Eating disorders across population groups with different weight status in Belgium: evidence for an integrative preventative approach

Abstract Background It is a common misperception that eating disorders (ED) predominantly affect individuals with underweight. This study aims to clarify the prevalence and odds of living with an ED across different weight groups within the Belgian population, and to identify sociodemographic factor...

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Main Authors: Fara Geerinck, Sabine Drieskens, Lydia Gisle, Stefanie Vandevijvere, Rana Charafeddine
Format: Article
Language:English
Published: BMC 2025-07-01
Series:BMC Public Health
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Online Access:https://doi.org/10.1186/s12889-025-23506-5
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author Fara Geerinck
Sabine Drieskens
Lydia Gisle
Stefanie Vandevijvere
Rana Charafeddine
author_facet Fara Geerinck
Sabine Drieskens
Lydia Gisle
Stefanie Vandevijvere
Rana Charafeddine
author_sort Fara Geerinck
collection DOAJ
description Abstract Background It is a common misperception that eating disorders (ED) predominantly affect individuals with underweight. This study aims to clarify the prevalence and odds of living with an ED across different weight groups within the Belgian population, and to identify sociodemographic factors associated with the comorbidity of ED and overweight or obesity. Methods Data for this study was sourced from the 2018 Belgian Health Interview Survey (BHIS). This is a cross-sectional survey that collects health information from approximately 10,000 individuals living in Belgium through face-to-face interviews and self-administered questionnaires. Data collection involved questions on EDs (SCOFF questionnaire), height and weight, and sociodemographic characteristics. The prevalence of EDs was determined through descriptive statistics. Multivariable logistic regression models were employed to assess the odds of living with an ED across different weight categories and to identify sociodemographic variables (age, sex, education, income, and ethnicity) linked to the comorbidity of EDs and obesity/overweight. Results General ED prevalence in this study was 7.1%. The prevalence of EDs was highest among individuals with obesity (12.3%, 95% CI: 10.0–15.1%) compared to those with normal weight (5.5%, 95% CI: 4.4–6.9%). Individuals with obesity had three times higher odds of living with an ED (adjusted odds ratio (AOR): 3.0, 95% CI: 2.1–4.1). Individuals with overweight also had increased odds of living with an ED (AOR: 1.4, CI: 1.0–2.0). The comorbidity of EDs and obesity/overweight was significantly linked to low educational levels (AOR: 1.8, 95% CI 1.1–2.8), financial difficulties (AOR: 1.9, 95% CI 1.4–2.7), and maternal non-EU origin (AOR: 2.4, 95% CI 1.6–3.7). Conclusions EDs disproportionally affect people with higher weight. This underscores the necessity for public health interventions that address the intertwined nature of EDs and obesity. Traditional weight-centric health campaigns focusing on individual responsibility may inadvertently contribute to the problem by promoting weight stigma. An integrative preventative approach holds promise for more effective management and prevention of EDs and obesity in the Belgian population.
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spelling doaj-art-783e393ed71a4e9abf71ac2d1212a7712025-08-20T03:04:17ZengBMCBMC Public Health1471-24582025-07-0125111210.1186/s12889-025-23506-5Eating disorders across population groups with different weight status in Belgium: evidence for an integrative preventative approachFara Geerinck0Sabine Drieskens1Lydia Gisle2Stefanie Vandevijvere3Rana Charafeddine4Faculty of medicine, University of AntwerpDepartment of Epidemiology and public health, SciensanoDepartment of Epidemiology and public health, SciensanoDepartment of Epidemiology and public health, SciensanoDepartment of Epidemiology and public health, SciensanoAbstract Background It is a common misperception that eating disorders (ED) predominantly affect individuals with underweight. This study aims to clarify the prevalence and odds of living with an ED across different weight groups within the Belgian population, and to identify sociodemographic factors associated with the comorbidity of ED and overweight or obesity. Methods Data for this study was sourced from the 2018 Belgian Health Interview Survey (BHIS). This is a cross-sectional survey that collects health information from approximately 10,000 individuals living in Belgium through face-to-face interviews and self-administered questionnaires. Data collection involved questions on EDs (SCOFF questionnaire), height and weight, and sociodemographic characteristics. The prevalence of EDs was determined through descriptive statistics. Multivariable logistic regression models were employed to assess the odds of living with an ED across different weight categories and to identify sociodemographic variables (age, sex, education, income, and ethnicity) linked to the comorbidity of EDs and obesity/overweight. Results General ED prevalence in this study was 7.1%. The prevalence of EDs was highest among individuals with obesity (12.3%, 95% CI: 10.0–15.1%) compared to those with normal weight (5.5%, 95% CI: 4.4–6.9%). Individuals with obesity had three times higher odds of living with an ED (adjusted odds ratio (AOR): 3.0, 95% CI: 2.1–4.1). Individuals with overweight also had increased odds of living with an ED (AOR: 1.4, CI: 1.0–2.0). The comorbidity of EDs and obesity/overweight was significantly linked to low educational levels (AOR: 1.8, 95% CI 1.1–2.8), financial difficulties (AOR: 1.9, 95% CI 1.4–2.7), and maternal non-EU origin (AOR: 2.4, 95% CI 1.6–3.7). Conclusions EDs disproportionally affect people with higher weight. This underscores the necessity for public health interventions that address the intertwined nature of EDs and obesity. Traditional weight-centric health campaigns focusing on individual responsibility may inadvertently contribute to the problem by promoting weight stigma. An integrative preventative approach holds promise for more effective management and prevention of EDs and obesity in the Belgian population.https://doi.org/10.1186/s12889-025-23506-5Eating disordersObesityPrevalenceSociodemographic factorsComorbidityPublic health policy
spellingShingle Fara Geerinck
Sabine Drieskens
Lydia Gisle
Stefanie Vandevijvere
Rana Charafeddine
Eating disorders across population groups with different weight status in Belgium: evidence for an integrative preventative approach
BMC Public Health
Eating disorders
Obesity
Prevalence
Sociodemographic factors
Comorbidity
Public health policy
title Eating disorders across population groups with different weight status in Belgium: evidence for an integrative preventative approach
title_full Eating disorders across population groups with different weight status in Belgium: evidence for an integrative preventative approach
title_fullStr Eating disorders across population groups with different weight status in Belgium: evidence for an integrative preventative approach
title_full_unstemmed Eating disorders across population groups with different weight status in Belgium: evidence for an integrative preventative approach
title_short Eating disorders across population groups with different weight status in Belgium: evidence for an integrative preventative approach
title_sort eating disorders across population groups with different weight status in belgium evidence for an integrative preventative approach
topic Eating disorders
Obesity
Prevalence
Sociodemographic factors
Comorbidity
Public health policy
url https://doi.org/10.1186/s12889-025-23506-5
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AT lydiagisle eatingdisordersacrosspopulationgroupswithdifferentweightstatusinbelgiumevidenceforanintegrativepreventativeapproach
AT stefanievandevijvere eatingdisordersacrosspopulationgroupswithdifferentweightstatusinbelgiumevidenceforanintegrativepreventativeapproach
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