Prevalence of Eating Disorders among Students of Quest University, Nawabshah, Pakistan

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Various studies in different settings have shown the role of media exposure and its effect on eating disorders, particularly with the development of body and women dissatisfaction (Stice et al., 1994). In a place like Pakistan, especially the drive for women to adopt European culture when viewed through the media has led to unhealthy diet and exercise (Choudry et al.,1999). Limitations in our study include that we focus more on medical students in colleges from established cities. Further studies will be conducted that will look at how to disturb food in rural areas. In addition, the most important limitation is the delivery and the inconsistency, which is the result of many studies with eating disorders. This is common in almost all studies related to eating disorders.

 

Dear Readers,

 

Please find below a study that was published in journal, ‘Prevalence of Eating Disorders among Students of Quest University, Nawabshah, Pakistan. We share this study for research and information purposes only.

 

 

 

 

Prevalence of Eating Disorders among Students of Quest University,

Nawabshah, Pakistan

 

Yasir Akbar Jamali1 , Salma Farrukh Memon2 , Zulfiqar Ali Lagahri, Jamshed Warsi and Ashique Ali Arain*

 

 

1 Teaching Assistant, Institue of Microbiology, Shah Abdul Latif University, Khairpur

2 Associate Professor, Department of Physiology, LUMHS

3 Professor Physiology Department of Physiology, University of Sindh Jamshoro

4 Associate Professor, Department of Physiology, University of Sindh Jamshoro

5 Consultant Family Physician, Assistant Professor, Department of Pharmacology, Muhammad Medical College, MirpurKhas, Sindh, Pakistan

*Corresponding Author E-mal: ashiquepcmd77@yahoo.com

 

Abstract

This worked was aimed at evaluating the increased risk of engineering students with eating disorders at the University of QUEST Nawab Shah, Sindh, Pakistan, using self-administered questionnaires. If this disorder is early diagnosed, evaluated and better treatment is provided, chances of full
recovery are better. We planned to conduct a survey to identify the frequency of such disturbances among engineering students and address
various strategies. A cross-sectional, descriptive study was conducted among 427 QUEST University engineering students. Data were collected
using two renowned self-administered questionnaires on eating disorders. One is SCOFF and the other is Eating Attitude Test (EAT) – 26
Questionnaire. Body Mass Index (BMI) of subjects was also measured. The data was sorted and analyzed in SPSS version 16. According to the Eating Attitude Test (EAT-26), 35.9% of participants were found to be at the high- risk of Eds. According to the SCOFF, 48.9% of participants were found to beat the high-risk of Eds. Eds risk more detected in female participants than nmale participants. Risk of Eds also present in Participants with normal BMI.

 

Our findings highlight the prevalence of eating disorder very high in engineering students. It is concluded that a significant number of students,
particularly women and underage persons, are more likely to develop eating disorders. It has been suggested that strategies should be advised to
prevent the occurrence of such diseases among students.

Keywords: SCOFF, EAT-26, Anxiety Nervosa, Teen Age, Binge Eating

 

INTRODUCTION

Eating disorders (Eds) are a chronic mental health problem associated with serious consequences and a very high mortality among mental illnesses(Field AE et al.,2012; Hudson JI et al., 2007). Two major types of Eds are Anorexia nervosa (AN) and Bulimia nervosa (BN) both Eds mostly noticeable in teens (Van Son GE et al., 2006).A life-threatening type of ED is AN regarded as the deep worry to become obese, amenorrhea and irregular body shape (Lucas AR et al.,1991;Von Ranson KM et al.,2002). AN frequently starts during the teenage years (14.5 – 18 years bimodal distribution) (Halmi KA et al.,1979). During these years major changing occur in teenagers such as psychological and physical growth (Mehler PS et al., 2001). BN another type of ED related with serious illness recognize by the recurrent episodes of Binge eating (BED) and person use the laxatives pills
and self-induced vomiting for reducing the effects of BED which may cause of becoming obese (Hudson JI et al., 2007). BED is a disorder people characterized by uncontrollable eating, during binges eat a huge quantity of food. The specific reason for Eds is mys- terious (Shaikh et al., 2014). In Karachi, 21.7% of female reported with the prevalence of AN these female students were enrolled in nursing and medical programs (9Israr SM et al., 2002). The prevalence of Eds were reported among female school and college is 64.3% of students (Shaikh Maet al.,2014) and 68.8% female students of the university have possible Eds and required for treatment (Shaikh et al., 2012). There is no previous study conducted on the prevalence of Eds among engineering students of engineering universities. This study was conducted to find out the prevalence of Eds among Engineering students of Quaid-e-Awam University of Engineering, Science and Technology (QUEST), Nawabshah, Pakistan.

