Prevalence of Risk of Eating Disorders and its Association with Obesity and Fitness

Abstract

The university stage is a critical developmental period for young adults, where lifestyles can determine future health. A cross-sectional study including 481 college students was conducted, with the following objectives: 1) to examine the prevalence of risk of developing eating disorders in college students, 2) to assess differences in obesity and physical fitness in those with and without risk of eating disorders, and 3) to determine whether cardiorespiratory fitness, muscular fitness or fat mass were associated with the risk of eating disorders. We measured fat mass percentage (by densitometry), risk of feeding or eating disorders (by SCOFF questionnaire), cardiorespiratory fitness levels and a muscular fitness index. The prevalence of risk of eating disorders in women (32.4%) was higher than in men (17.4%) (p<0.001). In both sexes, higher obesity indicator mean values were observed among those who were at risk of eating disorders. Men participants without risk had higher cardiorespiratory fitness means than their at-risk peers [39.4 (8.3) vs. 32.4 (5.5), p<0.001)], and women showed differences only in the dynamometry/weight variable. In college students, it is necessary to promote healthy habits, including good levels of physical fitness, and to prevent excess body fat to effectively prevent eating disorders.

Keywords

SCOFF - cardiorespiratory fitness - muscular fitness - college students - body composition

Publikationsverlauf

Eingereicht: 05. August 2019

Angenommen: 19. März 2020

Artikel online veröffentlicht:
02. Juni 2020

• References

• 1 Tavolacci MP, Ladner J, Grigioni S. et al. Prevalence and association of perceived stress, substance use and behavioral addictions: A cross-sectional study among university students in France, 2009-2011. BMC Public Health 2013; 13: 724
• 2 Herpertz-Dahlmann B. Adolescent eating disorders: Update on definitions, symptomatology, epidemiology, and comorbidity. Child Adolesc Psychiatr Clin N Am 2015; 24: 177-196
• 3 Association AP. Diagnostic and Statistical Manual of Mental Disorders (DSM-5^®): American Psychiatric Pub; 2013
• 4 Tavolacci MP, Grigioni S, Richard L. et al. Eating disorders and associated health risks among university students. J Nutr Educ Behav 2015; 47: 412.e1-420.e1
• 5 Veses AM, Martinez-Gomez D, Gomez-Martinez S. et al. Association between excessive body fat and eating-disorder risk in adolescents: The AFINOS Study. Med Clin (Barc) 2011; 136: 620-622
• 6 Zeiler M, Waldherr K, Philipp J. et al. Prevalence of eating disorder risk and associations with health-related quality of life: Results from a large school-based population screening. Eur Eat Disord Rev 2016; 24: 9-18
• 7 Smink FR, van Hoeken D, Hoek HW. Epidemiology of eating disorders: Incidence, prevalence and mortality rates. Curr Psychiatry Rep 2012; 14: 406-414
• 8 Golden NH, Schneider M, Wood C. et al. Preventing obesity and eating disorders in adolescents. Pediatrics 2016; 138: e20161649
• 9 Nascimento VSD, Santos AVD, Arruda SB. et al. Association between eating disorders, suicide and depressive symptoms in undergraduate students of health-related courses. Einstein (Sao Paulo) 2019; 18: eAO4908
• 10 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: 1141-1164
• 11 Rancourt D, McCullough MB. Overlap in eating disorders and obesity in adolescence. Curr Diab Rep 2015; 15: 78
• 12 Taylor SA, Ditch S, Hansen S. Identifying and preventing eating disorders in adolescent patients with obesity. Pediatr Ann 2018; 47: e232-e237
• 13 Jankauskiene R, Baceviciene M, Pajaujiene S. et al. Are Adolescent Body Image Concerns Associated with Health-Compromising Physical Activity Behaviours?. Int J Environ Res Public Health 2019; 16: 1225
• 14 Myers J, McAuley P, Lavie CJ. et al. Physical activity and cardiorespiratory fitness as major markers of cardiovascular risk: Their independent and interwoven importance to health status. Prog Cardiovasc Dis 2015; 57: 306-314
• 15 Ortega FB, Ruiz JR, Castillo MJ. et al. Physical fitness in childhood and adolescence: A powerful marker of health. Int J Obes (Lond) 2008; 32: 1-11
