Eating disorders among medical students of a rural teaching hospital: a cross-sectional study
Keywords:
Eating disorders, Body shape perception, Body Mass Index (BMI)Abstract
Background:Eating disorders are complex psychiatric syndromes in that can lead to significant and potentially life threatening medical and nutrition complications. Literature from India in this regard is restricted and issues such as eating attitudes and body shape dissatisfaction remain unexplored in the Indian setting. It has been argued that eating disorders are culture-bound disorders specific to western societies. Consequently, these conditions remain understudied in most non-western settings. Objectives: 1) To determine the prevalence of eating disorders and body shape perception among medical students. 2) To assess any association between eating disorders and body shape perception.
Methods:A cross-sectional study was conducted among 172 medical students using Eating Attitudes Test-26 (EAT-26), and the Body Shape Questionnaire (BSQ). Anthropometric measurements like height, weight was done for body mass index calculation and analysis was done with open Epi and Microsoft excel.
Results:An overall prevalence of overweight was calculated to be 17.4% and obesity, 6.4%. The prevalence of eating disorder symptoms and disordered eating attitudes and behaviours in our study was 16.9% and a significant correlation between distorted eating attitudes and age with body shape dissatisfaction was found.
Conclusions:The prevalence of overweight and obesity is on rise and a comparable level of eating disorders was observed. It is recommended to assess BMI along with the body shape concerns while screening for eating disorders among medical students.
References
American Dietetic Association. Position of the American Dietetic Association: nutrition intervention in the treatment of anorexia nervosa, bulimia nervosa, and eating disorders not otherwise specified (EDNOS). J Am Diet Assoc. 2001;101(7):810-9.
American Psychiatric Association, Task Force on DSM-IV. Diagnostic and statistical manual of mental disorders. In: DSM-IV, eds. The Manual. 4th ed. Washington, DC: American Psychiatric Association; 1994.
Kreipe RE, Birndorf SA. Eating disorders in adolescents and young adults. Med Clin North Am. 2000;84(4):1027-1049, viii-ix.
Brown JM, Mehler PS, Harris RH. Medical complications occurring in adolescents with anorexia nervosa. West J Med. 2000;172(3):189-93.
Schmidt U. Aetiology of eating disorders in the 21st century: new answers to old questions. Eur Child Adolesc Psychiatry. 2003;12 (Suppl 1):I30-7.
Simpson KJ. Anorexia nervosa and culture. J Psychiatr Ment Health Nurs. 2002;9:65-71.
Steinhausen HC. The outcome of anorexia nervosa in the 20th century. Am J Psychiatry. 2002;159:1284-93.
Herpertz-Dahlmann B, Müller B, Herpertz S, Heussen N, Hebebrand J, Remschmidt H. Prospective 10-year follow-up in adolescent anorexia nervosa - course, outcome, psychiatric co-morbidity, and psychosocial adaptation. J Child Psychol Psychiatry. 2001;42:603.
Yamamoto C, Uemoto M, Shinfuku N, Maeda K. The usefulness of body image tests in the prevention of eating disorders. Kobe J Med Sci. 2007;53:79-91.
Keel PK, Klump KL. Are eating disorders culture-bound syndromes? Implications for conceptualizing their etiology. Psychol Bull. 2003;129:747-69.
Yang SJ, Kim JM, Yoon JS. Disturbed eating attitudes and behaviours in South Korean boys and girls: a school-based cross-sectional study. Yonsei Med J. 2010;51:302-9.
Nasser M. Eating disorders: the cultural dimension. Soc Psychiatry Psychiatr Epidemiol. 1988;23:184-7.
Rucker CE, Cash TF. Body images, body size perceptions and eating behaviors among African-American and white college women. Int J Eat Disord. 1992;12:291-9.
le Grange D, Stone AA, Brownell KD. Eating disturbances in white and minority female dieters. Int J Eat Disord. 1998;24:395-403.
Mendhekar DN, Arora K, Lohia D, Aggarwal A, Jiloha RC. Anorexia nervosa: an Indian perspective. Natl Med J India. 2009;22:181-2.
Mendhekar DN, Mehta R, Srivastav PK. Bulimia nervosa. Indian J Pediatr. 2004;71:861-2.
Chhabra P, Grover VL, Aggarwal K, Kanan AT. Nutritional status and blood pressure of medical students in Delhi. Indian J Community Med. 2006;31:248-51.
Fernandez K, Singru SA, Kshirsagar M, Pathan Y. Study regarding overweight/obesity among medical students of a teaching hospital in Pune, India. Med J DY Patil Univ. 2014;7:279-83.
Szweda S, Thorne P. The prevalence of eating disorders in female health care students. Occup Med (Lond). 2002;52:113-9.
Nishizawa Y, Kida K, Nishizawa K, Hashiba S, Saito K, Mita R. Perception of self-physique and eating behavior of high school students in Japan. Psychiatry Clin Neurosci. 2003;57:189-96.
Anstine D, Grinenko D. Rapid screening for disordered eating in college-aged females in the primary care setting. J Adolesc Health. 2000;26(5):338-42.
Jones JM, Bennett S, Olmsted MP, Lawson ML, Rodin G. Disordered eating attitudes and behaviors in teenaged girls; a school based study. CMAJ. 2001;165(5):547-52.
Goyal RK, Shah VN, Saboo BD, Phatak SR, Shah NN, Gohel MC, et al. Prevalence of overweight and obesity in Indian adolescent school going children: its relationship with socioeconomic status and associated lifestyle factors. J Assoc Physicians India. 2010;58:151-8.
Palma-Coca O, Hernández-Serrato MI, Villalobos-Hernández A, Unikel-Santoncini C, Olaiz-Fernández G, Bojorquez-Chapela I. Association of socioeconomic status, problem behaviors, and disordered eating in Mexican adolescents: results of the Mexican National Health and Nutrition Survey 2006. J Adolesc Health. 2011;49(4):400-6.
Swanson SA, Crow SJ, Le Grange D, Swendsen J, Merikangas KR. Prevalence and correlates of eating disorders in adolescents. Results from the national comorbidity survey replication adolescent supplement. Arch Gen Psychiatry. 2011;68(7):714-23.
Prisco AP, Araújo TM, Almeida MM, Santos KO. Prevalence of eating disorders in urban workers in a city of the northeast of Brazil. Cien Saude Colet. 2013;18(4):1109-18.
Bosi ML, Luiz RR, Morgado CM, Costa ML, Carvalho RJ. Self-perception of body image among nutrition students in Rio de Janeiro (in Spanish). Braz J Psychiatry. 2006;55:34-40.
da Cunha Feio Costa L, de Assis Guedes de Vasconcelos F, Peres KG. Influence of biological, social and psychological factors on abnormal eating attitudes among female university students in Brazil. J Health Popul Nutr. 2010;28:173-81.
Santonastaso P, Zanetti T, Sala A, Favaretto G, Vidotto G, FavaroA. Prevalence of eating disorders in Italy: a survey on a sample of 16-year-old female students. Psychother Psychosom. 1996;65:158-62.
Goodman R, Meltzer H, Bailey V. The Strengths and Difficulties Questionnaire: a pilot study on the validity of the self-report version. Eur Child Adolesc Psychiatry. 1998;7:125-30.
Yang SJ, Kim JM, Yoon JS. Disturbed eating attitudes and behaviours in South Korean boys and girls: a school-based cross-sectional study. Yonsei Med J. 2010;51:302-9.
Neumark-Sztainer D, Hannan PJ. Weight-related behaviors among adolescent girls and boys: results from a national survey. Arch Pediatr Adolesc Med. 2000;154:569-77.