 

METHODOLOGY

Study setting and Participants This was a descriptive cross sectional study, carried out in the Quaid-e-Awam University of Engineering, Science
and Technology, Nawabshah, Pakistan.Approache the students during lectures at the campus and requested for their voluntary participation. Undergraduate engineering students of first to final semester were included in the study. Age of the students was range from 18 to 25
years. Engineering students who have any disorder were excluded from the study. Procedure and Measures For this study, we combined the SCOFF questionnaire (Morgan JF et al.,1999) and the EAT-26 (Garner DM et al.,1982), along with demographic and body mass index (BMI) questions, which comprised a 2-pages, 31- questions survey. Our both questionnaires SCOFF and EAT-26 fulfill the diagnostic criteria of Diagnostic and
Statistical Manual of Mental Disorders, fifth Edition, 2013 for the AN, BED and BN disorders. Demographic information included age, sex, height (in meters), and weight (in kilograms). A valid and self-administered questionnaire is used for the detection of Eds named The Eating Attitude Test-26 (EAT-26). It consists of 26 questions for which scoring was done on a 6-point liker scale from always to never. EAT-26have 2rrange of 0-78
which is the total sum of 26 questions score.It consists of 26 questions in which scores are scored on a 6-point scale from never to always. EAT-26 has a range of 0-78 which is a total of 26 questions). A person who gets more than 20 scores should contact with a health professional
for the assessment of a possible Eds, according to methodology (Garner DM et al., 1982). SCOFF Question- naire is also a self-administered questionnaire that is used to determine Eds. The answer is ‘No’ to every question, the test shows no food problem. The answer is “Yes” to 2 questions, the test shows that it is Jamali et al. 081 more likely than Anorexia Nervosa or Bulimia Nervosa.

While the answer is the subject of the question ‘Yes’ to 1, and the other is ‘No’, the test indicates that it has no eating disorders (Morgan JF et al.,1999). Body Mass Index (BMI: bodyweight {kg} / height {m2 }) as a useful indicator for measuring body weight as a measure of belly fat accumulation, that is, an indicator of central obesity (WHO., 2000). BMI references range below 18.5, 18.5-24.9, 25.0-29.9, and 30.0 or higher. The NHLBI labels these as lowly, normal weight, obesity and obesity (Adams KF et al., 2006).

Statistical Analysis Data were entered and analyzed using the Statistical Package for the Social Sciences (SPSS) version 16. Correct frequency and percentages were calculated by variance of fit while means that the standard deviation is calculated by variance of the quantity. P values were also
obtained by the Pearson Chi Square Test to determine the significance of the results.

RESULTS

The total number of participants were 427, returned 95.3% N=407. All participants were completed EAT-26 and SCOFF Questionnaire.The population of female participants was 36.9% (N=150) with mean age of 19.9+1.3years, BMI 19.1+2.9 and the population of male participants was 63.1% (N=257) with mean age of 21.1+1.4, BMI 22.4+4.6 (kg/m2), SCOFF score was 1.7+1.3 in males and 1.7+1.6 in females while the EAT- 26 score was 16.4+8.8 and 17.6+11.2 in males and females respectively. Mean population age was 20.7(1.5) years and BMI was 21.2+4.4 (kg/m2), Mean SCOFF and EAT-26 were 1.44+1.1(5) and 16.9+9.7(65) respectively. EAT-26 Findings According to EAT-26 findings, 35.9% participants were found to be at the high-risk of EDs.

