Media-Driven Sociocultural Pressures and Disordered Eating among Medical and Paramedical Students in Chengalpattu, Tamil Nadu: A Cross-Sectional Study
DOI:
https://doi.org/10.55489/njcm.170520266283Keywords:
Body Image, Dietary Habits, Medical Students, Peer Groups, Social Media Exposure, Sociological FactorsAbstract
Background: The rising prevalence of disordered eating among the young population is primarily driven by sociocultural pressures that promote idealised body images. Medical college students deal with academic demands and social pressures while being increasingly exposed to appearance-focused media. The objective was to estimate the prevalence of disordered eating and its relationship with sociocultural pressures amongst college students in Tamil Nadu.
Methodology: This cross-sectional study included 332 undergraduate medical and paramedical students from a tertiary care centre in Tamil Nadu. Sociocultural pressures and disordered eating were assessed using SATAQ-4 and EDE-QS. Associations were analysed using Chi-square tests with odds ratios (95% CI) and Spearman's correlation coefficient (ρ) using SPSS v25.
Results: The prevalence of disordered eating was 45.8% (95% CI: 40.4-51.3%). High sociocultural pressure tripled the odds of disordered eating (OR=3.21; 95% CI: 2.03-5.08; p<0.001). Media pressure had the strongest relationship with disordered eating, showing both higher odds (AOR = 2.54, 95% CI: 1.49-4.32, p < 0.001) and the highest correlation (ρ=0.448, p<0.001). Females showed greater odds of disordered eating than males. No significant difference was observed between medical and paramedical students.
Conclusions: Media-driven sociocultural pressures fuel disordered eating among college students, highlighting the need for targeted media literacy and psychosocial interventions.
References
Peschel SKV, Sigrist C, Voss C, Fürtjes S, Berwanger J, Ollmann TM, et al. Subclinical patterns of disordered eating behaviors in the daily life of adolescents and young adults from the general population. Child Adolesc Psychiatry Ment Health. 2024;18:69. DOI: https://doi.org/10.1186/s13034-024-00752-w PMid:38845025 PMCid:PMC11157754
Chaves E, Jeffrey DT, Williams DR. Disordered Eating and Eating Disorders in Pediatric Obesity: Assessment and Next Steps. Int J Environ Res Public Health. 2023 Aug 24;20(17):6638. DOI: https://doi.org/10.3390/ijerph20176638 PMid:37681777 PMCid:PMC10487955
López-Gil JF, García-Hermoso A, Smith L, Firth J, Trott M, Mesas AE, et al. Global Proportion of Disordered Eating in Children and Adolescents: A Systematic Review and Meta-analysis. JAMA Pediatr. 2023;177:363-372. DOI: https://doi.org/10.1001/jamapediatrics.2022.5848 PMid:36806880 PMCid:PMC9941974
Thompson JK, Heinberg LJ, Altabe M, Tantleff-Dunn S. Exacting Beauty: Theory, Assessment, and Treatment of Body Image Disturbance. Body Image. 2005;2(1):1-12.
