Risk factors and psychosocial correlates of feeding and eating disorders among Sicilian healthcare students: a cross-sectional study

Background Feeding and eating disorders (FED) are increasingly common among university students, particularly in healthcare settings characterized by high stress and performance demands. However, data on Southern Italian student populations remain limited. This study aimed to assess the prevalence of disordered eating behaviors, associated psychological factors, and preferred support strategies among Sicilian healthcare students. Methods A cross-sectional web-based survey was conducted between 2022 and 2024 across multiple Sicilian universities. The questionnaire included sociodemographic data, the Eating Attitudes Test-26 (EAT-26), the Depression Anxiety Stress Scales (DASS-21), and behavioral items assessing overeating, purging behaviors, and suicidal ideation. Multivariable linear regression analyses were performed to identify factors associated with EAT-26 scores. Results A total of 3,278 students participated. Although most had a normal BMI, substantial body dissatisfaction and unhealthy weight-control behaviors were reported. Overall, 14.2% screened positive for FED risk, while 38.7% met criteria for potential specialist referral. Higher EAT-26 scores were associated with vomiting, psychological distress, weight fluctuation, laxative use, body dissatisfaction, overeating episodes, female sex, younger age, and suicidal ideation (R² = 0.32). Different symptom patterns were also linked to distinct support preferences, with loss-of-control eating associated with greater demand for structured and digital support. Conclusions Sicilian healthcare students show a substantial and multifaceted mental health burden related to disordered eating, not captured by BMI alone. To effectively reach individuals with diverse needs, psychological support, mentoring, shared wellness spaces, and digital tools may be considered as components of a stepped, stigma-sensitive support pathway.