Risk of anorexia and bulimia nervosa and its associated factors in undergraduate students

DÍAZ MUÑOZ, Gustavo Alfonso

doi:10.1590/1678-9865202134e200067

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Sumário

Original • Rev Nutr 34 • 2021 • https://doi.org/10.1590/1678-9865202134e200067 copy

Risk of anorexia and bulimia nervosa and its associated factors in undergraduate students

Risco de anorexia e bulimia nervosa e seus fatores associados em estudantes de graduação

Authorship SCIMAGO INSTITUTIONS RANKINGS

ABSTRACT

Objective

To quantify the prevalence and related factors to the risk of anorexia and bulimia nervosa in undergraduate students at a private university in Bogotá, Colombia.

Methods

A cross-sectional study, which evaluated the frequency of food consumption, physical activity (International Physical Activity Questionnaire, short form), the risk of anorexia and bulimia nervosa (Sick, Control, One, Fat, and Food questionnaire) and demographic variables. The statistical analysis used a multivariate logistic regression model, where the outcome was the yes/no risk of anorexia or bulimia nervosa.

Results

A total of 1,545 university students participated. The average age was 19.2 years (+/-2.5), 65.7% were women, and 63.9% came from Bogotá. The risk of anorexia and bulimia nervosa was 27.6%. In the logistic regression, the risk was associated with female sex (OR 1.6 CI95% 1.2 to 2.1), daily consumption of cereals (OR 0.7 CI95% 0.6 to 0.9), daily fat consumption (OR 1.5 CI95% 1.1 to 2.1), eat light products (OR 1.8 CI95% 1.1 to 2.9), consume protein supplements (OR 0.4 CI95% 0.2 to 0.8), being in disagreement with physical activity for fun (OR 1.8 CI95% 1.1 to 3.1), and physical activity by appearance (OR 2.2 CI95% 1.6 to 2.9).

Conclusions

The prevalence of risk to anorexia and bulimia nervosa in the study sample is high. The associated factors were the consumption of cereals, fat, light products, and protein supplements. Physical activity by appearance and disagreement to do exercise by fun were associated with the risk of anorexia and bulimia nervosa. So it is recommended that universities implement awareness and education interventions to address this problem.

Keywords
Anorexia nervosa; Bulimia nervosa; Feeding and eating disorders; Universities

Variables		n=530			n=1,015		n=1,545
		34.3% (31.9-36.7)			65.7% (63.3-68.1)		n=1,545
			%	CI95%	%	CI95%	%	CI95%
Age
Mean±SD		19.5 ±2.6			19.1 ±2.5		19.2 ±2.5
CI95%		19.3-19.7			18.9-19.2		19.1-19.3
Age groups
	15-17 years		15.5	12.4-18.6	21.3	18.8-23.8	19.3	17.3-21.3
	18-25 years		80.9	77.6-84.3	76.7	74-79.3	78.1	76.1-80.2
	26-40 years		03.6	1.9-5.2	02.1	1.2-2.9	02.6	1.8-3.4
Provenance region
	Bogotá		64.3	60.3-68.4	63.7	60.8-66.7	63.9	61.6-66.3
	Bogotá surroundings		03.2	1.7-4.7	02.1	1.2-2.9	2.5	1.7-3.2
	Eastern		11.9	9.1-14.6	14.5	12.3-16.7	13.6	11.9-15.3
	Central		08.3	5.9-10.7	09.5	7.7-11.3	09.1	7.6-10.5
	Atlantic		04.9	3.1-6.7	04.1	2.9-5.4	04.4	3.4-5.4
	Pacific		02.5	1.1-3.8	02.0	1.1-2.8	02.1	1.4-2.9
	Amazon-Orinoquia		04.9	3.1-6.7	04.1	2.9-5.4	04.4	3.4-5.4
Socioeconomic level
	1		01.9	0.7-3	02.1	1.2-2.9	02.0	1.3-2.7
	2		11.9	9.1-14.6	14.8	12.6-17.0	13.8	12.1-15.5
	3		34.5	30.5-38.6	42.6	39.5-45.6	39.8	37.4-42.3
	4		33.4	29.4-37.4	26.0	23.3-28.7	28.5	26.3-30.8
	5		13.0	10.1-15.9	12.1	10.1-14.1	12.4	10.8-14.1
	6		05.3	3.4-7.2	02.5	1.5-3.4	03.4	2.5-4.3
Civil status
	Single		97.0	95.5-98.4	94.7	93.3-96.1	95.5	94.4-96.5
	With couple		03.0	1.6-4.5	05.3	3.9-6.7	04.5	3.5-5.6
Work, yes			18.3	15.0-21.6	10.9	9.0-12.9	13.5	11.8-15.2
Couple, yes			35.3	31.2-39.4	43.5	40.5-46.6	40.7	38.3-43.2
Faculty
	Science		07.7	5.5-10.0	04.3	3.1-5.6	05.5	4.3-6.7
	Economy		07.7	5.5-10.0	03.6	2.4-4.7	04.8	3.7-5.9
	Politic		03.6	2.0-5.2	03.8	2.7-5.0	03.7	2.8-4.7
	Creation		09.1	6.6-11.5	04.8	3.5-6.1	06.3	5.0-7.5
	Education		07.7	5.5-10.0	12.2	10.2-14.2	10.4	8.9-12.0
	Nursing		04.0	2.3-5.6	11.5	9.6-13.5	08.8	7.4-10.3
	Engineering		25.3	21.6-29.0	12.5	10.5-14.6	17.1	15.1-19.0
	Medicine		22.1	18.5-25.6	35.3	32.3-38.2	30.8	28.4-33.2
	Odontology		03.8	2.1-5.4	07.2	5.6-8.8	06.3	5.0-7.5
	Basic course		09.1	6.6-11.5	04.7	3.4-6.0	06.3	5.0-7.5
Semester
	I		30.4	26.3-34.4	22.6	19.9-25.2	25.3	23.0-27.5
	II		26.8	22.9-30.7	27.7	24.8-30.5	27.3	25.0-29.6
	III		19.4	16.0-22.9	20.7	18.1-23.2	20.2	18.2-22.3
	IV		23.4	19.7-27.1	29.1	26.2-32.0	27.1	24.8-29.4

