Prevalence and association between eating disorders, depression, and obesity among Palestinian adolescent refugees.

backgroundRefugee children often experience high levels of stress and poor quality of life, which can increase their vulnerability to depression, substance use, and obesity. Previous research has highlighted a significant prevalence of obesity among Palestinian refugees, particularly among children. This study aimed to explore sex-based differences in eating disorders among Palestinian adolescent refugees and to investigate potential associations with central obesity, depression, and disordered eating behaviors.

methodsA cross-sectional study was conducted among refugee teenagers aged 13–16 years in four West Bank refugee camps. A total of 313 teenagers were interviewed. Data, including waist circumference (WC) and body mass index (BMI), were collected through structured interviews and anthropometric measurements. The interviews included the Birleson Depression Self-Rating Scale and the Eating Attitudes Test-26 (EAT-26), a screening tool used to detect individuals at risk for disordered eating behaviors but who are not diagnosed with specific eating disorders. Behavior-related questions were also included.

resultsAmong the 313 participants, 51.7% were boys, 9.5% had increased WC, 22.3% were overweight, and 24.4% were obese. Additionally, 16.8% reported tobacco smoking, with a significantly higher prevalence among boys (26.6%) than girls (3.1%) (P value < 0.001). The prevalence of depression was 36.3%, and 27.5% of the participants scored ≥ 20 on the EAT-26. Moreover, 17.2% of the adolescents were identified as needing evaluation by a mental health professional. Girls had higher diet subscale scores (P value = 0.002), whereas boys had higher total behavior scores (P value = 0.004). Adjusted binary logistic regression identified several risk factors for disordered eating behaviors: female sex (OR = 2.25, P value = 0.004), high depression scores (OR = 2.251, P value = 0.004), working after school (OR = 2.492, P value = 0.028), and central obesity (OR = 5.83, P value = 0.003).

conclusionThis study revealed a significant prevalence of disordered eating behaviors and depression among adolescent refugees in the West Bank. Gender differences were evident, with girls showing more cognitive dietary concerns and boys displaying more behavioral risk patterns. These findings highlight the importance of early identification of at-risk individuals via tools such as the EAT-26, and they call for targeted, gender-sensitive mental health and nutritional interventions to support the well-being of refugee adolescents.