In a comprehensive survey assessing eating disorder prevalence among undergraduate university students in France, researchers found that 6.7 percent of participating students reported a diagnosed eating disorder, with notable disparities across gender identities. Within the sample of 2,678 undergraduates evaluated at the University of Normandy, self-reported eating disorders affected 35.2 percent of non-binary students, 7.7 percent of female students, and 2.8 percent of male students. The cross-sectional investigation, led by Elisa De Taevernier and colleagues, evaluated the burden of conditions such as anorexia nervosa, bulimia nervosa, and binge-eating disorder during the early years of higher education. After adjusting for age, sex, and academic discipline through multivariable logistic regression models, identifying as non-binary was associated with an adjusted odds ratio of 18.8 compared to male peers. The findings demonstrate that while eating disorders are widely recognized among female undergraduates, gender-diverse students experience a disproportionate burden alongside socioeconomic hardship and pervasive obstacles to accessing medical care.

The investigation addressed a notable gap in French epidemiological research, which has traditionally concentrated on healthcare and medical students. While medical trainees face demanding clinical workloads and academic pressures, evidence regarding the broader undergraduate population has remained limited. Higher education entry coincides with late adolescence and early adulthood, developmental periods marked by significant social transitions, irregular schedules, and increased autonomy in meal preparation. International literature cited in the study indicates that 10 to 50 percent of university students exhibit disordered eating behaviors or suggestive symptoms. The first three years of undergraduate study represent a critical period of adjustment where academic demands, financial strain, and peer pressures converge. By examining undergraduates across diverse degree paths, the study aimed to determine how sociodemographic variables, subjective health perceptions, lifestyle factors, psychiatric comorbidities, and healthcare utilization patterns interact to shape eating disorder risk during these formative academic years.

To evaluate these associations, the authors conducted a cross-sectional online survey at the University of Normandy in 2022. Invitations were delivered to the institutional email addresses of eligible undergraduates in their first, second, or third year of study, with up to five reminder emails sent to encourage participation. The survey was anonymous and voluntary, requiring 15 to 30 minutes to complete. Students in professional training or advanced degree programs were excluded to ensure the cohort focused strictly on early undergraduate study. Overall, 2,678 students completed the questionnaire, representing 7.7 percent of the eligible student body. Because the raw sample was not fully representative of the overall student population, researchers applied statistical weights adjusting for sex, age, study level, and university institution. In the weighted cohort, women represented 75.2 percent of participants, men accounted for 22.1 percent, and non-binary individuals comprised 2.6 percent, with a mean sample age of 20.2 years.

The dataset highlighted sharp discrepancies between objective body mass index and participants’ subjective body image perceptions. Body mass index was calculated from self-reported height and weight using standard World Health Organization categories, while body image perception was evaluated using a five-category rating scale ranging from too thin to too fat. Among students categorized as having a normal body mass index, 41 percent perceived themselves as overweight or too fat. Conversely, among underweight students, 49 percent perceived their weight as normal or overweight. Multivariable analysis showed that negative body image was strongly associated with reporting an eating disorder, carrying greater statistical weight than measured anthropometric status alone. Specifically, students who perceived themselves as too fat had an adjusted odds ratio of 13.6 for an eating disorder compared to peers without that perception, while objective obesity was also independently associated with heightened risk across the entire student population.

The disproportionate prevalence of eating disorders among non-binary undergraduates was accompanied by severe socioeconomic and psychiatric strain. Supplementary analyses comparing non-binary students with and without eating disorders revealed substantial disparities across multiple health dimensions. Non-binary students reporting an eating disorder experienced significantly higher rates of financial hardship, at 40.0 percent compared to 15.2 percent among those without the condition. Additionally, 36.0 percent of non-binary students with eating disorders reported a negative body image compared to 4.3 percent of their peers. Poor self-rated health was reported by 72.0 percent of non-binary students with eating disorders versus 19.4 percent without, and poor sleep affected 72.7 percent versus 46.6 percent. Notably, 96.0 percent of non-binary students with an eating disorder reported a co-occurring psychiatric condition, compared to 39.1 percent among unaffected non-binary peers. The authors highlighted that minority stress, systemic discrimination, and gender-related body dissatisfaction likely contribute to this elevated vulnerability.

Academic discipline and socioeconomic position also showed strong statistical relationships with eating disorder diagnoses across the cohort. Field of study was divided into five distinct groups: healthcare, sciences and techniques, humanities and social sciences, law and economics, and multiple study programs. Contrary to prior expectations derived from medical trainee literature, multivariable regression indicated that students outside of healthcare fields were significantly more likely to report an eating disorder. The researchers noted that non-healthcare students may have lower health literacy, reduced familiarity with university well-being support services, or encounter different social pressures. Alternatively, the authors suggested that healthcare students might underreport eating disorders because of diagnostic denial or fear of academic stigma. In parallel, financial difficulties were independently associated with higher eating disorder risk in the primary analysis, pointing to the detrimental role of financial insecurity, chronic socioeconomic stress, and restricted access to balanced nutritional resources during undergraduate studies.

