Eating Disorders and the Use of Cognitive Enhancers and Psychostimulants Among University Students: A Cross-Sectional Study

Abstract

Background University students, who are at risk of eating disorders (ED), are more liable to use cognitive enhancers and psychostimulants to improve their cognitive functions and lose weight. ED in Palestinian male students is a neglected health issue. We aimed to investigate the prevalence and the association between ED and cognitive enhancers, and psychostimulants use among An-Najah National University students (ANNU). Methods In a cross-sectional study conducted in 2020 at ANNU, 1047 students completed anonymous surveys for cognitive enhancers practice, the Eating Attitude Test-26 (EAT-26), Sick, Control, One, Fat and FOOD (SCOFF) screening tests. Results The prevalence of ED among ANNU students was 21.2% based on EAT-26 (17.1% in males, 23.8% in females) and 31.5% based on SCOFF (24.0% in males, 36.3% in females). The binary logistic regression revealed that students at risk to have ED were water-pipe smokers (OR: 1.471, p-value 0.047), especially males, while students who were less likely to have ED were males (OR: 0.341, p-value<0.001), coffee users (OR: 0.581, p-value 0.014) and chocolate users (OR: 0.530, p-value 0.041) than nonusers. Moreover, the risk of ED increased with increasing body mass index (p-value<0.01). Clinical medical students showed the lowest prevalence (11.1%) compared to preclinical (22.5%), health sciences (23.7%), and non-medical students (20.9%) (p-value 0.059). Conclusion Our findings highlight water-pipe smoking as a significant health problem in males with ED, which may require unique treatment and prevention strategies. Moreover, coffee and chocolate consumption were associated with decreased risk of ED, only among males. The gender-gap in ED prevalence was very narrow compared to international results. These results prompt the need to focus on both genders in future studies instead of females. They also suggest the urgent need to address ED among Palestinian university students by educating students about mental health, identifying high-risk students, and offering easily accessible psychological help.

The prevalence of feeding and eating disorders symptomology in medical students: an updated systematic review, meta-analysis, and meta-regression

“…Five studies [ 68 , 71 , 72 , 82 , 90 ] utilized two screening tools to assess FEDs symptomatology. Furthermore, one study was cross-sectional at two time points [ 90 ].…”

“…Influence analysis was used to identify and eliminate outliers in our meta-analysis. Results of outliers’ analysis revealed that nine studies contributed with thirteen data points were mathematical outliers [ 65 , 66 , 71 , 72 , 78 , 81 , 82 , 87 , 90 ]. After removing all outlier studies, meta-analytic results revealed random-effects model of the prevalence of FEDs in medical students of 16.58% (95% CI 15.25–17.99%), heterogeneity Q = 72.71 (21) P < 0.0001, τ 2 = 0.03 (95% CI 0.01–0.11); τ = 0.18 (95% CI 0.12–0.33), I 2 = 71.1% (95% CI 55.6–81.2%); H = 1.86 (95% CI 1.50–2.31).…”

Metabolic Syndrome Associated with Tobacco and Caffeine Products Use Among Refugee Adolescents: Risk of Dyslipidemia

“… 65 Association between waterpipe smoking and eating disorders was also observed among Palestinians in a previous study. 66 This association could indicate that waterpipe smoking could be associated with unhealthy food behaviours for weight loss among Palestinians. Further investigation is recommended.…”

“…72 A previous local study demonstrated that chocolate consumption was associated with decreased risk of eating disorders among young Palestinians. 66 It has been found that there is a relationship between guilt feeling when eating chocolate and developing abnormal eating behaviours; the high the guilt score, the more tendency to report symptoms such as binging and vomiting. 73 This study has some limitations.…”

Potential Triggers for Risking the Development of Eating Disorders in Non-Clinical Higher-Education Students in Emerging Adulthood

“…According to our study, 19.2% of Lithuanian higher-education students during emerging adulthood were at risk for ED. The results of the similar positive pre-pandemic ED screenings (from 16% to 33%) can be observed in the student populations in Nigeria [ 56 ], Lebanon [ 57 ], Singapore [ 58 ], Spain [ 59 ], Palestine [ 60 ], Pakistan [ 61 ], Turkey [ 62 ], Bangladesh [ 63 ], Iran [ 64 , 65 ], the United Arab Emirates [ 66 ], and Egypt [ 67 ]. Meanwhile, significantly lower pre-pandemic reports of the prevalence of the ED risk among students ranging from 4.5% to 14.9% were identified in the countries such as Poland [ 68 ], Croatia [ 69 ], the United States [ 70 , 71 ], Puerto Rico [ 72 ], Brazil [ 73 ], China [ 74 , 75 ], Japan [ 76 ], South India [ 29 ], and Malaysia [ 77 ].…”