Prevalence, influencing factors, and perspectives on bulimia, anorexia, and binge eating among university students in northern Morocco: A cross-sectional study

Introduction: Eating disorders (EDs) represent a significant mental health challenge globally, particularly among young adults, including university students. This study investigates the prevalence of ED and associated factors among Moroccan university students to inform targeted interventions and support mechanisms within the university environment. Methods: Using a cross-sectional design, including students from eight institutions affiliated with Abdelmalek Essaadi University in Tangier, Morocco, were randomly selected through stratified sampling. A questionnaire comprising sections on demographics, childhood history, and the Mini-International Neuropsychiatric Interview (MINI) was employed. The MINI included subscales for anorexia nervosa, bulimia nervosa, and binge ED. Results: Study included 1168 predominantly female students (59.1%) with a mean age of 20 years. The estimated prevalence of probable ED cases was 2.1% (95% confidence interval [CI]: 1.3–3), with bulimia showing the highest prevalence at 1.9% (95% CI: 1.2–2.8), followed by anorexia and binge eating at 0.3% each. Factors significantly associated with ED included medical history, treatment for anxiety/depression/addiction, sleep medication use, judicial history, psychological violence, sexual violence, and negative events during childhood/adolescence. Coexistence with mood, anxiety, and psychotic disorders was also noted. Multivariate analysis showed strong association between undergoing treatment for anxiety, depression, and/or addiction ( P < 0.003), judicial history ( P < 0.001), and sexual violence (<0.001). Conclusion: Our findings highlight a concerning rise in ED prevalence among Moroccan university students, influenced by complex interactions with psychiatric vulnerabilities, prior judicial involvement, and experiences of childhood sexual abuse. This underscores the need for personalized treatment strategies, with a focus on students and institutions that play a key role in promoting health initiatives during this pivotal period of life.