable, with associated risk factors, such as sex and body image perception, aligning with previous findings. The results highlight that female sex, body image underestimation, and dissatisfaction are key risk factors for developing eating disorders. These findings support the development of targeted interventions to prevent this condition.
References
Kabakuş Aykut M, & Bilici S. The relationship between the risk of eating disorder and meal patterns in University students. Eating and weight disorder. EWD. 2022; 27(2): 579-587. DOI: https://doi.org/10.1007/s40519-021-01179-4.
Treasure J, Duarte TA, & Schmidt U. Eating disorders. The Lancet (London, England). 2020; 395(10227): 899-911. DOI: https://doi.org/10.1016/S0140-6736(20)30059-3
Eli K. Latin American countries lead in Google search volumes for anorexia nervosa and bulimia nervosa: Implications for global mental health research. Int J Eat Disord. 2018; 51(12): 1352-1356. DOI: https://doi.org/10.1002/eat.22969.
Kolar DR, Rodriguez DL, Chams MM, & Hoek HW. Epidemiology of eating disorders in Latin America: a systematic review and meta-analysis. Curr Opin Psychiatry. 2016; 29(6): 363-371. DOI: https://doi.org/10.1097/YCO.0000000000000279.
Kolar DR, & Mebarak M. An update on the epidemiology of eating disorders in Latin America: current findings and future challenges. Curr Opin Psychiatry. 2022; 35(6): 385-389. DOI: https://doi.org/10.1097/YCO.0000000000000813.
Congreso Virtual. Establece una ley de prevención, atención, diagnóstico, y tratamiento de los trastornos de la conducta alimentaria. 2022 Recovered from https://congresovirtual.cl/project/3899.
Hunt J, & Eisenberg D. Mental health problems and help-seeking behavior among college students. J Adolesc Health. 2010; 46(1): 3-10. DOI: https://doi.org/10.1016/j.jadohealth.2009.08.008
Parker SC, Lyons J, & Bonner J. Eating disorders in graduate students: exploring the SCOFF questionnaire as a simple screening tool. J Am Coll Health. 2005; 54(2): 103-107. DOI: https://doi.org/10.3200/JACH.54.2.103-107.
Pengpid S, Peltzer K, & Ahsan GU. Risk of eating disorders among university students in Bangladesh. Int J Adolesc Health. 2015; 27(1): 93-100. DOI: https://doi.org/10.1515/ijamh-2014-0013.
Owen PR, & Laurel-Seller E. Weight and shape ideals: Thin is dangerously in. J. Appl. Soc. Psychol. 2000; 30(5): 979-990. DOI: https://doi.org/10.1111/j.1559-1816.2000.tb02506.x.
Culbert KM, Racine SE, & Klump KL. Research Review: What we have learned about the causes of eating disorders – a synthesis of sociocultural, psychological, and biological research. J Child Psychol Psychiatry. 2015; 56(11): 1141-1164. DOI: https://doi.org/10.1111/jcpp.12441.
Gaete P, & López C. Trastornos de la conducta alimentaria en adolescentes. Una mirada integral. Rev Chil Ped. 2020; 91(5): 784-793. DOI: https://dx.doi.org/10.32641/rchped.vi91i5.1534.
American Psychiatric Association (APA). Manual diagnóstico y estadístico de los trastornos mentales (DSM-IV TR). Barcelona: Masson; 2000.
Rueda Jaimes GE, Díaz Martínez LA, Ortiz Barajas DP, Pinzón Plata C, Rodríguez Martínez J, & Cadena Afanador LP. Validación del cuestionario SCOFF para el cribado de los trastornos del comportamiento alimentario en adolescentes escolarizadas. Atención Primaria. 2005; 35(2): 89-94. DOI: https://doi.org/10.1157/13071915.
Sanchez-Armass O, Raffaelli M, Andrade FCD, Wiley AR, Noyola ANM, Arguelles AC, & Aradillas-Garcia C. Validation of the SCOFF questionnaire for screening of eating disorders among Mexican university students. Eat Weight Disord. 2017; 22(1): 153-160. DOI: https://doi.org/10.1007/s40519-016-0259-7.