Variables		ABN Risk					p-value	Logistic Regression
Variables		Yes (n=427) 27.6%			No (n=1,118) 72.4%		p-value	OR	CI 95%
Age
Mean±SD		19.2±2.7			19.2±٢.٤		<0.399
CI95%		18.9-19.5			19.1-19.3
			%	CI 95%	%	CI 95%
Female Sex			74.9	70.8-79.1	62.2	59.3-65.0	<0.001	1.6	1.2 to 2.1
Provenance region							<0.791
	Bogotá		62.1	57,4-66,7	64.7	61.9-67.5
	Bogotá surroundings		02.3	0.9-3.8	02.5	1.6-3.4
	Eastern		13.6	10.3-16.8	13.6	11.6-15.6
	Central		09.8	7.0-12.7	08.9	7.1-10.4
	Atlantic		04.4	2.5-6.4	04.4	3.2-5.6
	Pacific		03.0	1.4-4.7	01.8	1.0-2.6
	Amazon-Orinoquía		04.7	2.7-6.7	004.3	3.1-5.5
Socioeconomic level
	1		01.2	0.1-2.2	2.3	1.4-3.2	<0.222	0.4	0.1 to 1.2
	2		10.5	7.6-13.5	15.0	12.9-17.1	<0.026	0.6	0.4 to 0.9
	3		41.5	36.8-46.1	39.2	36.3-42.0	<0.414
	4		29.7	25.4-34.1	28.1	25.4-30.7	<0.519
	5		13.6	10.3-16.8	12.0	10.1-13.9	00.390
	6		03.5	1.8-5.3	03.4	2.3-4.5	<0.877
Civil status
	Single		95.1	93.0-97.1	95.6	94.4-96.8	<0.651
	With couple		04.9	2.9-7.0	04.4	3.2-5.6
Work, yes			12.4	9.3-15.5	13.9	11.8-15.9	<0.455
Couple, yes			43.1	38.4-47.8	39.8	36.9-42.7	<0.239	1.1	0.9 to 1.4
Faculty
	Sciences		05.2	3.1-7.3	05.6	4.3-7.0	0.710
	Economy		04.0	2.1-5.8	05.4	4.0-6.7	<0.263
	Politic		04.0	2.1-5.8	03.7	2.6-4.8	<0.772
	Creation		04.9	2.9-7.0	06.8	5.3-8.3	<0.173
	Education		12.2	9.1-15.3	10.1	8.3-11.9	<0.239
	Nursing		07.7	5.2-10.3	09.4	7.7-11.1	<0.305
	Engineering		12.9	9.7-16.1	18.4	16.2-20.7	<0.009
	Medicine		34.7	30.1-39.2	29.2	26.6-31.9	<0.039
	Odontology		06.6	4.2-8.9	05.8	4.4-7.2	<0.583
	Basic course		08.0	5.4 -10.5	05.5	4.2-6.9	<0.078
Semester
	1‡		22.2	18.1-26.3	26.4	23.8-29.1	<0.101	0.9	0.7 to 1.3
	2‡		32.3	27.7-36.9	25.5	22.8-28.1	<0.009	1.4	1.1 to 1.9
	3		18.9	15.1-22.8	20.7	18.3-23.2	0.452
	4		26.5	22.1-30.9	27.4	24.7-30.1	0.743
BMI
Mean±SD		22.8±3.3			21.7 ±3.3		<0.001
CI 95%		22.5-23.1			21.5-21.9
BMI classification
	Underweight		05.3	3.1-7.5	13.2	11.1-15.3	<0.001
	Normal		74.9	70.7-79.2	72.5	69.7-75.2
	Overweight		16.2	12.6-19.8	12.3	10.3-14.4
	Obesity		03.5	1.7-5.4	02.0	1.1-2.8

