title: War stress may be another risk factor for eating disorders in civilians: a study in Lebanese university students.
abstract: OBJECTIVE
  Traumatic life events are important risk factors for eating disorders (ED). War has been associated, in military populations, with an increased post-service incidence of ED and an increased mean body mass index. We hypothesize that a modification of eating behavior (EB) related to stress during wartime may increase the risk of developing an ED later on among civilians exposed to war stress during adulthood.
  
  
  METHODS
  This descriptive cross-sectional study was performed in a group of 303 undergraduate young adult students of both sexes from Lebanon, 6 months after the July 2006 war. Modification of EB during wartime, sociodemographic and other potential risk factors were assessed retrospectively. Students were then screened for ED using the SCOFF questionnaire.
  
  
  RESULTS
  SCOFF was positive in 31.4% of the students, with a mean value 41.6% higher among subjects who reported an altered EB during the war. Among subjects with a positive SCOFF screening, 71% had experienced a change of EB during wartime. Alteration of EB during war was related to an odds ratio for a positive SCOFF screening of 2.6 (95% CI 1.54-4.34) and 1.8 (95% CI 1.01-3.21) for non-adjusted and adjusted analysis, respectively.
  
  
  CONCLUSIONS
  Modification of EB related to stress during wartime is associated with an increased risk of eating disorders. Early detection and treatment of eating disorders may be improved by routinely evaluation of EB modification in patients with a past history of war exposure.
authors.affiliation: Saint Joseph University, Beirut 1104-2020, Lebanon.
authors.forename: Antoine
authors.initials: A
authors.lastname: Aoun
authors.forename: Frederico Duarte
authors.initials: FD
authors.lastname: Garcia
authors.forename: Caroll
authors.initials: C
authors.lastname: Mounzer
authors.forename: Sani
authors.initials: S
authors.lastname: Hlais
authors.forename: Sebastien
authors.initials: S
authors.lastname: Grigioni
authors.forename: Khalil
authors.initials: K
authors.lastname: Honein
authors.forename: Pierre
authors.initials: P
authors.lastname: Déchelotte
mesh_terms: D000293:Adolescent; D000856:Anorexia Nervosa / Q000453:epidemiology* / Q000523:psychology; D052018:Bulimia Nervosa / Q000453:epidemiology* / Q000523:psychology; D003430:Cross-Sectional Studies; D005247:Feeding Behavior / Q000523:psychology*; D005260:Female; D006801:Humans; D007861:Lebanon; D008297:Male; D012307:Risk Factors; D013315:Stress, Psychological / Q000453:epidemiology* / Q000523:psychology; D013334:Students / Q000523:psychology* / Q000706:statistics & numerical data; D014495:Universities; D014857:Warfare; D055815:Young Adult