Eating disorders among women in primary care (Monastir, Tunisia)

Authors

  • Baha Slimane Zrafi
  • Rim Omezzine Gniwa
  • Afifa Abdelkafi Koubaa
  • Walid Bouali
  • Asma Sriha Belguith

Abstract

Background : Eating disorders (ED) are relatively frequent, but convey a high mortality and morbidity. More than half of individuals with ED remain undetected in primary care. The general practitioners (GP) are in a strategic position to detect patients with ED.
Aims : To determine the prevalence of ED in Tunisian women visiting their GP using the SCOFF-F score and to determinate the associated socioeconomic, clinical, and lifestyle factors.
Methods : This is a cross-sectional study of women who consulted two primary health care in the city of Monastir, during 4 months of the year 2020. The SCOFF-F was performed.
Results: We included 445 women; the mean age of our patients was 36 ± 12 years. SCOFF-F was positive in 48% of cases CI95% [43-52%], 14% presented with bulimia nervosa and 12% with binge eating disorder. Patients with ED were overweight in 33% of cases, 40% perform a physical activity and 53% eat three meals per day. A family history of ED was 35%. 20% of the patients have a history of psychiatric disorder. In multivariate analysis, performing physical activity to control weight, eating three meals a day, maintaining the current diet without trying to change into a different one, non continous occupation and anxiety increase the risk of ED with respective ORs of 2.34, 4.26, 3.69, 2.09 and 2.09 respectively. Ages between 35 and 60 years, and a history of ED in siblings increases the risk of ED by 1.6.
Conclusion: Our study concluded that ED was associated with common family behavior, especially among siblings, and with a particular psychological state which are interesting to screen by GP and to focus on targeting family care.

Downloads

Download data is not yet available.

References

Galmiche M, Déchelotte P, Lambert G, Tavolacci MP. Prévalence des troubles du comportement alimentaire au cours de la période 2000-2018 : une revue systématique de la littérature. J Clin Nutr Metab. 2019;33(1):112.

Garcia-Campayo J, Sanz-Carrillo C, Ibañez JA, Lou S, Solano V, Alda M. Validation of the Spanish version of the SCOFF questionnaire for the screening of eating disorders in primary care. J Psychosom Res. 2005 Aug 1;59(2):51-5.

Charfi N, Trigui D, Ben Thabet J et al. Etude du rapport des troubles des conduites alimentaires avec le niveau de stress et l’estime de soi chez les étudiants en médecine. Tunis Med. 2015; 93 : 721.

Ketata W, Aloulou J, Charfi N, Abid M, Amami O. Hyperphagie boulimique et obésité: aspects épidémiologiques, cliniques et psychopathologiques. Étude d’une population d’obèses à Sfax (Tunisie). Ann Endocrinol. 2009; 70:462-7.

Khiari M, Mizouri R, Boukhayatia F et al. Prévalence des troubles du comportement alimentaire chez un groupe d’obèses tunisiens. J Clin Nutr Metab. 2019;33(1):40-1.

Garcia FD, Grigioni S, Allais E, Houy-Durand E, Thibaut F, Déchelotte P. Detection of eating disorders in patients: validity and reliability of the French version of the SCOFF questionnaire. Clin Nutr. 2011;30(2):178-81.

Arnal M, Fayemendy P, Morin B et al. Dépistage des troubles du comportement alimentaire à l’aide du SCOFF-F chez 964 actifs et étudiants en Haute-Vienne. J Clin Nutr Metab. 2019;33(1):15-6.

Hubin-Gayte M. Troubles des conduites alimentaires et maternité : analyse de forums sur Internet. Ann Med Psychol. 2011;169(10):615-620.

Garcia FD, Grigioni S, Chelali S, Meyrignac G, Thibaut F, Dechelotte P. Validation of the French version of SCOFF questionnaire for screening of eating disorders among adults. World J Biol Psychiatry. 2010;11(7):888-93.

Lajili O, Htira Y, Benali K, Rachdi R, Benmami F. Obésité et troubles du comportement alimentaire chez les tunisiens. Ann Endocrinol. 2020; 81 :467.

Safer M, Zemni I, Mili M, Salem B, Zaafrane F. Eating disorders: Prevalence and associated factors among health occupation students in Monastir University (Tunisia). Tunis Med. 2020;98(12):895-912.

Deschasaux-Tanguy M, Druesne-Pecollo N, Esseddik Y et al. Diet and physical activity during the coronavirus disease 2019 (COVID-19) lockdown (March–May 2020): results from the French NutriNet-Santé cohort study. Am J Clin Nutr. 2021;113(4):924-38.

Manoudi F, Adali I, Asri F, Tazi I. Approche épidémiologique de la boulimie et du comportement alimentaire inhabituel en milieu universitaire à Marrakech (Maroc). Ann Med Psychol. 2010;168(9):694-697.

Lachaud M, Miquel V, Rousseau A, Chabrol H. Pratiques alimentaires et préoccupations corporelles chez les jeunes femmes. J Behav Cogn Ther. 2004;14(3):131-4.

Arnal M, Fayemendy P, Morin B et al. Dépistage des troubles du comportement alimentaire à l’aide du SCOFF-F chez 330 patients obèses pris en charge en Limousin. J Clin Nutr Metab. 2020;34(1):79.

Grigioni S, Déchelotte P. Épidémiologie et évolution des troubles du comportement alimentaire. Médecine & nutrition. 2012;48(1):28-32.

Tomori M, Rus-Makovec M. Eating behavior, depression, and self-esteem in high school students. J Adolesc Health.. 2000;26(5):361-7.

Williams PM, Goodie J, Motsinger CD. Treating eating disorders in primary care. Am Fam Physician. 2008 Jan 15;77(2):187-95.

Hoek HW. Review of the worldwide epidemiology of eating disorders. Curr Opin Psychiatry. 2016;29(6):336-9.

vancic L, Maguire S, Miskovic-Wheatley J, Harrison C, Nassar N. Prevalence and management of people with eating disorders presenting to primary care: a national study. Aust N Z J Psychiatry. 2021 Nov;55(11):1089-100.

Ogg EC, Millar HR, Pusztai EE, Thom AS. General practice consultation patterns preceding diagnosis of eating disorders. Int J Eat Disord. 1997 Jul;22(1):89-93.

Hay P, Mitchison D. Eating Disorders and Obesity: The Challenge for Our Times. Nutrients. 2019 May 11;11(5):1055.

Omri M, Mahjoub F, Ben Amor N, Triki S, Bahri A, Jamoussi H. Troubles du comportement alimentaire chez un groupe d’obèses Tunisiens candidats à une chirurgie bariatrique. Ann Endocrinol 2017;78:441.

Mangweth-Matzek B, Hoek HW. Epidemiology and treatment of eating disorders in men and women of middle and older age. Curr Opin Psychiatry. 2017;30(6):446

Delaunay AL, Gérardin P, Godart N. Prise en charge en hôpital de jour des adolescents présentant un trouble des conduites alimentaires : revue de la littérature internationale et état des lieux en France. Neuropsychiatr Enfance Adolesc. 2019;67(4):203-12.

Portzky G, van Heeringen K, Vervaet M. Attempted suicide in patients with eating disorders. Crisis: Crisis. 2014;35(6):378.

Cook-Darzens S. Apports de la recherche familiale dans les troubles du comportement alimentaire de l’enfant et de l’adolescent: acquis, défis et nouvelles perspectives. Thérapie familiale. 2013;34(1):39-67.

Downloads

Published

2022-03-12

Issue

Section

Original articles