Frederick DA, Tylka TL, Rodgers RF, Pennesi JL, Convertino L, Parent MC, et al. Pathways From Sociocultural and Objectification Constructs to Body Satisfaction Among Women: The U.S. Body Project I. Body Image. 2022;41:195-208. DOI: https://doi.org/10.1016/j.bodyim.2022.02.001 PMid:35299008 PMCid:PMC9764838
Frederick DA, Tylka TL, Rodgers RF, Convertino L, Pennesi J-L, Parent MC, et al. Pathways From Sociocultural and Objectification Constructs to Body Satisfaction Among Men: The U.S. Body Project I. Body Image. 2022;41:84-96. DOI: https://doi.org/10.1016/j.bodyim.2022.01.018 PMid:35247867 PMCid:PMC9812655
Ganesan S, Ravishankar SL, Ramalingam S. Are Body Image Issues Affecting Our Adolescents? A Cross-sectional Study among College Going Adolescent Girls. Indian J Community Med. 2018;43(Suppl 1):S42-S46. DOI: https://doi.org/10.4103/ijcm.IJCM_62_18 PMid:30686874 PMCid:PMC6324036
Lavender JM, Brown TA, Murray SB. Men, Muscles, and Eating Disorders: an Overview of Traditional and Muscularity-Oriented Disordered Eating. Curr Psychiatry Rep. 2017;19:32. DOI: https://doi.org/10.1007/s11920-017-0787-5 PMid:28470486 PMCid:PMC5731454
Mazaraki J, Bussey K, Cunningham M, Jewell T, Trompeter N. Muscularity-oriented disordered eating: investigating body image concerns and the moderating role of emotion dysregulation in cyclists. J Eat Disord. 2024 Nov 21;12(1):189. DOI: https://doi.org/10.1186/s40337-024-01109-6 PMid:39574180 PMCid:PMC11580638
Vaidyanathan S, Menon V. Research on Feeding and Eating Disorders in India: A Narrative Review. Indian J Psychiatry. 2024;66:9-25. DOI: https://doi.org/10.4103/indianjpsychiatry.indianjpsychiatry_782_23 PMid:38419929 PMCid:PMC10898522
Alzahrani SH, Saeedi AA, Baamer MK, Shalabi AF, Alzahrani AM. Eating Habits Among Medical Students at King Abdulaziz University, Jeddah, Saudi Arabia. Int J Gen Med. 2020;13:77-88. DOI: https://doi.org/10.2147/IJGM.S246296 PMid:32184649 PMCid:PMC7062392
Fekih-Romdhane F, Daher-Nashif S, Alhuwailah AH, Al Gahtani HMS, Hubail SA, Shuwiekh HAM, et al. The prevalence of feeding and eating disorders symptomology in medical students: an updated systematic review, meta-analysis, and meta-regression. Eat Weight Disord. 2022 Aug;27(6):1991-2010. DOI: https://doi.org/10.1007/s40519-021-01351-w PMid:35067859 PMCid:PMC8784279
Tavolacci MP, Doudeau N, Vilain F, Sadat K, Ladner J, Morvan Y, et al. Eating Disorder Symptoms and Associated Risk Factors Among Medical Students in France: A Nationwide Cross-Sectional Study. J Eat Disord. 2025;13:255. DOI: https://doi.org/10.1186/s40337-025-01436-2 PMid:41214798 PMCid:PMC12604336
Sharma M, Singh SK, Tiwari P, Chauhan N. Body Image Perception, Eating Attitude and Influence of Media Among Undergraduate Students of Medical College in Delhi: A Cross-Sectional Study. Int J Res Med Sci. 2019;7(12):4627-4634. DOI: https://doi.org/10.18203/2320-6012.ijrms20195529
Wilksch SM, O'Shea A, Ho P, Byrne S, Wade TD. The Relationship Between Social Media Use and Disordered Eating in Young Adolescents. Int J Eat Disord. 2020 Jan;53(1):96-106. DOI: https://doi.org/10.1002/eat.23198 PMid:31797420
Roorda BA, Cassin SE. A Review of Food-Related Social Media and Its Relationship to Body Image and Disordered Eating. Nutrients. 2025;17:342. DOI: https://doi.org/10.3390/nu17020342 PMid:39861472 PMCid:PMC11767927
Suhag K, Rauniyar S. Social Media Effects Regarding Eating Disorders and Body Image in Young Adolescents. Cureus. 2024;16:e58674. DOI: https://doi.org/10.7759/cureus.58674
Dopelt K, Houminer-Klepar N. The Impact of Social Media on Disordered Eating: Insights from Israel. Nutrients. 2025;17(1):180. DOI: https://doi.org/10.3390/nu17010180 PMid:39796614 PMCid:PMC11722979
