The Hidden Picture: Unhealthy Eating Attitudes And Behaviors In A Non-Clinical Population From Bulgaria

INTRODUCTION: Eating disorders have been intensively researched over recent decades. However, there has been insufficient research into the early assessments for detecting the risk of developing disordered eating. We report preliminary results from a project aiming to assess the prevalence of eating attitudes and behaviors that heighten the risk of eating disorders. The study examines a non-clinical sample of adolescents and adults from two cities of South Bulgaria.METHODS: In this cross-sectional epidemiological study, a total of 1285 volunteers of 828 females and 453 males, aged 14 to 59 years, were surveyed to assess disordered eating attitudes and behaviors. For this purpose, the study used the ‘SCOFF’ questionnaire, the Eating Disorder Diagnostic Scale (EDDS), and the Eating Attitudes and Behaviors Questionnaire (EABQ), which was developed for this study.RESULTS: The proportion of these volunteers underweight (body mass index below 17.5) was 9.8%. Of the total subject, 34.7% provided two or more positive answers for the SCOFF questionnaire (two being the upper threshold for indicating 100% sensitivity to anorexia and bulimia). The results differed between males and females: 21.6% and 42.1%, respectively, in this regard. A factor analysis (oblimin rotation) of EABQ items revealed four main factors: body shape and weight concerns, personal control over eating and calorie intake, dieting, and preoccupation with food and binge eating. A Spearman’s correlation analysis showed moderately significant correlations (p < 0.001) between the total scores of the SCOFF questionnaire, EABQ, and the scores for three groups of items in the EDDS for assessing eating attitudes and behaviors.CONCLUSION: We found a greater ED risk in adolescents compared with the older groups and in females compared with males. One fifth of males studied were at high risk of ED and ages between 19 and 39 years also appeared at risk. The EABQ was validated as a sensitive and reliable self-report instrument that can be used for early detection for the risk of ED. Our results could form a basis for developing programs in disordered eating prevention.