Risk of eating disorders and its association with body image concerns, depression, anxiety and stress among medical students in a college in Kerala

Authors

  • Chitra Tomy Assistant Professor, Department of Community Medicine , Amrita Institute of Medical Sciences , Amrita Vishwa Vidyapeetham
  • Anju Lakshmi V House surgeon , Amrita Institute of Medical Sciences , Amrita Vishwa Vidyapeetham
  • Kathleen Anne Mathew Senior Resident, Department of Psychiatry, Amrita Institute of Medical Sciences ,Amrita Vishwa Vidyapeetham
  • Arya Jith Assistant professor , Department of Psychiatry ,Amrita institute of Medical Sciences, Amrita Vishwa Vidhyapeetham.

DOI:

https://doi.org/10.30834/KJP.34.2.2021.278

Keywords:

Eating disorders, medical students, body shape concerns, depression, anxiety, stress

Abstract

Background: Eating disorders are one of the most under-recognised psychiatric conditions which can lead to considerable morbidity. With their high workloads, academic pressure, and peer influence, medical students may be more likely to develop eating disorders. This study aimed to assess the prevalence of eating disorders among medical students in a college in Kerala.  It was also planned to find its association with body shape concerns, depression, anxiety and stress. Methods: A cross-sectional study was conducted among 472 undergraduate medical students and interns at a medical college in Kerala. Socio-demographic proforma, Eating Attitudes Test-26 (EAT-26), Body Shape Questionnaire-8C (vBSQ-8C), Depression, Anxiety and Stress Scale-21(DASS-21)-were administered after obtaining informed written consent. Statistical analysis was done using the chi-square test and Pearson correlation. Results: The prevalence of risk of eating disorders among medical students was 19.1%. Depression, anxiety and stress were significantly associated with the risk of eating disorders (p=0.034, p=0.001 and p=0.001, respectively). A positive correlation was found between the risk of eating disorders, body shape concerns and body mass index (p=0.001). Conclusion: A considerable risk of eating disorders was noted among medical students in Kerala. Body shape concerns and symptoms suggestive of depression, anxiety, and stress showed a significant association with the risk of eating disorders. Increased awareness and early identification can help institute timely interventions.

References

Jahrami H, Sater M, Abdulla A, Faris MA-I, AlAnsari A. Eating disorders risk among medical students: a global systematic review and meta-analysis. Eat Weight Disord. 2019 Jun;24(3):397–410.

Diagnostic and statistical manual of mental disorders: DSM-5. 2. American Psychiatric Association. 5th edition. Arlington, VA: American Psychiatric Association; 2013. 947 p.

Srinivasan TN, Suresh TR, Jayaram V, Fernandez MP. Eating disorders in India. Indian J Psychiatry. 1995 Jan;37(1):26–30.

Yang SJ, Choi Y, Lee HY. Eating Attitude, Ego-Identity, and Self-Esteem among the Urban High School Girls. Journal of Korean Neuropsychiatric Association. 2016 Jul 21;40(3):477–86.

Memon AA, Adil SE-R, Siddiqui EU, Naeem SS, Ali SA, Mehmood K. Eating disorders in medical students of Karachi, Pakistan-a cross-sectional study. BMC Res Notes. 2012 Dec;5(1):84.

Singh M, Parsekar S, Bhumika T. Body Image, Eating Disorders and Role of Media among Indian Adolescents. J Indian Assoc Child Adolesc Ment Health. 2016 Jan 1;12:9–35.

Nivedita N, Sreenivasa G, Rao TS, Malini SS. Eating disorders: Prevalence in the student population of Mysore, South India. Indian Journal of Psychiatry. 2018 Oct 1;60(4):433.

Ramaiah RR. Eating disorders among medical students of a rural teaching hospital: a cross-sectional study. International Journal Of Community Medicine And Public Health. 2017 Feb 4;2(1):25–8.

Vaidyanathan S, Kuppili PP, Menon V. Eating Disorders: An Overview of Indian Research. Indian Journal of Psychological Medicine. 2019 Jul;41(4):311–7.

Taneja N, Sachdeva S, Dwivedi N. Assessment of depression, anxiety, and stress among medical students enrolled in a medical college of New Delhi, India. Indian J Soc Psychiatry 2018;34:157-62

Gupta N, Bhargava R, Chavan B, Sharan P. Eating attitudes and body shape concerns among medical students in Chandigarh. Indian J Soc Psychiatry. 2017;33(3):219.

