Eating disorders and eco-anxiety: exploring mental health challenges in university students

Climate change is a major global challenge with profound psychological impacts, including eco-anxiety, defined as a chronic fear of environmental catastrophe. Despite its potential role of exacerbating vulnerabilities to maladaptive coping mechanisms such as eating disorders (EDs), the relationship between eco-anxiety and eating disorders EDs remains underexplored, particularly in student populations. This study aimed to investigate the associations between eco-anxiety, EDs, and psychological variables among university students.

A cross-sectional study was conducted among students, using an anonymous online questionnaire. Eco-anxiety was measured with the Hogg Eco-Anxiety Scale (HEAS-13), EDs were screened using the SCOFF questionnaire combined with body mass index to classify EDs into four categories: restrictive, hyperphagic, bulimic, and others. Additional measures included depression (CESD-8), insomnia severity (ISI), burnout (MBI-SS), and pro-environmental behaviors (PEBs). Multivariate analyses were used to identify determinants of EDs, and Multiple Correspondence Analysis (MCA) was conducted to explore relationships between categorical variables.

A total of 1826 university students were included. Overall, 47.3% of the sample screened positive for a probable ED, with a higher prevalence among women (53.6%) compared to men (29.2%).; (p < 0.0001). Higher eco-anxiety quartile was associated with restrictive, hyperphagic, and bulimic EDs in multivariate model. By adding depression in the multivariate model, associations with restrictive and hyperphagic EDs diminished, suggesting a mediating role for depression. In contrast, eco-anxiety maintained a direct effect on bulimic EDs. The MCA revealed distinct clusters, with high eco-anxiety, insomnia, and depression closely linked to restrictive and hyperphagic EDs. Bulimic EDs were associated with intermediate levels of eco-anxiety and emotional exhaustion.

The study underscores eco-anxiety as an emerging risk factor for EDs, mediated in part by depression and other psychological factors. Differences in mechanisms across ED subtypes suggest that eco-anxiety contributes both directly and indirectly. This study enriches the knowledge by demonstrating how environmental stressors intersect with mental health and eating behaviors in vulnerable populations like university students. Public health initiatives should address eco-anxiety and its psychological sequelae to mitigate the risk of EDs, emphasizing tailored interventions based on ED subtype.