A. Salles1, E. E. Fitzimmons-Craft2, G. Nicol2, D. Wilfley2, J. Yu1, C. Herleth5, T. M. Ciesielski4, R. P. McAlister3 5McCallum Place,St. Louis, MO, USA 1Washington University in St. Louis,Surgery,St. Louis, MO, USA 2Washington University,Psychiatry,St. Louis, MO, USA 3Washington University,Obstetrics And Gynecology,St. Louis, MO, USA 4Washington University,Department Of Medicine,St. Louis, MO, USA
Introduction: There is increasing attention on the ongoing physician well-being crisis. Numerous studies have documented the high rates of burnout among physicians and, in particular, surgeons. One consequence of being a surgeon is having little time for eating and drinking. This may, in turn, be associated with disordered eating, which can include episodes of eating in which people feel they cannot control what or how much they eat. In this study, we assessed surgical trainees across multiple specialties at one institution for evidence of disordered eating. We also assessed whether stress and burnout are associated with disordered eating.
Methods: We invited all surgical residents at Washington University School of Medicine in St. Louis to participate in a voluntary online survey regarding eating behaviors and well-being in spring 2018. Measures included the Dutch Eating Behaviour Questionnaire (DEBQ), Cohen’s perceived stress scale (PSS), and representative items from the emotional exhaustion and depersonalization subscales of the Maslach Burnout Inventory (MBI).
Results: A total of 146 trainees participated in the survey (response rate 67%; 54% women). The scores on the key measures are shown in the table. The perceived stress scale (r=0.24, p=0.007) and both subscales of the MBI (emotional exhaustion r=0.29, p<0.001; depersonalization r=0.33, p<0.001) were significantly associated with disordered eating as measured by the DEBQ. In regression analyses controlling for gender and post-graduate year, these relationships remained statistically significant (B=1.74, p=0.04 for perceived stress, B=3.71, p=0.004 for emotional exhaustion, B=4.20, p=0.03 for depersonalization) such that more stress and more burnout were associated with more disordered eating.
Conclusion: This is the first study we are aware of that examines disordered eating among surgical residents. Our results suggest that surgical trainees are affected by disordered eating which was associated with stress and burnout. These data are cross-sectional in nature, so no causation can be inferred. Future studies should examine the effects of interventions targeting healthy eating behaviors and well-being outcomes including burnout. Something as simple as providing easy access to food and drink may counteract the tendency toward disordered eating, which may be in part fueled by limited time for eating and drinking during working hours. Any intervention aimed at improving eating behaviors will be most likely to be successful as part of a comprehensive well-being program.
