{
  "abstract": "Background: Disordered eating behaviors (DEBs) and psychological distress may complicate type 2 diabetes mellitus (T2DM) care. Objective: To estimate the frequency of DEB screening positivity and examine associated characteristics in a Tunisian T2DM clinic sample. Methods: This cross-sectional study included 400 adults assessed between January and April 2023 using the Sick, Control, One stone, Fat, Food (SCOFF) questionnaire; Bulimic Investigatory Test Edinburgh (BITE); four-item Perceived Stress Scale (PSS-4); and Hospital Anxiety and Depression Scale (HADS). Exploratory analysis estimated crude prevalence ratios (PRs). Adjusted odds ratios (aORs) came from a logistic model including age, sex, body mass index (BMI), diabetes duration, and PSS-4. Separate secondary models replaced PSS-4 with the Hospital Anxiety and Depression Scale anxiety subscale (HADS-A) or depression subscale (HADS-D). Results: DEB positivity was 26.8% (107/400; 95% confidence interval [CI], 22.6–31.3%). Crude DEB prevalence was higher in women than men (30.4% versus 19.2%; PR, 1.58; 95% CI, 1.06–2.35), in participants with HADS-A ≥11 versus <11 (PR, 2.28; 95% CI, 1.64–3.17), and with HADS-D ≥11 versus <11 (PR, 1.49; 95% CI, 1.08–2.05). In the primary adjusted model, DEB positivity was associated with younger age (aOR per year, 0.952; 95% CI, 0.922–0.982), higher BMI (aOR per kg/m2, 1.083; 95% CI, 1.042–1.126), and higher PSS-4 (aOR per point, 1.133; 95% CI, 1.067–1.203). HADS scores were positively associated in separate adjusted models. Glycated hemoglobin (HbA1c) was high in both groups (10.36% versus 9.91%; difference, 0.45 percentage points; 95% CI, −0.01 to 0.92). Conclusions: Approximately one-quarter of this clinic sample had a positive DEB screen. Associations with psychological symptoms support attention to eating concerns and emotional well-being in diabetes care. However, cross-sectional data limit causal interpretation, and future longitudinal studies are warranted.",
  "abstract_shown": true,
  "affiliations": [
    "Research Unit on Obesity UR18ES01, Faculty of Medicine, University Tunis El Manar, 15 Rue Jebel Lakhdar, Beb Saadoun, Tunis 1007, Tunisia",
    "Faculty of Medicine, University of Tunis El Manar, Tunis, 11 Rue Jebel Lakhdar, Beb Saadoun, Tunis 1007, Tunisia",
    "National Institute of Nutrition and Food Technology of Tunis, 11 Jbal Lakhdar Street, Tunis 1007, Tunisia",
    "Higher Institute of Sport and Physical Education of Ksar Said, University of Manouba, Manouba 2010, Tunisia",
    "Physical Activity Research Unit, Sport and Health (UR18JS01), National Observatory of Sports, Tunis 1003, Tunisia",
    "Physical Education and Sports Teaching Department, Faculty of Sports Sciences, Atatürk University, Erzurum 25240, Türkiye",
    "Health Services Vocational School, Atatürk University, Erzurum 25240, Türkiye",
    "Laboratory for Industrial and Applied Mathematics (LIAM), Department of Mathematics and Statistics, York University, Toronto, ON M3J 1P3, Canada",
    "Department of Physical Education and Sport, Faculty of Sciences, Physical Education and Informatics, National University of Science and Technology Politehnica Bucharest, Pitești University Center, 060042 Pitești, Romania"
  ],
  "article_type": "research article",
  "arxiv": null,
  "author_total": 9,
  "authors": [
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        1,
        2
      ],
      "name": "Rym Ben Othman",
      "orcid": "0000-0002-2453-9778"
    },
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        2
      ],
      "name": "Syrine Trabelsi"
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    {
      "affs": [
        3,
        4
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      "name": "Ismail Dergaa",
      "orcid": "0000-0001-8091-1856"
    },
    {
      "affs": [
        5
      ],
      "name": "Halil İbrahim Ceylan",
      "orcid": "0009-0005-2214-4667"
    },
    {
      "affs": [
        6
      ],
      "name": "Deniz Öztürk",
      "orcid": "0000-0002-9939-5895"
    },
    {
      "affs": [
        7
      ],
      "name": "Nicola Luigi Bragazzi",
      "orcid": "0000-0001-8409-868X"
    },
    {
      "affs": [
        2
      ],
      "name": "Yasmine Jallouli"
    },
    {
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        8
      ],
      "name": "Valentina Stefanica",
      "orcid": "0000-0003-4031-1412"
    },
    {
      "affs": [
        0,
        1
      ],
      "name": "Henda Jamoussi",
      "orcid": "0000-0002-8215-3718"
    }
  ],
  "bibtex": "https://research.draconitic.com/paper/c5sn8e7dgqcmr.bib",
  "cited_by": 0,
  "doi": "10.3390/jcm15208115",
  "fulltext_url": "https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13706280/?tool=EBI",
  "id": "c5sn8e7dgqcmr",
  "issns": [
    "2077-0383"
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  "landing_url": "https://www.mdpi.com/2077-0383/15/20/8115",
  "language": "eng",
  "licence": "CC-BY-4.0",
  "licence_label": "CC BY 4.0",
  "licence_source": "article",
  "licence_url": "https://creativecommons.org/licenses/by/4.0/",
  "metadata_licence": null,
  "native_subjects": [
    [
      "openalex",
      "3203|Eating Disorders and Behaviors"
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  ],
  "openalex": "W7222918993",
  "pdf_url": "https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13706280/pdf/?tool=EBI",
  "pmcid": "PMC13706280",
  "pmid": null,
  "published": "2026-10-01",
  "publisher": "MDPI AG",
  "ris": "https://research.draconitic.com/paper/c5sn8e7dgqcmr.ris",
  "sources": [
    {
      "first_seen": "2026-10-30T12:20:01Z",
      "native_id": "10.3390/jcm15208115",
      "source": "crossref",
      "url": "https://www.mdpi.com/2077-0383/15/20/8115"
    },
    {
      "first_seen": "2026-10-30T12:21:49Z",
      "native_id": "PMC:PMC13706280",
      "source": "europepmc",
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  "subjects": [
    {
      "field": "medicine",
      "origin": "openalex:3203|Eating Disorders and Behaviors",
      "subfield": "psychiatry"
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  ],
  "title": "Disordered Eating Behaviors and Psychological Distress in Patients with Type 2 Diabetes Mellitus: A Cross-Sectional Study from Tunisia",
  "title_text": "Disordered Eating Behaviors and Psychological Distress in Patients with Type 2 Diabetes Mellitus: A Cross-Sectional Study from Tunisia",
  "type": "peer-reviewed",
  "updated_at": "2026-10-30T12:21:49Z",
  "url": "https://research.draconitic.com/paper/c5sn8e7dgqcmr",
  "venue": "Journal of Clinical Medicine",
  "versions": []
}