Association between risk of eating disorders and an unhealthy lifestyle score in university students: uniHcos project

Abstract

Introduction The first year of university is a critical period for the consolidation of lifestyle habits and has been associated with an increased risk of developing eating disorders (EDs). This study aimed to assess the prevalence of ED risk among first-year Spanish university students and to develop a composite score based on ten unhealthy lifestyle habits to explore its potential association with ED risk. Methods A serial cross-sectional study was conducted using data from 11,500 university students. ED risk was assessed with the SCOFF questionnaire. An Unhealthy Habit Score (UHS) was created by summing ten lifestyle factors. Descriptive, bivariate and multivariate analyses were performed stratified by sex. Associations between ED risk and lifestyle factors were examined using logistic regression models. Results The overall prevalence of ED risk was 21.4%, significantly higher in women (24.8%) than in men (12.3%). The UHS ranged from 0 to 9 with a median of 3 and no significant sex differences. Most lifestyle factors showed significant associations with ED risk. A strong relationship was found between the UHS and ED risk, with each additional point in the UHS increasing the odds of ED risk by 31% in men (OR = 1.31) and 23% in women (OR = 1.23). Conclusions The risk of EDs was high among first-year university students, particularly among women, and was associated with multiple unhealthy lifestyle habits. The UHS developed in this study could serve as a valuable tool for predicting ED risk, especially in contexts where only general lifestyle information is available.