Variables		ABN risk					p-value
		Yes (n=427) 27.6%			No (n=1,118) 72.4%			OR	CI 95%
			%	CI 95%	%	CI 95%		OR	CI 95%
Meals:
	Breakfast		97.4	95.9-98.9	98.0	97.2-98.8	0.460
	Elevens		81.0	77.3-84.8	84.3	82.2-86.5	0.117
	Lunch		99.5	98.9-100	100	100-100	0.022
	Supper		70.5	66.2-74.8	73.9	71.3-76.4	0.18
	Dinner		99.3	98.5-100	99.4	98.9-99.8	0.867
	Night meal		34.7	30.1-39.2	36.1	33.3-39.0	0.588
Daily consumption of food groups:
	Cereals		42.0	37.3-46.7	46.1	43.2-49.0	0.150	0.7	0.6 to 0.9
	Vegetables		21.8	17.7-25.9	21.8	19.3-24.3	0.990
	Fruits		42.1	37.4-46.8	45.0	42.0-47.9	0.317
	Dairy products		46.9	42.1-51.7	48.5	45.5-51.4	0.587
	Meat and eggs		42.8	38.1-47.5	43.8	40.9-46.7	0.728
	Legumes		12.0	8.9-15.2	12.5	10.6-14.5	0.791
	Fat		21.9	17.9-25.9	18.0	15.7-20.3	0.087	1.5	1.1 to 2.1
	Sugar		43.4	38.6-48.2	40.8	37.9-43.7	0.365
Daily consumption of other foods:
	Carbonated beverages		20.8	16.7-24.9	18.8	16.3-21.2	0.391
	Package food		13.7	10.2-17.3	12.5	10.4-14.5	0.534
	Coffee. tea		30.7	26.1-35.4	31.1	28.2-34.1	0.890
	Light products		18.2	13.7-22.6	11.6	9.3-14.0	0.006	1.8	1.1 to 2.9
	Whole grain foods		19.4	15.1-23.7	14.5	12.1-16.9	0.040	1.2	0.7 to 1.9
	Vitamins		17.9	11.9-24.0	18.1	14.6-21.7	0.957
	Protein supplements		12.0	5.5-18.5	19.7	15.4-24.0	0.079	0.4	0.2 to 0.8
Physical activity level:
	Low		48.9	44.2-53.7	43.6	40.6-46.5	0.057	1.1	0.8 to 1.5
	Medium		20.1	16.3-24.0	19.5	17.2-21.8	0.777
	High		31.0	26.5-35.3	36.9	34.1-39.8	0.027	0.9	0.6 to 1.3
Motivation for doing physical activity
Fun
	Agreement		30.0	25.6-34.3	33.6	30.9-36.4	0.171	0.8	0.6 to 1.1
	Disagreement		19.2	15.5-23.0	13.6	11.6-15.6	0.006	1.8	1.1 to 3.1
Appearance
	Agreement		47.5	42.8-52.3	31.1	28.4-33.8	<0.001	2.2	1.6 to 2.9
	Disagreement		11.2	8.2-14.2	15.1	13.0-17.2	0.050	0.6	0.4 to 0.9
Health
	Agreement		47.3	42.6-52.1	47.9	45.0-50.9	0.823
	Disagreement		11.9	8.9-15.3	08.6	6.9-10.2	0.044	1.6	0.9 to 2.9
Competition
	Agreement		31.6	27.2-36.0	34.5	31.7-37.3	0.279
	Disagreement		18.7	15.0-22.5	15.7	13.5-17.8	0.144	0.9	0.5 to 1.4
Socialize
	Agreement		6.8	4.4-9.2	06.1	4.7-7.5	0.607
	Disagreement		38.4	33.8-43.0	39.4	36.5-42.2	0.733

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