• 16 Garrido-Miguel M, Torres-Costoso A, Martínez-Andrés M et al. The risk of eating disorders and bone health in young adults: The mediating role of body composition and fitness. Eat Weight Disord 2017 1145-1154
• 17 McMahon EM, Corcoran P, O’Regan G. et al. Physical activity in European adolescents and associations with anxiety, depression and well-being. Eur Child Adolesc Psychiatry 2017; 26: 111-122
• 18 Veses AM, Martinez-Gomez D, Gomez-Martinez S. et al. Physical fitness, overweight and the risk of eating disorders in adolescents. The AVENA and AFINOS studies. Pediatr Obes 2014; 9: 1-9
• 19 Joy E, Kussman A, Nattiv A. 2016 update on eating disorders in athletes: A comprehensive narrative review with a focus on clinical assessment and management. Br J Sports Med 2016 (50) 154-162
• 20 Trott M, Jackson SE, Firth J et al. A comparative meta-analysis of the prevalence of exercise addiction in adults with and without indicated eating disorders. Eat Weight Disord 2020. [ahead of print] doi: 10.1007/s40519-019-00842-1
• 21 Cook BJ, Hausenblas HA. The role of exercise dependence for the relationship between exercise behavior and eating pathology: Mediator or moderator?. J Health Psychol 2008; 13: 495-502
• 22 Harrer M, Adam SH, Messner EM et al. Prevention of eating disorders at universities: A systematic review and meta-analysis. Int J Eat Disord 2020. [ahead of print] doi: 10.1002/eat.23224
• 23 Lee DC, Artero EG, Sui X. et al. Mortality trends in the general population: The importance of cardiorespiratory fitness. J Psychopharmacol 2010; 24: 27-35
• 24 Ruiz JR, Sui X, Lobelo F. et al. Association between muscular strength and mortality in men: Prospective cohort study. BMJ 2008; 337: a439
• 25 Ortiz-Galeano I, Sánchez-López M, Notario-Pacheco B. et al. Relationship between weight status, physical fitness levels and blood pressure components in young women. Rev Esp Salud Publica 2012; 86: 523-531
• 26 Harriss DJ, MacSween A, Atkinson G. Ethical standards in sport and exercise science research: 2020 update. Int J Sports Med 2019; 40: 813-817
• 27 Ruiz-Ruiz J, Mesa JLM, Gutiérrez A. et al. Hand size influences optimal grip span in women but not in men. J Hand Surg Am 2002; 27: 897-901
• 28 Díez-Fernández A, Sánchez-López M, Gulías-González R. et al. BMI as a mediator of the relationship between muscular fitness and cardiometabolic risk in children: A mediation analysis. PLoS One 2015; 10: e0116506
• 29 Beekley MD, Brechue WF, deHoyos DV. et al. Cross-validation of the YMCA submaximal cycle ergometer test to predict VO₂max. Res Q Exerc Sport 2004; 75: 337-342
• 30 Nieman DC, Lasasso H, Austin MD. et al. Validation of Cosmed’s FitMate in measuring exercise metabolism. Res Sports Med 2007; 15: 67-75
• 31 Perry L, Morgan J, Reid F. et al. Screening for symptoms of eating disorders: Reliability of the SCOFF screening tool with written compared to oral delivery. Int J Eat Disorder 2002; 32: 466-472
• 32 Botella J, Sepulveda AR, Huang H. et al. A meta-analysis of the diagnostic accuracy of the SCOFF. Span J Psychol 2013; 16: E92
• 33 Garcia-Campayo J, Sanz-Carrillo C, Ibanez JA. et al. Validation of the Spanish version of the SCOFF questionnaire for the screening of eating disorders in primary care. J Psychosom Res 2005; 59: 51-55
• 34 World Health Organization. Global Database on Body Mass Index. Geneva (Switzerland): 2006
• 35 Cohen J. Statistical Power Analyses for the Social Sciences. Hillsdale, NJ: Lawrence Erlbauni Associates; 1988
• 36 Martínez-González L, Fernández Villa T, Molina de la Torre AJ. et al. Prevalencia de trastornos de la conducta alimentaria en universitarios españoles y factores asociados: proyecto uniHcos. Nutr Hosp 2014; 30: 927-934
• 37 Bénard M, Bellisle F, Kesse-Guyot E et al. Impulsivity is associated with food intake, snacking, and eating disorders in a general population. Am J Clin Nutr 2019; 109: 117–126
• 38 Fragkos KC, Frangos CC. Assessing eating disorder risk: the pivotal role of achievement anxiety, depression and female gender in non-clinical samples. Nutrients 2013; 5: 811-828
