1. No category

1
Applied Psychology, November 2014
Applied Psychology
Citation this paper:
Akram B., Javed M.(2014). Eating Disorders among University Students: Prevalence and Gender
Difference. Applied Psychology, 10, 1-7.
The online version of this article can be found at:
http://www.jourpsyc.com/majaleh/1001.pdf
Additional services and information for Applied Psychology can be found at:
http://www.jourpsyc.com
Email: [email protected]
ABSTRACTED/ INDEXED IN:
COPERNICUS, INDEX COPERNICUS IRAN, Directory Of Research Journal Indexing
(DRJI),J-Gate, EBSCO, SCIRUS, Eyesourse,Electronic Journals Library (EZB), SSRN eLibrary,
Global Impact Factor (GIF), Google Scholar, Research Bible, NewJour, Magiran, Sjournals, Iran
Journal.
Eating Disorders among University Students: Prevalence and Gender Difference
Applied Psychology
Vol. 2(10), pp. 1-7, November 2014
http:// www. Jourpsyc.com
Eating Disorders among University Students: Prevalence and Gender Difference
Bushra Akram
Head Department of Psychology, University of Gujrat
[email protected]
Maryam Javed
M.Phil Scholar, Department of Psychology, University of Gujrat
Received: 7 Sep, 2014
Accepted: 18 Oct, 2014
Abstract
Objective: This exploratory study was aimed to explore the point prevalence
of eating disorders among university students. Method: Two Likert type scales
were developed on the basis of the criteria of anorexia nervosa and bulimia
nervosa mentioned in DSM IV. These scales were reached acceptable levels of
reliability and validity. For field study N=241 participants were selected
through simple random sampling. Results: Results showed that majority of
students have moderate level of symptoms of eating disorders. There was no
significant difference on the basis of gender. Conclusion: It is concluded to
take steps to make aware the students about the effects of eating disorder on
their health and academic career.
Key Words: Prevalence, Anorexia Nervosa, Bulimia Nervosa, Gender
Difference
2
3
Applied Psychology, November 2014
Introduction
The present research was conducted to explore the point prevalence of eating disorders among
university students. Many researchers were focusing on eating disorders from many decades and
find that the rate of eating disorders increased from last three decades. They have explored the
nature, causes and factors of eating disorders. There are two main types of eating disorders
differing in their basic symptoms, course, age of onset and biological, social and psychological
effects. These types are anorexia nervosa and bulimia nervosa.
People with anorexia nervosa have intense fears of becoming overweight. They refuses to
maintain more than 85% of normal body weight. They have unrealistic and distorted view of
weight and shape. Usually females stop menstruating (Amenorrhea) and become infertile. They
have intense fear of becoming fat therefore do not take sufficient food. thus lose weight. Their
diet do not show any variety. A specific proportion of the patients with anorexia may also
develop the symptoms of bulimia
The persons suffering from bulimia consume large amount of food (binge) and then purge or
vomit in order to avoid weight gain. These vomits are self induced. They force themselves to
vomit after having food or by using laxatives or diuretics. However they are usually close to
their normal body weight.
Majority of the theorists and researchers documented following factors contributing in eating
disorders.
Psychological Factors: Following factors are known as psychological factors:
1. Ego deficiencies: poor mother-child communication leads to ego-deficiencies (including
a poor sense of independence and control) and to severe perceptual
disturbances that jointly help to produce eating disorders.
2. Cognitive factors: as a result of ineffective parenting, victims improperly label their
internal sensations and needs. Generally feel little control over their body shape, size and
eating habits. This leads towards broad cognitive distortions that are at the center of
eating disorders.
3. Mood disorders: A mood disorder sets the stage for eating disorders.
Biological Factors: Biological theorist claims that certain genes may leave some persons
susceptible for eating disorders. Consistent with this idea, relatives of people with anorexia
nervosa has six time greater tendency to develop this disorder. Moreover, if one identical twin
has anorexia nervosa or bulimia nervosa, there are 70% and 23%chances for the other
respectively. The rate for fraternal twins is 20% for anorexia and 9% for bulimia nervosa.
