Purpose: Age, gender and body mass index (BMI) are commonly described risk factors for the development of eating disorders. However, the magnitude of these factors (individually and together) is still not well-defined in some populations.
Methods: A systematic search was performed for studies that reported the prevalence of eating disorder risk among medical students using the Eating Attitudes Test-26 (EAT-26) and age, gender and BMI as risk factors. We included studies published in English peer-reviewed journals between 1982 and 2017. A total of 14 studies were included in the analyses, and the meta-regression analyses were performed using mean age (years), gender (proportion of female subjects), and mean BMI (kg/m2) as moderators with the risk of eating disorders measured using EAT-26 as an outcome variable. Four interaction terms were created (1) age × gender (2) age × BMI (3) gender × BMI and (4) age × gender × BMI to assess if two or more independent variables simultaneously influence the outcome variable.
Results: Utilizing the EAT-26, the pooled prevalence of at risk for eating disorders among medical students (k = 14, N = 3520) was 10.5% (95% CI 7.3-13.7%). Meta-regression model of age, gender and BMI alone revealed poor predictive capabilities. Meta-regression model of age × gender × BMI interaction revealed statistically significant results with a covariate coefficient of 0.001 and p value of 0.044.
Conclusion: Results from this sample of medical students provided evidence for the role of interactions between risk factors (e.g., age × gender × BMI) in predicting individuals at risk for eating disorders, whereas these variables individually failed to predict eating disorders.
Level of evidence: Level I, systematic review and meta-analysis.
Keywords: Eating disorders; High risk; Meta-regression; Risk factors; University students.