Mumford DB, Whitehouse AM, Platts M. Sociocultural Correlates of Eating Disorders among Asian Schoolgirls in Bradford. Br J Psychiatry. 1991 Feb;158(2):222–8.

Pleplé A, Lalanne C, Huas C, Mattar L, Hanachi M, Flament MF, et al. Nutritional status and anxious and depressive symptoms in anorexia nervosa: a prospective study. Sci Rep. 2021 Dec;11(1):771.

Hosseini SA, Padhy RK. Body Image Distortion. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2021 [cited 2021 May 31]. Available from: http://www.ncbi.nlm.nih.gov/books/NBK546582/

WHO Expert Consultation. Appropriate body-mass index for Asian populations and its implications for policy and intervention strategies. Lancet. 2004 Jan 10;363(9403):157–63.

Garner DM, Olmsted MP, Bohr Y, Garfinkel PE. The Eating Attitudes Test: psychometric features and clinical correlates. Psychol Med. 1982 Nov;12(4):871–8.

Evans C, Dolan B. Body Shape Questionnaire: derivation of shortened “alternate forms.” Int J Eat

Disord. 1993 Apr;13(3):315–21.

Lovibond PF, Lovibond SH. The structure of negative emotional states: Comparison of the Depression Anxiety Stress Scales (DASS) with the Beck Depression and Anxiety Inventories. Behaviour Research and Therapy. 1995 Mar;33(3):335–43.

Sharma MK, Hallford DJ, Anand N. Confirmatory factor analysis of the Depression, Anxiety, and Stress Scale among Indian adults. Indian J Psychiatry. 2020 Aug;62(4):379–83.

Nurwanti E, Hadi H, Chang J-S, Chao JC-J, Paramashanti BA, Gittelsohn J, et al. Rural-Urban Differences in Dietary Behavior and Obesity: Results of the Riskesdas Study in 10-18-Year-Old Indonesian Children and Adolescents. Nutrients. 2019 Nov 18;11(11).

Spigarelli MG, Haney SE, Butler K, Sotiriou EG. 40. Assessing Body Dissatisfaction in Medical Students: Results of the BSQ-8C (Body Shape Questionnaire). Journal of Adolescent Health. 2013 Feb;52(2): S40.

Azzouzi N, Ahid S, Bragazzi NL, Berhili N, Aarab C, Aalouane R, et al. Eating disorders among Moroccan medical students: cognition and behavior. Psychol Res Behav Manag. 2019;12:129–35.

Brechan I, Kvalem IL. Relationship between body dissatisfaction and disordered eating: mediating role of self-esteem and depression. Eat Behav. 2015 Apr;17:49–58.

Serino S, Dakanalis A, Gaudio S, Carrà G, Cipresso P, Clerici M, et al. Out of body, out of space: Impaired reference frame processing in eating disorders. Psychiatry Research. 2015 Dec;230(2):732–4.

Al Banna MdH, Brazendale K, Khan MSI, Sayeed A, Hasan MT, Kundu S. Association of overweight and obesity with the risk of disordered eating attitudes and behaviors among Bangladeshi university students. Eating Behaviors. 2021 Jan;40:101474.

Fan Y, Li Y, Liu A, Hu X, Ma G, Xu G. Associations between body mass index, weight control concerns and behaviors, and eating disorder symptoms among non-clinical Chinese adolescents. BMC Public Health. 2010 Dec;10(1):314.

Fragkos K, Frangos C. Assessing Eating Disorder Risk: The Pivotal Role of Achievement Anxiety, Depression and Female Gender in Non-Clinical Samples. Nutrients. 2013 Mar 12;5(3):811–28.

Brytek-Matera A, Czepczor K. Models of eating disorders: a theoretical investigation of abnormal eating patterns and body image disturbance. Arch Psych Psych. 2017 Mar 1;19(1):16–26.

Schaumberg K, Welch E, Breithaupt L, Hübel C, Baker JH, Munn-Chernoff MA, et al. The Science Behind the Academy for Eating Disorders’ Nine Truths About Eating Disorders: Nine Truths. Eur Eat Disorders Rev. 2017 Nov;25(6):432–50.

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Published

2021-09-18

How to Cite

Chitra Tomy, Anju Lakshmi V, Kathleen Anne Mathew, & Jith, A. (2021). Risk of eating disorders and its association with body image concerns, depression, anxiety and stress among medical students in a college in Kerala. Kerala Journal of Psychiatry. https://doi.org/10.30834/KJP.34.2.2021.278

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Section

Research Report