Societal Pressure
Eating disorders is more prevalent in the western societies than in other parts of the world
because they have more critical standards of women’s attractiveness and beauty, partly
responsible for the emergence of eating disorders.
Swanson, et al (2011) conducted research on Prevalence and Correlates of Eating Disorders in
Adolescents. Results indicated that lifetime prevalence estimates of anorexia nervosa, bulimia
nervosa, and binge-eating disorder were 0.3%, 0.9%, and 1.6%, respectively. It was also
observed that majority of the participants did not receive any treatment specifically for their
eating or weight problems. On the other hand Gibbons (2004) found relationship between eating
disorders and socioeconomic status. They concluded that the findings of recent studies show that
Eating Disorders among University Students: Prevalence and Gender Difference
eating disorders are prevalent in heterogeneous population irrespective of their socioeconomic
status in contrary of past researches that showed more prevalence in the higher socioeconomic
status groups. The current studies have also demonstrated that females belong to lower socio
economic group report higher rates of mal eating behaviors such as vomiting, use of diet pills,
diuretics, or laxatives as means to lose weight. Similarly Rodríguez Martín (2004) reported no
effect of socioeconomic status on eating behaviors however family dysfunction was found to be
associated with higher scores on the measures of eating disorders.
Rohan, Paula and Shamin (2009) reviewed the literature on health risk behaviors among
adolescents. With the all other mental health risks, overweight-11%, and obese-7% people have
the eating disorders. However factors like the adolescent's family of origin, home environment
and parent-child relationships were found to play significant role. Angela Favaro (2003)
conducted research on the prevalence of spectrum of eating disorders among general population.
Data was collected from 934 females from urban and sub urban areas, age range from 18-25
through interviews. Results indicated the prevalence of anorexia nervosa, bulimia nervosa,
lifetime atypical eating disorders and that of binge eating disorder was 4.7%, 2.0%, 4.6% and
0.6% respectively. Social class, occupation, and education were not associated with eating
disorders, whereas the number of hypo caloric diets, having been a victim of childhood abuse,
and being overweight were associated factors.
The present study has been conducted in the University of Gujrat where no systematic or
scientific study has been conducted so far. This study would be a good source of preliminary
information for the future researchers who want to conduct some therapeutic outcome studies for
targeted psychiatric problems. The academic lives of the students is becoming stressful due to
competition and challenges at the study as well as work places which may lead towards different
health and psychological problems and eating disorder is one of them. This study will indicate
the point prevalence of eating disorders in the students and will alert the relevant professionals to
work for the prevention and treatment of the eating problems among students.
The objectives of the study were to find:
1.
The point prevalence of eating disorders (anorexia nervosa, bulimia nervosa) among
university students.
2.
Demographic correlates of eating disorders. Demographic variables are gender,
residential areas (rural, urban) and socio-economic status. But the responses showed that
the participants only respond on gender. Majority of them did not mention their
residential areas and socio economic status.
On the basis of above mentioned objectives following questions are formulated:
Q-1. What is the point prevalence of eating disorders anorexia nervosa, bulimia nervosa) among
university students (age range17-23) in university of Gujrat?
Q-2 Is there any difference in eating disorders of the students on the basis of their gender?
Method
Survey research method was used for the data collection
Sample & Sampling technique
Probability sampling technique was used because of the availability of sampling frame. Total
241 young students were selected through simple random sampling technique.
Instrument of the study
4
5
Applied Psychology, November 2014
Two self-made questionnaires were used to find the point prevalence of anorexia nervosa and
bulimia nervosa among university students. There were 47 items in the anorexia nervosa scale
and 53 in the bulimia nervosa scale. Responses were recorded on a 5 point Likert scale on the
basis of DSM-1V criteria.
Procedure of developing the instrument
Considering the purpose of the present study two scales of eating disorders were developed and
validated. The items of both of the scales were generated through following three steps:
1. The review of local and foreign literature was thoroughly done to study the
phenomenology of eating.
