The results of our study showed that there is a higher risk of a positive screening for AN or BN and NES in doctors in training in our population (48.8%) compared to the young population of northeastern Mexico (27.6%). The risk is also higher than the data previously reported in international studies on EDs in doctors in training (that varies according to studies between 10–30%) [11, 12].

EDs are very frequently studied in the student population, generally in the adolescent population. There are few studies in graduate students and/or those studying a medical specialty or an undergraduate internship. Therefore, it is important to know the frequency of these disorders and to implement actions to improve their lifestyle.

In other Latin American countries such as Peru or Colombia, studies have been conducted where the prevalence of AN and BN in medical students has been reported to vary from 12.5 to 39.7% respectively, although it is important to emphasize that in both studies’ different questionnaires and instruments have been used for the detection of these disorders. Also, important to consider the cultural diversity of different countries and social customs [26,27,28].

On the other hand, the prevalence of NES in our population of 32.6% also exceeded that of the reviewed literature reported worldwide of 1.5%, although it is important to mention that there are not many studies on NES in the general population or in the medical student setting [8]. In a study conducted in Saudi Arabia in a medical student population, the prevalence was found to be 10% using the same instrument as our study. Although it is important to mention that in other studies that have been performed the cut-off point for considering positive NEQ varies from 25 or 30 [29].

Although the prevalence was higher in our study population, no significant associations were found between the risk factors that have been described as the most common for developing EDs. There are associations that are already well documented, such as the risk of developing AN or BN with age, female sex, and an overweight or obese BMI for NES [12,13,14,15,16]. However there have been inconsistent association in the literature also [7, 8]. The most frequent risk factor in the literature is female sex, which in our study was not statistically significant [12]. However, we found that the first year of medical specialty were most likely to have a positive screening questionnaire for AN or BN. Our hypothesis is that the first year of a residency program is related to adjusting to a new environment with higher stress, a higher level of responsibility in the hospital with less expertise. Also, less time to eat and rest and high competitiveness and expectations of academic performance would make doctors in training start developing an eating disorder.

We also observed an increase in BMI in persons with at least one positive questionnaire, this may be due to an insufficient number of questionnaires completed, or to some other factor such as work stress or inadequate sleep quality, which were factors that were not considered in the study.

As mentioned above, EDs can have a variety of consequences; for example: risk of obesity, mental problems (depression, anxiety, among others), substance abuse, pharmacological measures to reduce weight, chronic stress that contributes to metabolic or cardiovascular diseases. Therefore, timely identification and prevention of these disorders is of utmost importance, although a main barrier to achieving this is the social stigma that exists around these disorders. It has been established that those who are exposed to prevention or early identification strategies increase their probability of recovery [30].

The strategies that currently exist for the prevention and management of EDs that have proven to be effective in reducing risk factors include identification of modifiable risk factors, promotion of healthy lifestyle, positive body image, balanced nutrition and physical activity, interactive tools that increase the participation of the young population and help them cope with the diagnosis and include long-term follow-up. However, there is currently insufficient information in the literature focused on EDs prevention programs that have a significant impact on reducing the frequency of EDs [31].

In the four private hospitals in our study, there are resources to support doctors in training by the affiliated university, such as the center for anxiety treatment and research, with which we could work to implement timely and early interventions on an individualized basis for fellow physicians who require both accompaniment and follow-up as well as channeling to more specialized help for their benefit. The inclusion of a multidisciplinary team providing support from a mental health professional has been reported in studies of EDs prevention as vital in prevention and early detection programs [32, 33].

It is also important to mention the limitations of the study, among which are the type of study, which was a cross-sectional survey and therefore no causal association was made. Also, the lack of parametric tests and inclusion of other sociodemographic variables that would be useful to extend the information on associated risk factors in our population, as well as the inclusion of another group of participants outside the medical area for comparative purposes. On the other hand, some of the data were provided by each participant subjectively and could be over or underestimated.