Abstract
An online cross-sectional study was conducted in May 2021 to identify factors, such as changes in food choices, lifestyle, risk and protective behavior, mental health, and social demographics, on eating disorders (ED) among students of a French university. Students were invited to fill out an online questionnaire. ED were identified using the French version of the five-item “Sick, Control, One stone, Fat, Food” (SCOFF) questionnaire. The Expali™-validated algorithmic tool, combining SCOFF and body mass index, was used to screen EDs into four diagnostic categories: bulimic ED, hyperphagic ED, restrictive ED and other ED. A total of 3508 students filled the online questionnaire, 67.3% female, mean age 20.7 years (SD = 2.3). The prevalence of ED was 51.6% in women and 31.9% in men (p < 0.0001). Lower food security scores were associated with a higher risk for all ED categories. Depression and academic stress due to COVID-19 were associated with ED regardless of category. Regarding health behaviors, a high adherence to the National nutrition recommendation was a protective factor for the risk of bulimic ED, hyperphagic ED and restrictive ED. A lower frequency of moderate and vigorous physical activity was associated with a higher risk of hyperphagic ED. Our study has shown a high screening of ED among the students of a French university fourteen months after the beginning of the COVID-19 pandemic. By disrupting academic learning, jobs and social life, the COVID-19 pandemic could have exacerbated existing ED or contributed to the onset of new ED.
Highlights
University students may constitute a vulnerable population for mental health problems with the transition to adulthood, frequent economic difficulties and academic burden [1]
There are a variety of stressors that contribute to increased levels of anxiety, stress, and depressive thoughts as students live through the COVID-19 pandemic [11]
The COVID-19 pandemic has led to anxiety and depression symptoms among university students [19,20] which are well known to be associated with eating disorders (ED) [21,22]
Summary
University students may constitute a vulnerable population for mental health problems with the transition to adulthood, frequent economic difficulties and academic burden [1]. University years coincide with the typical age of onset of eating disorders (ED) with a significant concern among university students, worsened by academic stress [2]. To this context was suddenly added the Coronavirus Disease 2019 (COVID-19) pandemic on 11 March 2020 which led to multiple lockdowns in France and curfews [3]. There are a variety of stressors that contribute to increased levels of anxiety, stress, and depressive thoughts as students live through the COVID-19 pandemic [11]. The COVID-19 pandemic has led to anxiety and depression symptoms among university students [19,20] which are well known to be associated with ED [21,22]. Few studies have evaluated the risk of onset or worsening of ED and associated factors among the student population [25,26]
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