2. Further DSM IV criterion of eating disorders (anorexia nervosa and bulimia nervosa) was
thoroughly studied for understanding and used to generate the pool of items.
3. Many case reports of eating disorders were studied to know the intensity and frequency
of the symptoms of eating disorders.
Following these three steps, 115 items for anorexia nervosa and 110 items for bulimia
nervosa were generated. These items were validated (face and content validity) by nine clinical
psychologists. After this, some items were excluded while some were rephrased for the clear
understanding of students as suggested by the experts. The left 89 items for anorexia nervosa and
82 items for bulimia nervosa were listed together for initial administration. In pilot study, the
data was collected from 193 participants recruited through simple random sampling technique.
Signed informed consent was taken from the participants and they were assured about the
confidentiality. Rapport was established with the students and the rationale of the study
explained to them. The questionnaires were self administered, so the instructions were given to
the adolescents about the filling of the questionnaire and response categories. After collecting the
data, in order to retain the most appropriate items, data was entered in the SPSS and factor
analysis was run with initial Eigen value 1.Verimax rotation was performed. On anorexia
nervosa scale 47 items were loaded on five factors with 0.3 and above value whereas 53 items
for bulimia nervosa loaded on five dimensions (Table 1). On both scales these five factors were
named as: F-1 Signs and Symptoms; F2. Food Preoccupation, F3.Body Weight and Shape
Perception,F-4.Social Functioning andF-5.Medical Problems.
Internal consistency of the scales was also computed, which was .795 for bulimia nervosa scale
and .790 for anorexia nervosa scale, it showed that both the scales had high internal consistency.
For field study, a sample of 241 university students was selected using simple random sampling.
Again Signed informed consent was taken from the participants and they were assured about the
confidentiality of the responses they provided. Rapport was established with the students and the
rationale of the study explained to them. The questionnaires were self administered, so the
instructions were given to the adolescents about the filling of the questionnaire and response
categories.
Results
The data was analyzed on SPSS V. 16. The frequency program was run to find the point
prevalence of anorexia nervosa and bulimia nervosa among university students. Respondents
were divided in three groups based on their severity level of the symptoms. The obtained scores
were placed in the ranges of three severity levels that are given in table 2.
6
Eating Disorders among University Students: Prevalence and Gender Difference
Table 2- Ranges of three severity levels of Anorexia Nervosa & Bulimia Nervosa
Ranges of Anorexia Nervosa
Ranges of Bulimia Nervosa
43- 109
53-123
110- 172
124 -194
173-235
195-265
Severity level
Mild
Moderate
Severe
Table 3- Frequencies and percentages of prevalence of anorexia & bulimia nervosa
Anorexia Nervosa
Bulimia Nervosa
Frequency
%age
Frequency
%age
Mild
03
2.5
0
0
Moderate
92
79.0
109
89.3
Severe
22
18.5
13
10.7
Total
117
100.0
122
100.0
Table 3 reveals that 2.5% students have low level of symptoms, 79.0% students have moderate
level of symptoms whereas 18.5% students have severe level of symptoms of anorexia nervosa.
Table 3 also shows that 89.3% students have moderate level whereas 10.7% students have severe
level of symptoms of bulimia nervosa. The results shows that majority of the students of
university of Gujrat have the tendency to develop the eating disorders at moderate level.
Table 4- Mean comparison of prevalence of anorexia and bulimia
Types of Eating Disorders
Gender
N
M
Anorexia Nervosa
Male
49
1.61
Female
70
1.60
Bulimia Nervosa
Male
41
1.76
Female
81
1.77
nervosa on the basis of gender
SD
T
P
15.27
-.631
.530
14.76
16.31
-.461
.645
16.21
Conclusion
The present study was conducted to find the point prevalence of eating disorders i.e. anorexia
nervosa and bulimia nervosa. It is indicated by the results that the majority of students showed
moderate levels of symptoms of bulimia nervosa (89.3%) and (79.0%) from anorexia nervosa
have moderate levels of symptoms. It shows that to some extent the university students have the
tendency to develop eating disorders. The results are consistent with the findings of study
conducted by Taylor et al (2007) who reported binge eating as most prevalent eating disorder
among adult and adolescents. It is because of many factors such as family and peer pressures, as
many families have excessive concerns about the weight gain, prevalence of psychological
problems like depression and anxiety that may lead to eating problems. Furthermore the and On
the other hand group norms as many behaviors are to confirm the group pressure.
