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Eating disorders among international migrants: a systematic review and meta-analysis

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Abstract

Purpose

Migrants may have elevated exposure to stressors, which can affect their physical and mental well-being. However, migrants often experience a healthy immigrant effect, the applicability of this phenomena to eating disorders is unknown. We aimed to synthesize the available literature and estimate a summary measure of prevalence odds ratio for eating disorders in migrant populations compared to local populations.

Methods

A literature search was conducted using MEDLINE, Embase, PsycINFO, and Web of Science with keywords on migration and eating disorders. Inclusion criteria involved using a validated eating disorder scale and having a comparator group. Two independent reviewers performed study screening and data extraction. The NIH Quality Assessment Tool for Observational Cohort and Cross-Sectional Studies was used to assess risk of bias. Random-effects models of meta-analysis were applied to compare eating disorder prevalence between migrants and local populations.

Results

There were 10 studies included in our review (meta-analysis = 6, narrative synthesis = 4). Studies provided prevalence estimates for: any eating disorder, binge eating disorder, anorexia nervosa, and bulimia nervosa. Among studies with a diagnostic instrument, the pooled prevalence odds ratio (POR) between migrants and local populations for any eating disorder was 0.45 (95%CI: 0.35–0.59). However, a subgroup analysis of eating disorder instruments among studies using risk assessment tools demonstrated inconsistent findings, with both increases and decreases in prevalence.

Conclusion

Migrants were found to have a lower prevalence of eating disorders compared to local populations, supporting the healthy immigrant hypothesis. However, this effect differs between diagnostic and risk assessment tools.

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Acknowledgements

We would like to thank Peter Farrell, research librarian at uOttawa for his assistance in developing the search strategies. In addition, we would like to thank Drs. Melissa Brouwers, Manoj Lalu & Mathew McInnes for their mentorship.

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Authors and Affiliations

  1. School of Epidemiology and Public Health, University of Ottawa, Ottawa, ON, Canada

    Sara Siddiqi, Asia Akther, Dawn-Li Blair, Heidi Eccles, Brianna Frangione, Alexa Keeshan, Shubhdeep Nagi & Ian Colman

  2. Ottawa Hospital Research Institute, Ottawa, ON, Canada

    Sara Siddiqi & Alexa Keeshan

  3. Department of Neuroscience, Carleton University, Ottawa, ON, Canada

    Brianna Frangione

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  1. Sara Siddiqi
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Contributions

S.S: Conceptualization, Investigation, Data curation, Formal analysis, Visualization, Project administration, Writing – original draft, Writing – review & editing. A.A: Conceptualization, Investigation, Data curation, Formal analysis, Visualization, Writing – original draft, Writing – review & editing. D.B: Conceptualization, Investigation, Writing – original draft, Writing – review & editing. H.E: Conceptualization, Investigation, Visualization, Writing – original draft, Writing – review & editing. B.F: Conceptualization, Investigation, Data curation, Writing – original draft, Writing – review & editing. A.K: Conceptualization, Investigation, Writing – original draft, Writing – review & editing. S.N: Conceptualization, Investigation, Visualization, Writing – original draft, Writing – review & editing. I.C: Conceptualization, Supervision, Writing – review & editing.

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Correspondence to Ian Colman.

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Siddiqi, S., Akther, A., Blair, DL. et al. Eating disorders among international migrants: a systematic review and meta-analysis. Soc Psychiatry Psychiatr Epidemiol (2024). https://doi.org/10.1007/s00127-024-02666-6

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