Male participants 35.0% were at the lower rate of risk of EDs as compared to female participants 37.3% at risk of EDs. The age group of 18-21 years was found more affected, 52.4% participants than the age group of 22-25, 41.7% participants (Table 3). BMI results of EAT-26 showed that 30.6% participants belong to normal BMI while these participants also found with risk of EDs. 56.8% subjects were worried for thinness, 36.3% were scared of obese, and 37.7% were involved in dieting behavior. Although, 63.7% were showed control on eating food and nearly 15.1% vomiting after a meal (Table 3). The response of all questions of positive and negative participants for EAT-26 were represented in Table 2. Demographic 082 Merit Res. J. Med. Med. Sci.

Table 1. EAT-26 results in relation to Gender, Age group and BMI ratios Variables Positive (n=146) Negative (n=261) Total 407 P – value
Gender Male 90 (35.0%) 167 (65.0%) 257 (100%) >.05
Female 56 (37.3%) 94 (62.7%) 150 (100%)

Age group
18-21 years 96 (34.9%) 179 (65.1%) 275 (100%) >.05
22-25 years 55 (41.7%) 77 (58.3%) 132 (100%)
BMI kg/m2
Underweight 41 (47.1%) 46 (52.9%) 87 (100%) <.05
Normal 75 (30.6%) 170 (69.4%) 245 (100%)
Overweight 19 (33.3%) 38 (66.7%) 57 (100%)
Obese class I 11 (61.1%) 7 (38.9%) 18 (100%)

 

Table 2. Analysis of EAT-26 Questionnaire
S.No Questions from EAT-26 Frequency of response
of 146 High-Risk
Individuals (YES/NO)

Frequency of response of 261 negative
Individuals (YES/NO)
P– value
1 Am terrified about being overweight 53/93 54/207 <.05
2 Avoid eating when I am hungry. 69/77 34/227 <.05
3 Find myself preoccupied with food. 62/84 45/216 <.05
4 Have gone on eating binges where……… 70/76 85/176 <.05
5 Cut my food into small pieces. 94/52 111/150 <.05
6 Aware of the calorie content of…………. 67/79 28/233 <.05
7 Particularly avoid food with a high……….. 57/89 49/212 <.05
8 Feel that others would prefer if……… 45/101 36/225 <.05
9 Vomit after I have eaten. 22/124 10/251 <.05
10 Feel uncomfortable after eating……. 54/92 35/226 <.05
11 Am preoccupied with a desire……….. 83/63 93/168 <.05
12 Think about burning up calories……… 100/46 87/174 <.05
13 Other people think that I am…………… 71/75 71/190 <.05
14 Am preoccupied with the thought………… 84/62 62/199 <.05
15 Take longer than others to eat my meals. 57/89 59/202 <.05
16 Avoid foods with sugar in them. 53/93 44/217 <.05
17 Eat diet foods. 85/61 76/185 <.05
18 Feel that food controls my life. 88/58 115/146 <.05
19 Display self-control around food. 93/53 106/155 <.05
20 Feel that others pressure me to eat. 71/75 56/205 <.05
21 Give too much time and thought……… 74/72 44/217 <.05
22 Feel uncomfortable after eating………. 53/93 38/224 <.05
23 Engage in dieting behavior. 55/91 27/234 <.05
24 Like my stomach to be empty. 37/109 29/232 <.05
25 Have the impulse to vomit after meals. 24/122 11/250 <.05
26 Enjoy trying new rich foods. 44/102 53/208 <.05

 

Table 3. SCOFF Results in Relation to gender, Age group, and BMI Ratio
Variables Positives (N=199) Negative (N=208) Total (N=407) P – value
Gender
Male 124 (48.2%) 133 (51.8%) 257 (100%) >.05
Female 75 (50.0%) 75 (50.0%) 150 (100%)
Age group
18-21 years 144 (52.4%) 131 (47.6%) 275 (100%) <.05
22-25 years 55 (41.7%) 77 (58.3%) 132 (100%)
BMI kg/m2
Underweight 33 (37.9%) 54 (62.1%) 87 (100%) <.05
Normal 122 (49.8%) 123 (50.2%) 245 (100%)
Overweight 28 (49.1%) 29 (50.9%) 57 (100%)
Obese class I 16 (88.9%) 2 (11.1%) 18 (100%)

Jamali et al. 083

Table 4. Analysis of SCOFF Questionnaire
Questions from Bulimia and Anorexia of SCOFF

Frequency of response of positive 199 Individuals
(YES/NO)

Frequency of response of Negative 208 Individuals
(YES/N0)

