Substance use associated with eating attitudes and behaviors, neglected health issues among Palestinian refugees

Objective: We aimed to investigate substance use and its association with eating attitudes and behaviors among male Palestinian refugees.Methods: In a cross-sectional study, male Palestinian refugees(N = 566) were recruited to fill out self-administrated questionnaire on eating attitudes and behaviors (EAT-26) and to give urine samples to test current illicit drug use.Results: The response rate was 47.7%. Substance use was highly prevalent among participants (28.9%). The percentage of participants with eating disorders (ED) among substance users was as follows: Any illicit drug (30.8%), benzodiazepine (32.6%), methamphetamines(40.7%), amphetamine (39.3%), tetrahydrocannabinol (25.8%), barbiturates (20%),and alcohol (12.50%). Obese participants were at higher risk of having ED(OR = 2.344, p < .05) than underweight participants. Binge eaters were more likely to be tetrahydrocannabinol users (OR = 2.745, p < .05). Increased riskof self-induced vomiting behavior was associated with binge behavior (OR = 5.97, p < .05, laxative use (OR = 26.38, p < .01), barbiturates use (OR = 59.36, p < .05), waterpipe smoking (OR = 8.62, p < .05), vape smoking (OR = 10.37, p < .05), and inversely associated with age (OR = 0.832, p < .001).Conclusion: Findings from this study demonstrated a substantially increased frequency of substance use among Palestinian refugees with ED and unhealthy weight control behaviors. This study highlighted new challenge for the health system to deal with new emerging health conditions among male refugees.