Cross-Sectional Associations Between Depressive and Anxiety Symptoms and Disordered Eating Behaviors by Sex in University Students

Depressive and anxiety symptoms are associated with a greater likelihood of disordered eating behaviors (DEBs), but the role of sex in these associations is unclear. Objectives: The aim of this study was to analyze the associations between depression, anxiety, and DEBs in a sample of Spanish university students. Methods: Depression was assessed with the Beck Depression Inventory-II (BDI-II), anxiety with the Generalized Anxiety Disorder (GAD-7) instrument, and DEBs with the Sick, Control, One stone, Fat, Food (SCOFF) questionnaire. Statistical analyses included generalized linear regression models adjusted for sociodemographic, body composition, and lifestyle covariates as the main confounders. Results: Among the 453 students analyzed (71.5% female), the frequencies of mild-to-severe depression, mild-to-severe anxiety, and of DEBs were higher in the females (42.0%, 77.5%, and 32.7%, respectively) than in the males (24.0%, 52.7%, and 20.2%, respectively). The results of the adjusted GLMs were similar for both the sexes, indicating higher estimated marginal means of the SCOFF total score and greater odds of DEBs among those with mild-to-severe depression or anxiety than among those without these conditions. Conclusions: Depression and anxiety symptoms are cross-sectionally associated with DEBs in Spanish university students of both sexes. Future prospective studies are needed to examine the direction of these associations separately for females and males.