Prevalence and Correlates of Classical and Non-Classical Eating Disorders during COVID-19 Lockdown

Abstract

Introduction: Eating Disorders (EDs) are mental illnesses that affect all individuals worldwide, causing severe complications. EDs can be divided into classical (Anorexia Nervosa, Bulimia Nervosa, and Binge-Eating Disorder), and non-classical (Pica, Avoidant/Restrictive Food Intake Disorder, and Night Eating Syndrome). Several risk factors might lead to their development, in particular, stressful life events. The current COVID-19 pandemic is imposing psychological distress, mainly on individuals with existing mental health issues. To our knowledge, no studies have assessed the prevalence of classical and non-classical EDs and their correlates in Lebanon during the COVID-19 lockdown. Objectives: Assess the prevalence and correlates of classical and non-classical EDs among students from different Lebanese universities during the COVID-19 lockdown. Methods: This cross-sectional study included 458 students recruited in 2020 and 2021 from several Lebanese universities, and used a self-administered 6 section survey. The Statistical Package for Social Science (SPSS) version 23 for widows was used for data entry and analysis. p<0.05 was considered to be statistically significant. Results: Among 458 students the prevalence for Classical Eating Disorders was 5.2% and 6.8% Non-Classical Eating Disorders. Sick-Control-One Stone-Fat-Full (SCOFF) questionnaire was positive in 36.9% of participants. Significant associations were observed between Classical EDs and Body Mass Index (BMI), diet habits, anxiety, and changed eating habits during quarantine; between Non-Classical EDs and BMI, previous personal and familial diagnosis of ED or mental health disorder, and changed habits during quarantine. SCOFF was significantly associated with gender, BMI, previous diagnosis of ED or mental health illness, having medicinal disturbances, dietary habits and changed habits due to quarantine. Logistic regression showed higher risk of developing Classical EDs when underweight or overweight, as well as gaining weight due to quarantine. Participants were at higher risk of Non-classical EDs development if overweight, partaking in non-medicinal drugs, and increased sleep due to quarantine. Lower risks were observed among underweight participants for SCOFF positivity, but increased risks were observed among females, as a result of increased food intake during quarantine, and weight changes during quarantine. Conclusion: This study provides an insight to the current prevalence of classical and non-classical EDs among the university student population in Lebanon and their relevant risk factors during quarantine altered behavior times.