• 39 Eisenberg D, Nicklett EJ, Roeder K. et al. Eating disorder symptoms among college students: Prevalence, persistence, correlates, and treatment-seeking. J Am Coll Health 2011; 59: 700-707
• 40 Saleh RN, Salameh RA, Yhya HH. et al. Disordered eating attitudes in female students of An-Najah National University: A cross-sectional study. J Eat Disord 2018; 6: 16
• 41 Feng T, Abebe DS. Eating behaviour disorders among adolescents in a middle school in Dongfanghong, China. J Eat Disord 2017; 5: 47
• 42 Keating Charlotte. Stephens. et al. Gender differences in weight-related and non-weight-related appearance concerns in a community sample. Austr J Psychol 2016; 68: 11-19
• 43 de Ridder D, Adriaanse M, Evers C. et al. Who diets? Most people and especially when they worry about food. Appetite 2014; 80: 103-108
• 44 Costarelli V, Demerzi M, Stamou D. Disordered eating attitudes in relation to body image and emotional intelligence in young women. J Hum Nutr Diet 2009; 22: 239-245
• 45 Uchôa FNM, Uchôa NM, Daniele TMDC. et al. 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: 1508
• 46 Sonneville KR, Thurston IB, Milliren CE. et al. Weight misperception among young adults with overweight/obesity associated with disordered eating behaviors. Int J Eat Disord 2016; 49: 937-946
• 47 da Luz FQ, Hay P, Touyz S. et al. Obesity with comorbid eating disorders: associated health risks and treatment approaches. Nutrients 2018; 10: 829
• 48 Neumark-Sztainer D, Wall M, Guo J. et al. Obesity, disordered eating, and eating disorders in a longitudinal study of adolescents: How do dieters fare 5 years later?. J Am Diet Assoc 2006; 106: 559-568
• 49 Flament MF, Henderson K, Buchholz A. et al. Weight status and DSM-5 diagnoses of eating disorders in adolescents from the community. J Am Acad Child Adolesc Psychiatry 2015; 54: 403-411
• 50 Udo T, Grilo CM. Physical activity levels and correlates in nationally representative sample of U.S. adults with healthy weight, obesity, and binge-eating disorder. Int J Eat Disord 2020; 53: 85-95
• 51 Martínez C, Berengüí Gil R, Garcés de los Fayos Ruiz EJ. Relación del índice de masa corporal, percepción de peso y variables relacionadas con los trastornos de la conducta alimentaria en estudiantes universitarios. Nutr Clín Diet Hosp 2016; 36: 54-63
• 52 Holland G, Tiggemann M. A systematic review of the impact of the use of social networking sites on body image and disordered eating outcomes. Body Image 2016; 17: 100-110
• 53 Cecil J, Dalton M, Finlayson G. et al. Obesity and eating behaviour in children and adolescents: contribution of common gene polymorphisms. Int Rev Psychiatry 2012; 24: 200-210
• 54 Bouchard C. The biological predisposition to obesity: Beyond the thrifty genotype scenario. Int J Obes (Lond) 2007; 31: 1337-1339
• 55 Castellini G, Franzago M, Bagnoli S. et al. Fat mass and obesity-associated gene (FTO) is associated to eating disorders susceptibility and moderates the expression of psychopathological traits. PLoS One 2017; 12: e0173560
• 56 ChB C, Pangrazi R, Franks B. Definition: Health, fitness, and physical activity. President’s Council on Physical Fitness and Sports Research Digest 2003; 3: 1-11
• 57 Volaklis KA, Halle M, Meisinger C. Muscular strength as a strong predictor of mortality: A narrative review. Eur J Intern Med 2015; 26: 303-310
• 58 El Ghoch M, Soave F, Calugi S. et al. Eating disorders, physical fitness and sport performance: A systematic review. Nutrients 2013; 5: 5140-5160
• 59 Dosil J. Eating Disorders in Athletes. England: John Wiley & Sons; 2008
• 60 Martínez-Gómez D, Veses AM, Gómez-Martínez S. et al. Television viewing time and risk of eating disorders in Spanish adolescents: AVENA and AFINOS studies. Pediatr Int 2015; 57: 455-460
• 61 Linardon J, Brennan L. The effects of cognitive-behavioral therapy for eating disorders on quality of life: A meta-analysis. Int J Eat Disord 2017; 50: 715-730
• 62 Bratland-Sanda S, Sundgot-Borgen J, Rø Ø. et al. Physical activity and exercise dependence during inpatient treatment of longstanding eating disorders: an exploratory study of excessive and non-excessive exercisers. Int J Eat Disord 2010; 43: 266-273