Lachenbruch PA. Review of Sample Size Determination in Health Studies: A Practical Manual, by S. K. Lwanga & S. Lemeshow. Journal of the American Statistical Association. 1991;86(416):1149. DOI: https://doi.org/10.2307/2290547
Schaefer LM, Burke NL, Thompson JK, Dedrick RF, Heinberg LJ, Calogero RM, et al. Development and Validation of the Sociocultural Attitudes Towards Appearance Questionnaire-4 (SATAQ-4). Psychol Assess. 2015;27(1):54-67. DOI: https://doi.org/10.1037/a0037917 PMid:25285718
Prnjak K, Mitchison D, Griffiths S, Mond J, Gideon N, Serpell L, et al. Further development of the 12-item EDE-QS: identifying a cut-off for screening purposes. BMC Psychiatry. 2020;20:146. DOI: https://doi.org/10.1186/s12888-020-02565-5 PMid:32245441 PMCid:PMC7118929
Gideon N, Hawkes N, Mond J, Saunders R, Tchanturia K, Serpell L. Development and Psychometric Validation of the EDE-QS, a 12 Item Short Form of the Eating Disorder Examination Questionnaire (EDE-Q). PLoS One. 2016 May 3;11(5):e0152744. DOI: https://doi.org/10.1371/journal.pone.0152744. Erratum in: PLoS One. 2018 Nov 5;13(11):e0207256. DOI: https://doi.org/10.1371/journal.pone.0207256. PMID: 27138364; PMCID: PMC4854480
Fairburn CG, Cooper Z, Shafran R. Cognitive behaviour therapy for eating disorders: a "transdiagnostic" theory and treatment. Behav Res Ther. 2003 May;41(5):509-528. DOI: https://doi.org/10.1016/S0005-7967(02)00088-8 PMid:12711261
Jahrami H, Saif Z, Trabelsi K, Ghazzawi H, Pandi-Perumal SR, Seeman MV. An Umbrella Review and a Meta-analysis of Meta-analyses of Disordered Eating Among Medical Students. Alpha Psychiatry. 2024;25:165-174. DOI: https://doi.org/10.5152/alphapsychiatry.2024.241515 PMid:38798808 PMCid:PMC11117415
Mitchison D, Hay P, Slewa-Younan S, Mond J. The changing demographic profile of eating disorder behaviors in the community. BMC Public Health. 2014;14:943. DOI: https://doi.org/10.1186/1471-2458-14-943 PMid:25213544 PMCid:PMC4246495
Tomy C, Lakshmi AV, Mathew KA, Jith A. Risk of Eating Disorders and Its Association With Body Image Concerns, Depression, Anxiety and Stress Among Medical Students in a College in Kerala. Kerala J Psychiatry. 2021;34:105-111. DOI: https://doi.org/10.30834/KJP.34.2.2021.278
Iyer S, Shriraam V. Prevalence of Eating Disorders and Its Associated Risk Factors in Students of a Medical College Hospital in South India. Cureus. 2021;13:e12926. DOI: https://doi.org/10.7759/cureus.12926
Mallaram GK, Sharma P, Kattula D, Singh S, Pavuluru P. Body Image Perception, Eating Disorder Behavior, Self-Esteem and Quality of Life: A Cross-Sectional Study Among Female Medical Students. J Eat Disord. 2023;11(1):225. DOI: https://doi.org/10.1186/s40337-023-00945-2 PMid:38102717 PMCid:PMC10724937
Lempp H, Seale C. The hidden curriculum in undergraduate medical education: qualitative study of medical students' perceptions of teaching. BMJ. 2004;329(7469):770-773. DOI: https://doi.org/10.1136/bmj.329.7469.770 PMid:15459051 PMCid:PMC520997
Christakis NA, Fowler JH. The spread of obesity in a large social network over 32 years. N Engl J Med. 2007;357(4):370-379. DOI: https://doi.org/10.1056/NEJMsa066082 PMid:17652652
Dahlgren CL, Sundgot-Borgen C, Kvalem IL, Wennersberg AL, Wisting L. Further Evidence of the Association Between Social Media Use, Eating Disorder Pathology and Appearance Ideals and Pressure: A Cross-Sectional Study in Norwegian Adolescents. J Eat Disord. 2024;12(1):34. DOI: https://doi.org/10.1186/s40337-024-00992-3 PMid:38424579 PMCid:PMC10905800