Aparicio-Martinez P, Perea-Moreno AJ, Martinez-Jimenez MP, Redel-Macías MD, Pagliari C, & Vaquero-Abellan M. Social Media, Thin-Ideal, Body Dissatisfaction and Disordered Eating Attitudes: An Exploratory Analysis. Int J Environ Res Public Health. 2019; 16(21): 4177. DOI: https://doi.org/10.3390/ijerph16214177.
Jiménez-Limas K, Miranda-Barrera VA, Muñoz-Díaz KF, Novales-Huidobro SR, & Chico-Barba G. Body Dissatisfaction, Distorted Body Image and Disordered Eating Behaviors in University Students: An Analysis from 2017-2022. Int. J. Environ. Res. Public Health. 2022; 19(18): 11482. DOI: https://doi.org/10.3390/ijerph191811482.
Neumark-Sztainer D, Wall MM, Chen C, Larson N I, Christoph MJ, & Sherwood N. E. Eating, Activity, and Weight-related Problems from Adolescence to Adulthood. Am. J. Prev. Med. 2018; 55(2): 133–141. DOI: https://doi.org/10.1016/j.amepre.2018.04.032.
Paphiti A, Newman E, & Collin P. “It’s a Lot Deeper than the Way It Looks”: An interpretative phenomenological analysis of body image for men with eating disorders. J. Men’s Stud. 2024; 32(3): 1-32. DOI: https://doi.org/10.1177/10608265231225400.
da Cunha MCF, Junqueira ACP, de Carvalho PHB, & Laus MF. Disordered eating behaviors among CrossFit athletes. Jornal Brasileiro de Psiquiatria. 2022; 71(4): 280-287.
Uchôa FNM, Uchôa NM, Daniele TMdC, Lustosa RP, Garrido ND, Deana NF, Aranha ÁCM, & Alves N. Influence of the Mass Media and Body Dissatisfaction on the Risk in Adolescents of Developing Eating Disorders. Int J Environ Res Public Health. 2019; 16(9): 1508. DOI: https://doi.org/10.3390/ijerph16091508.
Sharpe H, Griffiths S, Choo TH, Eisenberg ME, Mitchison D, Wall M, & Neumark-Sztainer D. The relative importance of dissatisfaction, overvaluation and preoccupation with weight and shape for predicting onset of disordered eating behaviors and depressive symptoms over 15 years. Int J Eat Disord. 2018; 51(10): 1168-1175. DOI: https://doi.org/10.1002/eat.22936.
Bulik CM, Wade TD, Heath AC, Martin NG, Stunkard AJ, & Eaves LJ. Relating body mass index to figural stimuli: population-based normative data for Caucasians. Int J Ob. 2001; 25(10): 1517- 1524. DOI: https://doi.org/10.1038/sj.ijo.0801742.
Cortes-Martínez G, Vallejo-de la Cruz N, Pérez-Salgado D, & Ortiz-Hernández L. Utilidad de siluetas corporales en la evaluación del estado nutricional en escolares y adolescentes de la Ciudad de México. Boletín médico del Hospital Infantil de México. 2009; 66(6): 511-521. Recuperado en 10 de septiembre de 2025, de http://bit.ly/3KwNhF9.
Parzer V, Sjöholm K, Brix JM, Svensson PA, Ludvik B, & Taube, M. Development of a BMIAssigned Stunkard Scale for the Evaluation of Body Image Perception Based on Data of the SOS Reference Study. Obesity facts. 2021; 14(4): 397-404. DOI: https://doi.org/10.1159/000516991.
López GF, Díaz A, & Smith L. Análisis de imagen corporal y obesidad mediante las siluetas de Stunkard en niños y adolescentes españoles de 3 a 18 años. An Psicol. 2018; 34(1):167-172. DOI: http://dx.doi.org/10.6018/analesps.34.1.294781.
Garcia-Campayo J, Sanz-Carrillo C, Ibañez JA., Lou S, Solano V, & Ald M. Validation of the Spanish version of the SCOFF questionnaire for the screening of eating disorders in primary care. J. Psychosom. Res. 2005; 59(2). 51-55. DOI: https://doi.org/10.1016/j.jpsychores.2004.06.005.
