Association between eating disorders and mental health disorders among Bangladeshi school and college students: a cross-sectional study

Eating disorders (EDs) are psychiatric conditions often co-occurring with mental health issues in adolescents. This study investigated the association between eating disorder (ED) risk, assessed via symptoms, and specific mental health disorders (depression, anxiety, stress) among school and college adolescents in Dhaka, Bangladesh, an understudied population in this context. A cross-sectional study was conducted among 1,185 participants aged 13-19 years from selected educational institutions using convenience sampling. The Eating Attitudes Test (EAT-26) assessed ED symptoms, while the Depression, Anxiety, and Stress Scale (DASS-21) evaluated mental health status. The Chi-square test determined a significant association between EDs in participants' sociodemographic and mental health variables. Multivariate logistic regression identified factors significantly associated with ED symptoms. Based on Eating Attitudes Test (EAT-26) scores ≥20, 35.3% of students were screened as being at risk for EDs." (Clarifies "risk" vs. diagnosis). Significant associations were found between ED risk and participants' sociodemographic characteristics (excluding family income and size), as well as with depression, anxiety, and stress. Multivariate logistic regression revealed significantly higher odds of ED risk among participants with severe (OR=2.24) and extremely severe (OR=2.44) anxiety, and mild (OR=1.52) to extremely severe (OR=4.17) stress, compared to those with normal levels. However, after adjusting for covariates, depression levels were not significantly associated with ED risk in this cohort. The findings highlight a strong link between ED risk and elevated anxiety and stress among adolescents. Findings underscore the importance of targeting anxiety and stress in mental health interventions and preventive strategies to address ED risk among Bangladeshi adolescents.