Eating Disorder Risk and Its Biobehavioural Correlates in Italian University Students: The UniFoodWaste Study.

Background/Objectives: To assess the prevalence of eating disorder (ED) risk in a sample of Italian university students and to examine its independent associations with mental health indicators, self-rated health, body mass index (BMI), lifestyle behaviours, and engagement with digital food-related applications. Methods: Of the 2779 Italian university students who accessed the survey, 2691 completed and were included in the analysis. ED risk was assessed with the validated 5-item SCOFF questionnaire. Exposure included socio-demographics, BMI, depressive symptoms (PHQ-9), self-rated health, adherence to the Mediterranean diet (Medi-Lite), smoking, alcohol use (AUDIT-C), and use of food delivery and food waste apps. Multivariable logistic regression models, stratified by sex, and adjusted by age and education, estimated associations with ED risk. Results: Overall, 34.6% of participants screened positive for ED risk (women 39.5%, men 21.8%). Smoking and use of food delivery apps and food waste apps were independently associated with ED risk. Clinically relevant depressive symptoms (PHQ-9 ≥ 10) (aOR 3.37, 95% CI 2.82-4.02) and poor/fair self-rated health (aOR 2.45, 95% CI 1.93-3.11) showed the strongest association. Overweight (aOR 1.47, 95% CI 1.06-2.03) and obesity (aOR 2.48, 95% CI 1.53-4.01) increased the likelihood of ED risk. Risky alcohol use was also associated (aOR 1.42, 95% CI 1.15-1.75). Conclusions: More than one in three Italian university students is at risk for an ED, highlighting a substantial public health concern. Strong links with depression, perceived poor health, digital food app use, and unhealthy behaviours underscore the need for early screening and integrated mental health and nutrition interventions within university settings.