Ruiz-Centeno C, Cueto-Galán R, Pena-Andreu JM, Fontalba-Navas A. Problematic internet use and its relationship with eating disorders. Front Public Health. 2025 Jan 23;13:1464172. DOI: https://doi.org/10.3389/fpubh.2025.1464172 PMid:39916705 PMCid:PMC11801017
Dane A, Bhatia K. The Social Media Diet: A Scoping Review to Investigate the Association Between Social Media, Body Image and Eating Disorders Amongst Young People. PLoS Glob Public Health. 2023;3(3):e0001091. DOI: https://doi.org/10.1371/journal.pgph.0001091 PMid:36962983 PMCid:PMC10032524
Singh MM, Parsekar SS, Bhumika TV. Body Image, Eating Disorders and Role of Media among Indian Adolescents. J. Indian Assoc. Child Adolesc. Ment. Health. 2016;12(1):9-35. DOI: https://doi.org/10.1177/0973134220160102
Hadaye RS, Rahini S. A Cross-Sectional Study to Estimate the Prevalence of Eating Disorders and Ascertain Factors for Eating Disorder Risk Among Senior College Students in a Metropolitan City. J Educ Health Promot. 2024;13:343. DOI: https://doi.org/10.4103/jehp.jehp_1079_23 PMid:39679015 PMCid:PMC11639438
Sharma N, Mehta R. Predicting Body Image Dissatisfaction From Social Media Use and Peer Comparison. J Adolesc Youth Psychol Stud. 2024;5:154-62. DOI: https://doi.org/10.61838/kman.jayps.5.7.17
Alburkani BSS, Yousef FM, Arab A, Alzahrani AM, Alghamdi F, Alotaibi T, et al. The Impact of Social Media and Family Attitudes on the Body Image and Eating Patterns of Male and Female Students. Middle East Curr Psychiatry. 2024;31:87. DOI: https://doi.org/10.1186/s43045-024-00474-x
Som N, Mukhopadhyay S. Body weight and body shape concerns and related behaviours among Indian urban adolescent girls. Public Health Nutr. 2015;18(6):1075-1083. DOI: https://doi.org/10.1017/S1368980014001451 PMid:25079706 PMCid:PMC10271564
Kapoor A, Upadhyay MK, Saini NK. Prevalence, Patterns and Determinants of Body Image Dissatisfaction Among Female Undergraduate Students of University of Delhi. J Family Med Prim Care. 2022;11(5):2002-2007. DOI: https://doi.org/10.4103/jfmpc.jfmpc_1851_21 PMid:35800482 PMCid:PMC9254831
Thakur M, Guha Thakurta T. Eating attitude and its relationship with gender among first year MBBS students using EAT-26 questionnaire in a medical college in West Bengal: a cross-sectional study. Biomedicine (Kolkata). 2024;44(4):399-405. DOI: https://doi.org/10.51248/v44i4.122
Linardon J, Gleeson J, Yap K, Murphy K, Brennan L. Meta-Analysis of the Effects of Third-Wave Behavioural Interventions on Disordered Eating and Body Image Concerns: Implications for Eating Disorder Prevention. Cogn Behav Ther. 2019;48(1):15-38. DOI: https://doi.org/10.1080/16506073.2018.1517389 PMid:30307377
Godfrey KM, Gallo LC, Afari N. Mindfulness-based interventions for binge eating: a systematic review and meta-analysis. J Behav Med. 2015;38(2):348-362. DOI: https://doi.org/10.1007/s10865-014-9610-5 PMid:25417199
Treasure J, Claudino AM, Zucker N. Eating disorders. Lancet. 2010;375(9714):583-593. DOI: https://doi.org/10.1016/S0140-6736(09)61748-7 PMid:19931176
Stice E, Onipede ZA, Marti CN. A meta-analytic review of trials that tested whether eating disorder prevention programs prevent eating disorder onset. Clin Psychol Rev. 2021;87:102046. DOI: https://doi.org/10.1016/j.cpr.2021.102046 PMid:34048952
Holland G, Tiggemann M. A systematic review of the impact of the use of social networking sites on body image and disordered eating outcomes. Body Image. 2016;17:100-110. DOI: https://doi.org/10.1016/j.bodyim.2016.02.008 PMid:26995158
Anam H, S J, Mg R. Prevalence and Risk Factors of Eating Disorders Among Indian Adolescents. Cureus. 2025;17:e90909. DOI: https://doi.org/10.7759/cureus.90909 PMID: 41001288 PMCID: PMC12457094
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