Abstract

The aim of this paper was to identify the characteristics of broader categories of eating disorders (ED) and help- and care-seeking among college students. An online cross-sectional study was conducted among students of the University of Rouen-Normandy, France. The Expali-validated algorithmic tool, combining SCOFF test (Sick, Control, One stone, Fat, Food) and body mass index, was used to screen eating disorders into three diagnostic categories: restrictive eating disorders, bulimic eating disorders, and hyperphagic eating disorders. A total of 1493 college students were included; mean age was 20.1 years (SD = 1.9). The prevalence of likely cases of eating disorder was 24.8% (95% CI, 22.6–27.0). Percentage distributions of bulimic eating disorders, hyperphagic eating disorders, and restrictive eating disorders were 13.3%, 8.6%, and 2.9%, respectively. The two main resources for help-seeking in emotional stress situations were friends and family, whatever the ED. Students with eating disorders consulted their general practitioner more often for stress or anxiety than students without eating disorders: hyperphagic eating disorders (44.9%), restrictive eating disorders (35.1%), bulimic eating disorders (30.2%), and no eating disorder (20.4%) (p < 0.0001). The prevalence of healthcare renunciation was 21.9%, with a higher risk among students with bulimic eating disorders (AOR CI 95% 1.91 (1.34–2.72). The findings show one quarter of students screened positive for an eating disorder. Stress management was not necessarily different between students with eating disorders and students without eating disorders, but the former had a greater risk of renouncing treatment, especially related to a fear of seeing a general practitioner.

Highlights

  • Eating disorders (EDs), as anorexia nervosa, bulimia nervosa, and binge eating, are serious mental illnesses characterized by disturbances of body image and eating behavior [1]

  • EDs mainly related to hyperphagic EDs [2]. This is the first study conducted in a large population of college students in France, focusing on

  • This is the first study conducted in a large population of college students in France, focusing on the relationship between the risk of ED and academic environment and health behavior

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Summary

Introduction

Eating disorders (EDs), as anorexia nervosa, bulimia nervosa, and binge eating, are serious mental illnesses characterized by disturbances of body image and eating behavior [1]. A recent literature review indicated that binge eating, bulimia nervosa and anorexia nervosa, had the highest lifetime prevalences [2]. College years coincide with the typical age of onset for EDs [3,4], and it is well-documented that EDs are a significant concern among college students [5,6] with a higher risk of restrictive EDs [7]. The academic pressures of meeting grade requirements, test-taking, the volume of material to be learned, and a job in parallel have been shown to be a significant source of stress for students [9]. Academic stress is caused by high workloads, and coincides with a stage of life in which students must face many changes; Int. J. Public Health 2020, 17, 5914; doi:10.3390/ijerph17165914 www.mdpi.com/journal/ijerph

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