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. 2025 Mar 10;17(3):e80374.
doi: 10.7759/cureus.80374. eCollection 2025 Mar.

Prevalence and Factors Associated With Eating Disorder Risk Among College Students in Kerala, India: A Cross-Sectional Study

Swathy Krishna  1 , Jeby Jose Olickal  1 , P Sankara Sarma  1 , Kavumpurathu Raman Thankappan  1
Affiliations

Prevalence and Factors Associated With Eating Disorder Risk Among College Students in Kerala, India: A Cross-Sectional Study

Swathy Krishna et al. Cureus. .

Abstract

Introduction Unhealthy diets are a major contributor to the global burden of disease, with eating disorders (EDs) being among the most prevalent psychological disorders affecting youth worldwide. Despite their increasing recognition, there is limited research quantifying ED risk in India. Therefore, we aimed to estimate the risk of ED in the Indian state of Kerala and to find the sociodemographic factors associated with it. Methods We conducted this study among 823 students (females: 60%) aged 18-22 years in randomly selected colleges in two of the 14 districts in Kerala. Data were collected using the self-administered Eating Attitudes Test-26 (EAT-26). Information on social media disorder was collected using the Bergen Social Media Addiction Scale (BSMAS). Log binomial regression analysis was done to find the factors associated with ED risk, and adjusted prevalence ratios (APR) with a 95% confidence interval (CI) were calculated. Results ED risk was reported by 242 students (29.4%, 95% CI: 26.3-32.6). Home-staying students are more likely to report a higher risk of ED compared to hostel or paying guest students (APR = 1.40; 95% CI: 1.08-1.80). Similarly, students belonging to high-income groups of social class I (APR = 9.60; 95% CI: 5.11-18.04), social class II (APR = 5.51; 95% CI: 2.89-10.47), and social class III (APR = 3.18; 95% CI: 1.54-6.56) were more likely to report ED risk compared to their counterparts. Additionally, students who were underweight (APR = 1.60; 95% CI: 1.24-2.05), overweight/obese (APR = 2.42; 95% CI: 1.96-3.01), and those with social media disorder (APR = 1.69; 95% CI: 1.27-2.24) had a higher likelihood of reporting ED risk. Conclusion Nearly one-third of college students were at risk of ED. Measures to reduce ED risk are required among students prioritizing those belonging to high-income groups, overweight/obese, underweight, and those having social media disorder.

Keywords: eating disorder; kerala; mental health; social media addiction; young adults.

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Conflict of interest statement

Human subjects: Consent for treatment and open access publication was obtained or waived by all participants in this study. Amrita School of Medicine, Kochi issued approval ECASM-AIMS-2024-067. The study protocol was reviewed and approved by the Institute Ethics Committee of Amrita School of Medicine, Kochi (Approval number: ECASM-AIMS-2024-067). Animal subjects: All authors have confirmed that this study did not involve animal subjects or tissue. Conflicts of interest: In compliance with the ICMJE uniform disclosure form, all authors declare the following: Payment/services info: All authors have declared that no financial support was received from any organization for the submitted work. Financial relationships: All authors have declared that they have no financial relationships at present or within the previous three years with any organizations that might have an interest in the submitted work. Other relationships: All authors have declared that there are no other relationships or activities that could appear to have influenced the submitted work.

Figures

Figure 1
Figure 1. Flowchart depicting the selection of study participants
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