Teixeira AA, Roque MA, de Freitas AA, dos Santos NF, Garcia FM, Khoury JM, et al. The Brazilian version of the SCOFF questionnaire to screen eating disorders in young adults: cultural adaptation and validation study in a university population. Braz J Psychiatry. 2021; 43(6): 613-616. DOI: http://dx.doi.org/10.1590/1516-4446-2020-1667.
Morgan JF, Reid F, & Lacey JH The SCOFF questionnaire: a new screening tool for eating disorders. West J. Med. 2000; 172(3): 164-165. DOI: https://doi.org/10.1136/ewjm.172.3.164.
Tavolacci MP, Gillibert A, Zhu Soubise A, Grigioni S, & Déchelotte P. Screening four broad categories of eating disorders: suitability of a clinical algorithm adapted from the SCOFF questionnaire. BMC Psychiatry. 2019; 19(1): 366. DOI: https://doi.org/10.1186/s12888-019-
-6.
Urzúa M, Alfonso, Castro R, Sandy, Lillo O, America, & Leal P, Carolina. Prevalencia de riesgo de trastornos alimentarios en adolescentes escolarizados del norte de Chile. Rev Chil Nut. 2011; 38(2): 128-135. DOI: https://dx.doi.org/10.4067/S0717-75182011000200003.
Zapata FD, Granfeldt MG, Muñoz RS, Celis BM, Peterman RF, Gaete D, Leonario M, & Mosso, C. Riesgo de trastorno de la conducta alimentaria en adolescentes chilenos de diferentes tipos de establecimientos educacionales. Arch Latinoam Nutr. 2020; 68: 217-223. DOI: https://www.doi.org/10.37527/2018.68.3.004.
Fernández-Aranda F, Casas M, Claes L, Bryan DC., Favaro A, Granero R, Gudiol C, JiménezMurcia S, Karwautz A, Le Grange D, Menchón JM, Tchanturia K, & Treasure J. COVID-19 and implications for eating disorders. Eur Eat Disord Rev. 2020; 28(3): 239-245. DOI:
https://doi.org/10.1002/erv.2738.
Weissman RS, Bauer S, & Thomas JJ. Access to evidence-based care for eating disorders during the COVID-19 crisis. Int J Eat Disord. 2020; 53(5), 369–376. https://doi.org/10.1002/eat.23279.
Culbert KM, Sisk CL, & Klump KL. A narrative review of sex differences in eating disorders: Is there a biological basis? Clin Ther. 2021; 43(1): 95-111. DOI: https://doi.org/10.1016/j.clinthera.2020.12.003.
Klump KL, Racine S, Hildebrandt B, & Sisk CL. Sex differences in binge eating patterns in male and female adult rats. Int J Eat Disord. 2013; (7): 729-736. DOI: https://doi.org/10.1002/eat.22139.
Friars D, Walsh O, & McNicholas F. Assessment and management of cardiovascular complications in eating disorders. J Eat Disord. 2023; 11(1): 13. DOI: https://doi.org/10.1186/s40337-022-00724-5.
Hay P, Girosi F, & Mond J. Prevalence and sociodemographic correlates of DSM-5 eating disorders in the Australian population. J Eat Disord. 2015; 3: 19. DOI: https://doi.org/10.1186/s40337-015-0056-0.
Solmi M, Radua J, Stubbs B, Ricca V, Moretti D, Busatta D, Carvalho AF, Dragioti E, Favaro A, Monteleone AM, Shin JI, Fusar-Poli, P, & Castellini G. Risk factors for eating disorders: an umbrella review of published meta-analyses. Braz J Psychiatry. 2021;43(3): 314-323. Doi: https://doi.org/10.1590/1516-4446-2020-1099
Keski-Rahkonen A, & Mustelin L. (2016). Epidemiology of eating disorders in Europe: prevalence, incidence, comorbidity, course, consequences, and risk factors. Curr Opin Psychiatr, 29(6): 340-345. DOI: https://doi.org/10.1097/YCO.0000000000000278.