The survey gathered data on daily routines and substance use, uncovering several behavioral markers that independently correlated with eating disorders. Behavioral measures included diet quality, dietary restrictions such as vegetarianism or veganism, sleep quality, and consumption of tobacco, cannabis, and alcohol. Binge drinking was defined as consuming five or more alcoholic drinks within approximately two hours. Daily lunch skipping emerged as one of the most prominent behavioral correlates: students who skipped lunch every day exhibited substantially higher odds of reporting an eating disorder. Furthermore, frequent tobacco smoking, frequent cannabis use, poor sleep quality, and recurring binge drinking episodes—defined as three or more episodes per month—were each independently linked to higher disorder odds. The authors observed that the co-occurrence of disordered eating with substance use aligns with clinical findings suggesting shared underlying psychological traits, such as elevated impulsivity and difficulties with emotional regulation when confronting academic and personal stressors.

Physical and psychiatric health indicators demonstrated robust associations with eating disorders throughout the student sample. Undergraduates reporting poor self-rated health or chronic digestive diseases faced significantly higher odds of an eating disorder diagnosis, reflecting known bidirectional relationships between digestive pathology and disordered eating patterns. Self-reported psychiatric diagnoses, such as clinical depression and anxiety disorders, were strongly linked to eating pathology. The survey also evaluated severe psychiatric vulnerability by asking students whether they had attempted suicide within the past twelve months. Undergraduates reporting a suicide attempt in the previous year had an adjusted odds ratio of 5.8 for an eating disorder, with a 95 percent confidence interval ranging from 3.3 to 10.3. These findings align with established literature documenting elevated psychiatric comorbidity and heightened suicide risk among individuals with eating disorders, indicating that disordered eating among undergraduates is intertwined with severe emotional distress and critical mental health vulnerabilities.

A central finding of the research was a pronounced paradox in healthcare utilization: students with eating disorders frequently avoided medical consultations despite experiencing greater physical and psychological morbidity. Among students with eating disorders, 40.5 percent avoided general practitioner visits compared to 15.2 percent of unaffected peers, while 51.7 percent forgone psychiatric care compared to 15.7 percent without an eating disorder. Undergraduates who avoided general practitioner visits had an adjusted odds ratio of 3.4 for an eating disorder. The primary reasons for avoiding general practitioners that differed significantly between groups were financial constraints, fear of seeking medical care, and the lack of a regular attending doctor. In an extended sensitivity model adjusting simultaneously for financial hardship, diet quality, meal skipping, and healthcare avoidance, skipping lunch maintained a dose-response association with eating disorders, with adjusted odds ratios between 1.81 and 5.24. In the same model, forgoing psychiatric consultations and general practitioner care remained independently associated with eating disorders, while financial difficulties lost independent significance.

The authors outlined several methodological strengths and limitations that define the interpretation of their findings. Strengths include the large sample size of 2,678 participants, the evaluation of undergraduates across multiple study disciplines beyond healthcare fields, and the application of demographic weighting to adjust for sex, age, study level, and institution. Additionally, evaluating healthcare avoidance provided new empirical data on structural barriers separating at-risk students from clinical support. Conversely, the cross-sectional study design prevents establishing causal directions between observed risk factors and eating disorders. Furthermore, eating disorder cases were identified through self-reported diagnoses rather than standardized screening instruments such as the SCOFF questionnaire, which likely underestimated true prevalence by capturing only recognized cases while omitting undiagnosed students experiencing active symptoms. Finally, because the survey was conducted within a single university consortium in Normandy among undergraduate students, the findings cannot be generalized to advanced degree candidates or the broader French university student population.

Subject of Research: Eating disorder prevalence, risk factors, and healthcare avoidance among French undergraduate students

Article Title: Understanding eating disorders in French undergraduate students: gender gaps, lifestyle factors, and barriers to care

Article References: De Taevernier, E., Telfils, R., Leveque-Morlais, N., Pfister, J., Yon, A., Couvreur, M., & Tavolacci, M.-P. (2026). Understanding eating disorders in French undergraduate students: gender gaps, lifestyle factors, and barriers to care. Eating and Weight Disorders – Studies on Anorexia, Bulimia and Obesity, 31(1), Article 70. https://doi.org/10.1007/s40519-026-01871-3

Image Credits: AI Generated

DOI: 10.1007/s40519-026-01871-3

Keywords: eating disorders, undergraduate students, anorexia nervosa, bulimia nervosa, binge-eating disorder, non-binary students, gender identity, body image perception, healthcare avoidance, general practitioner consultations, psychiatric care, meal skipping, suicide attempts, University of Normandy, socioeconomic hardship, multivariable logistic regression