Prevalence and associated factors of eating disorders’ risk among Alexandria University medical students

Abstract Background Eating disorders (EDs) are a group of mental health conditions involving aberrant eating behaviors and psychiatric symptoms, substantially affecting quality of life, physical and psychosocial functioning, particularly among medical students due to academic stress, transitional life phases, and lifestyle factors. Despite growing global awareness, EDs remain underdiagnosed in Arab regions. Methods A cross-sectional study was conducted among 372 medical students during the academic year 2024–2025, using stratified random sampling. Data were collected via a self-administered questionnaire assessing sociodemographic, behavioral factors, medical, and family history of EDs, as well as the Eating Attitudes Test (EAT-26), and the Depression, Anxiety, and Stress Scale (DASS-21). Results The prevalence of EDs’ risk was 21.8%, with most encountered disordered eating behaviors being excessive exercise (37.4%), followed by binge eating (14.8%), intentional vomiting (6.2%), and lastly laxatives or diuretics use (5.6%). Additionally, 70.7% of the students screened positively for depression, while 66.4% for anxiety, and 56.5% for stress. Independent predictors of EDs’ risk included female gender, clinical academic year, living alone, smoking, prior weight loss attempts, family history of underweight or malnutrition, and higher levels of depression and stress. Other factors, such as family income, obesity, and anxiety, were associated with EDs in univariate but not multivariate analyses. Conversely, Age, marital status, physical activity, and unsupervised psychiatric drug use showed no significant association. Conclusion A substantial proportion of medical students exhibit risk of EDs and psychological distress. Targeted screening, mental health support, and integration of nutrition and stress management into the curriculum are essential to mitigate EDs’ risk in this vulnerable group.