Disordered eating behaviors, body dissatisfaction and their determinants in Indian adolescents: A cross-sectional observational study

Abstract

Objective: Although the prevalence of disordered eating is maximum in high-income countries, the most significant rise occurred in East Asia and South Asia over the last three decades. Body dissatisfaction and disordered eating behaviors (DEBs) are more common than full-blown eating disorders. The cognitive distortion leading to these manifestations mainly occurs during adolescence and early adulthood. In this study, we assess the burden of DEBs in a cohort of Indian adolescents and determine their correlation with body dissatisfaction, calorie intake, and clinicosocial determinants. Methods: The study was conducted from November 2016 to November 2020 and enrolled 180 adolescents of 10-18 years attending the outpatient department of a tertiary-care hospital. Subjects were screened for DEBs, using a 15-item Screening Questionnaire for Eating Distress Syndromes, and for body dissatisfaction, using Photographic-Figure-Rating-Scale. Clinicosocial interviews, dietary and anthropometric evaluation, and psychiatric screening using a Mini-International Neuropsychiatric Interview (MINI-KIDS screen) were conducted. Results: DEB was present in 17.2% of adolescents, while 81.1% had body dissatisfaction and 32.2% had some psychiatric symptoms. The prevalence of DEBs in females was much higher than in males (OR = 7.89, 95%CI: 2.25-27.75, P = 0.001). More males (84.1%) reported body dissatisfaction than females (76.7%) [χ² =9.2, P = 0.010]. However, while females wished to lose weight, males desired weight gain, as measured by body dissatisfaction score (t = 2.9, P = 0.004). Apart from sex, other factors found significant in predicting DEBs in multivariate analysis were education, body dissatisfaction, BMI, and the number of siblings. Conclusion: We conclude that, unlike overt eating disorders, DEBs are common in Indian adolescents. The development of DEBs is influenced by gender, education, body dissatisfaction, BMI, and the number of siblings.