The findings of the study showed no difference in the level of eating disorders with respect of
gender. However the results are not in align with the study conducted by Striegel-Moore, et.al
(2009). They obtained the responses of 3,714 women and 1,808 men. The findings showed
significant difference on the basis of gender. Male reported the symptoms of overeating while
female showed body checking and avoidance, binge eating, fasting, and vomiting. But the
results are consistent with the findings of Taylor et al (2007) who reported no significant gender
7
Applied Psychology, November 2014
difference among adolescents. The possible reason might be the cultural variations. In Pakistan
there is a tendency to eat food containing fat and rich in protein whereas the media is promoting
thin culture. The youth is in the state of conflict. Their family pressurized them to eat more at
homes while in university among peers they try to be thin. Thus they may have the symptoms of
binge-purge. herefore there is a dire need to create awareness among them about a balanced and
healthy food. It is a common idea that women are weight conscious and they strive to become
thin however a few studies found that both females and males show concern about their bodies
but in different aspects. Cash, Winstead, & Janda, (1986) concluded that males felt good about
their bodies if they were fit and exercised regularly on the other hand females showed more
weight conscious and they were more concerned with aspects of their appearance. Further the
main focus of the study was not to explore gender difference but to investigated the difference
of prevalence of eating disorders among university students. The results showed that eating
problems are equally prevailed across gender however the difference might be observed if this
study would have focused the patterns or aspects of eating problems.
References
American Psychological Association.(2000). Diagnostic and statistical manual of mental
disorders (4th ed.). USA: American Psychological Association.
Angela Favaro, S. F. (2003). The Spectrum of Eating Disorders in Young Women: A
Prevalence Study in a General Population Sample. Journal of psychosomatic
medicine , 701-708. vol. 65 no. 4 1.doi: 10.1097/01.PSY.0000073871.67679.
Cash T. F, Winstead , B. A.,& Janda, L. H. (1986) “The Great American Shape-Up” in
Psychology Today, April 30-37.
Gibbons, P. (2004). The Relationship between Eating Disorders and Socioeconomic
Status.Nutrition Noteworthy, 1-6. Retrieved from escholarship.org/uc/item/1k70k3fd.pdf/
Mandal, A. (2014). What is an eating disorder? Retrieved from
http://www.news-medical.net/health/What-is-an-Eating-Disorder.aspx/4/1/14
Rohan G. M, Paula & Shamin (2009). Health risk behaviours among adolescents in the
English-Speaking.Child and Adolescent Psychiatry and Mental Health, 1-12.
Retrieved from www.camph.com/content/3/1/10
Rodríguez Martín, J. P. (2004) Epidemiological study of the influence of family and
socioeconomicstatus in disorders of eating behaviour. European Journal of Clinical Nutrition ,
846–852, 58. doi:10.1038/sj.ejcn.1601884. Retrieved fromE:\socio economic. htm
Striegel-Moore, R. H., Rosselli, F., Perrin, N., DeBar, L. Wilson, G, May, A & Kraemer, H. C
(2009) Gender difference in the prevalence of eating disorders: International Journal of
Eating Disorders: 42 (5) 471-474. Doi:10.1002/eat.20625
Swanson, Sonja A., Crow, Scott J., Le Grange, Daniel, Swendsen, Joel, Merikangas,
Kathleen R. (2011). Prevalence and correlates of eating disorders in adolescents:
Results from the National Comorbidity Survey Replication Adolescent
Supplement. Archives of General Psychiatry. 68, (7), 714-723.
Taylor, J. Y., Caldwell, C.H, Baser, R. E., Faison, N.& Jackson, J. S. (2007) Prevalence of
eating disorders among blacks in the National Survey of American Life: International
Journal of Eating Disorders. (40) Doi 10.1002/eat.20451