title: Risk of eating disorders in a non-western setting: an exploratory study in Khartoum state, Sudan.
abstract: OBJECTIVE
  Recent research suggests an emergence of eating disorders [ED] in non-western settings for unknown reasons. This research investigates the presence of ED in Khartoum State [Sudan], and explores relevant factors amongst women at risk of ED and stakeholders involved with mental health care and policy-making.
  
  
  METHODS
  Women from four summer schools were approached and screened for risk of ED using a validated and adapted form of the Eating Attitudes Test-26. Focus groups were performed within the schools, selected participants at high risk were interviewed, and interviews with stakeholders were performed.
  
  
  RESULTS
  Around a third (32.6%) of participants scored as having high risk of ED. Interviews showed recurring themes determining eating attitudes including: intention, knowledge, environment and habit. Stakeholders' opinions depended on whether they work directly with those affected by ED or in policy-making. The former advocated increased attention on ED, the latter did not. Overall, services for ED were lacking.
  
  
  CONCLUSIONS
  A high presence of negative eating attitudes was found amongst screened participants with high risk of ED. Individual intention overrides all other determinants for abnormal eating. Moreover, evidence suggests that westernization may attribute to ED, supporting the view that ED are culturally bound. The differing stakeholders' views, together with other data found in this study, allow a number of recommendations for increasing awareness and identification of ED in Sudan.
authors: Faculty of Health, Medicine and Life Sciences, University of Maastricht, Universiteitssingel 60, 6229 ER, Maastricht, The Netherlands.
authors: Charlotte C L
authors: CCL
authors: Lau
authors: Department of Genetics and Cell Biology, Faculty of Health, Medicine and Life Sciences, Institute of Public Health Genomics, Research Institute GROW, University of Maastricht, Universiteitssingel 50, 6229 ER, Maastricht, The Netherlands. e.ambrosino@maastrichtuniversity.nl.
authors: Elena
authors: http://orcid.org/0000-0001-6975-8213
authors: E
authors: Ambrosino
mesh_terms: D000293:Adolescent; D003469:Culture; D001068:Feeding and Eating Disorders / Q000175:diagnosis*; D005260:Female; D017144:Focus Groups; D006801:Humans; D012306:Risk; D013397:Sudan; D011795:Surveys and Questionnaires; D055815:Young Adult
keywords: Culture; Determinants; Eating disorder behaviors; Non-western setting; Sudan; Women