Risk of Eating Disorders and Associated Factors Among Medical Students in Baghdad, Iraq: A Cross-Sectional Study Using EAT-26 and SCOFF

Background: Eating disorders are among the most serious psychiatric disorders and have the highest mortality rates. Medical students are a group highly vulnerable to mental disorders, including disordered eating, due to the chronic stress and risk of burnout associated with medical education, with the risk progressively increasing; however, little is known about eating disorders in Iraq. Objectives: This study aimed to investigate medical students at risk of developing eating disorders and their associated factors in Baghdad, Iraq. This study also aimed to identify vulnerable individuals, evaluate the influence of demographic variables, and determine the relationship between body mass index and eating disorders in this population. Subjects and methods: A cross-sectional study was conducted in two major Iraqi universities: the University of Baghdad and Al-Mustansiriyah University. Data were collected using an online Google Form: a semi-structured multiple-choice questionnaire with sections on sociodemographic factors; the Sick, Control, One, Fat, Food (SCOFF) questionnaire; and the Eating Attitudes Test (EAT-26) questionnaire for screening eating disorders. Body mass index was calculated. The non-probability snowball sampling technique was used. Data were analyzed using SPSS version 26, involving descriptive statistics and logistic regression, to identify factors independently and statistically significantly associated with eating disorders. Results: Of the 726 medical students screened [71.9% female; 28.1% male], the EAT-26 identified 250 (34.4%) as being at risk of developing eating disorders [37% females; 27.9% males], while the SCOFF questionnaire identified 336 (46.3%) as being at risk [46.6% females; 45.6% males]. According to the BMI calculations, 58.5% of the participants were of normal weight, 23.3% were overweight, 8.7% were obese, 6.5% were underweight, and 3% were severely underweight. Statistically significant associations varied according to the screening tool used, particularly for age, sex, a history of mental illness, and BMI (p < 0.05). Multivariate logistic regression analysis showed that students diagnosed with a mental illness had more than threefold higher odds of screening positive than students without a diagnosis (AOR = 3.69, 95% CI: 1.899–7.163, p < 0.001). These results highlight the urgent need for Iraqi medical colleges to adopt early prevention measures and strengthen mental health support. Conclusion: This study highlights the burden of eating disorder risk among Iraqi medical students. Many are at risk for eating disorders, with students diagnosed with mental illness carrying a higher risk than those without such a diagnosis.