Risk of eating disorders in relation to stress in a sample of Egyptian students in Ain-Shams university

Abstract Background Eating disorders (EDs) are serious psychiatric conditions with increasing prevalence among university students, often linked to high stress levels and unhealthy coping mechanisms. Medical students are particularly susceptible due to their demanding academic environment. This study aimed to assess the prevalence of EDs risk among medical and non-medical undergraduate students and examine its association with perceived stress and related factors. Methods A comparative cross-sectional study was conducted on 319 undergraduate students aged 17–24 years from Ain Shams University, including 173 medical and 146 non-medical students. Participants completed validated Arabic versions of the Eating Attitudes Test (EAT-26), Eating Disorder Examination Questionnaire (EDE-Q), and Perceived Stress Scale (PSS). Students were classified into high- and low-risk groups for EDs based on EAT-26 scores. Results EDs risk was significantly higher in medical students (35.8%) compared to non-medical students (24.7%, P = 0.031). Medical students also showed higher perceived stress scores (19.87 ± 7.46 vs. 17.03 ± 7.32, P < 0.001) and more frequent severe stress (24.3% vs. 11%, P = 0.006). EDE-Q scores for restraint, shape concern, weight concern, and global score were significantly higher in medical students. High-risk students had elevated BMI (25.32 ± 4.06 vs. 23.70 ± 3.36, P = 0.001) and higher smoking prevalence (39.8% vs. 9.5%, P < 0.001). Severe stress (OR = 2.091) and smoking (OR = 9.208) were independent predictors of EDs risk. Conclusions Medical students are at elevated risk of EDs, largely driven by high perceived stress and unhealthy lifestyle behaviors.