P – values
Do you make ………. 95/104 22/186 <.05
Do you worry………. 75/124 14/194 <.05
Have you recentl……… 66/133 26/182 <.05
Do you believe………. 114/85 23/185 <.05
Would you say……….. 121/78 31/177 <.05

characteristics of EAT-26 positive and EAT-26 negative participants shows in Table-1. Most affected participants was 37.9% with high-risk of EDs belonged to the age group of 22-25 years than the age group of 18-21 participants, 34.9%. High-risk EDs participants were more present in obese class I 61.1% as compared to normal 30.6%, underweight 47.1% and overweight 33.3%

Table-1. The response rate of the subjects was statistically significant (P<.05) SCOFF findings According to SCOFF, 48.9% of participants were found to be at the high-risk of EDs. A greater number of 50% female participants were at risk of EDs than male participants 48.2% (Table 5). 52.4% participants of age group 18-21 were more at the risk of EDs than 41.7% participants of age group 22-25 years participants (Table 3). Participants 49.8% with normal BMI were also at the risk of EDs (Table 3). Demographic information of SCOFF positive and SCOFF negative participants showed in Table 3. An analysis of the SCOFF questionnaire shows that 47.7% of high-risk EDs participants gave an answer that they had vomited or felt ill from being dissatisfied, 37.7% gave an answer that they were worried about how much they were eating, 33.2% gave answers that they should have lost 6.5 kg in 3 months and 57.3% responded by saying that some mean your little one, while someone thinks of obesity.The difference was statistically significant (p<0.05) Table-4.

DISCUSSION

Previous study reported prevalence rate of 23.33% in EAT-26 and 10% in SCOFF in Business School of Karachi among students of MBA program and an other study showed 22.7% of students scored above 20 for Eating Attitude test-26 and 17% of students reported a score above 1 for SCOFF. The later study also reported that 65.6% of students were at risk of EDs for these groups of students from 18-21. Although 34.3% of students received EDs ranging in age from 22-23 years for medical students and the BMI values, 29.6% obese, 18.2% obese, and 15.6% lower still suffering from an eating disorder as diagnosed by EAT-26 while according to SCOFF, 23.5% is normal, 21.2% and 12.2% of low-risk individuals were suffering from EDs that was not consistent with our results (Mahmood et al., 2014; Memon et al., 2012). Previous studies also reported that 25.4% of women in EAT-26 and 16.9% of women in SCOFF were at higher risk of eating disorders than men that is also inconsistent with our results (Mahmood et al., 2014; Memon et al., 2012). Another study showed that a larger proportion of women (1.0% -4.0%) with AN and 6.8% to 18.6% with BN) suffered from ED than male
subjects (Pope Jr HG et al.,1984). Other studies have shown that 49% of women get binge eating disorder and 4% of women get BN, these results indicate a higher risk of EDs(Sample C et al.,1984). As can be seen in our research with universities located in urban centers, women in such a situation are more likely to develop effective media, especially EDs. Various studies in different settings have shown the role of media exposure and its effect on eating disorders, particularly with the development of body and women dissatisfaction (Stice et al., 1994). In a place like Pakistan, especially the drive for women to adopt European culture when viewed through the media has led to unhealthy diet and exercise (Choudry et al.,1999). Limitations in our study include that we focus more on medical students in colleges from established cities. Further studies will be conducted that will look at how to disturb food in rural areas. In addition, the most important limitation is the delivery and the inconsistency, which is the result of many studies with eating disorders. This is common in almost all studies related to eating disorders.

CONCLUSION

Our findings highlight the increased incidence of eating disorders in engineering studies. It has been concluded that a large number of students, especially women and under age, may have eating disorders. It has been suggested that strategies should be developed to prevent the spread of EDs.

ACKNOWLEDGMENT

This research carried out with the support of Quaid-e- Awam University of Engineering Nawbshah and Universiy of Sindh Jamshoro. This research did not receive any grant from any funding agencies.

084 Merit Res. J. Med. Med. Sci.

Conflict of Interest:

 

There is no any conflict of intrest.

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Islam and Eating Disorders founded in 2012 – run by Maha Khan, the blog creates awareness of Eating Disorders in the Muslim world, offers information and support for sufferers and their loved ones.

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