The purpose of this study is to draw attention to dieting behaviors, weight control practices, and the current body image perceptions among female students in Palestine. Moreover, it aimed at having a role in guiding health education messages delivered to females in colleges about healthy attitudes and practices towards diet and body weight.
Weight control behaviors were assessed based on EAT-26, which is a widely used instrument that provides information about the symptoms and the risk of eating disorders in non-clinical settings. More specifically, it is a useful screening instrument to assess "eating disorder risk" in high school and college.(20)It has been used in many countries including regional ones.(12,22,23)
The result showed that 36.9% of female students had risky eating behaviors. Comparable to other neighboring countries; the risky eating behaviors among female participants in Palestine are higher which indicates a higher tendency to develop eating disorders,(24) and reported a high level of concern about dieting, body weight, and prone to risky eating behaviors as compared to other Arab countries. This worrying result may be due to rapid socio-cultural and lifestyle change, which includes modernization and urbanization. Besides, it may be due to the spread of social media, which represents a thin body as beauty. In comparison with Jordan, the results were almost closed with a slight increase among Jordanian females, this similarity results may due to the convergence of cultural and social norms between the two neighboring countries.(22) This result is a cause for concern, as risky eating behaviors are associated with the development of eating disorders. It is also associated with other health concerns including depression, anxiety, nutritional and metabolic disorders(7,25–27)
Regarding body image, the result showed that the majority of participants preferred a thin figure for themselves and most of them were dissatisfied with their body shape, where 55% of participants had negative body image. This agrees with the findings reported by several studies.(7,28,29)
Moreover, the results on body image perception was compared with another previous study conducted in Palestine, where the percentage of female dissatisfied with their body image increased by 10%.(18)This increase could be attributed to the spread of social media and photo sharing in addition to the media pressures and the model of beauty imposed by modern society, which reflects the thin woman body as the ideal body, regardless of women health.
In regards to BMI and weight control behavior, no significant association was found between risky eating behaviors and BMI. This indicates that participants were engaging in risky eating behaviors regardless of their BMI classification. In regards to weight control behaviors and weight perception, no significant relationship was observed. This result is a risk indicator; as students who were following risky eating, behaviors had accurate weight estimation and healthy BMI which may lead to difficulty in convincing them that there is no need for such behaviors.
Body image dissatisfaction is strongly associated with risky eating behaviors of female students; 45.3% of participants who engaged in risky eating behaviors had negative body image. This supports the hypothesis that body image dissatisfaction would present higher levels of disordered eating attitudes.(30–33) Moreover, this indicates that body image dissatisfaction, rather than actual BMI, is a better predictor of dieting behaviors among study participants, a result supported by the literature.(32,34)
Finally, we have to admit that risky eating behaviors are extremely associated with the development of eating disorders. It is also associated with other health concerns including depression, anxiety, self-hatred, nutritional and metabolic problems, obsessive-compulsive issues, and suicide.(26) Therefore, participants who scored ≥ 20 were asked to seek health evaluation by a health professional that specializes in the treatment of eating disorders to determine their health status.(35)
Some limitations of this study should be considered when interpreting its results. The cross-sectional design of this study makes it difficult to determine the temporal relationships and causality between the weight control behaviors and the studied independent variables. Besides, using a convenient sample may not represent the study population. We were unable to have the list of students enrolled in the university (sample frame) as the regulations did not allow. However, great care has been taken to select students from both campuses and all faculties equal to their proportion in the university.