Reciprocal longitudinal relations between weight/shape concern and comorbid pathology among women at very high risk for eating disorder onset
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Understanding how known eating disorder (ED) risk factors change in relating to one another over time may inform efficient intervention targets. We examined short-term (i.e., 1 month) reciprocal longitudinal relations between weight/shape concern and comorbid symptoms (i.e., depressed mood, anxiety) and behaviors (i.e., binge drinking) over the course of 24 months using cross-lagged panel models.
Participants were 185 women aged 18–25 years at very high risk for ED onset, randomized to an online ED preventive intervention or waitlist control. We also tested whether relations differed based on intervention receipt.
Weight/shape concern in 1 month significantly predicted depressed mood the following month; depressed mood in 1 month also predicted weight/shape concern the following month, but the effect size was smaller. Likewise, weight/shape concern in 1 month significantly predicted anxiety the following month, but the reverse was not true. Results showed no temporal relations between weight/shape concern and binge drinking in either direction. Relations between weight/shape concern, and comorbid symptoms and behaviors did not differ based on intervention receipt.
Results support focusing intervention on reducing weight/shape concern over reducing comorbid constructs for efficient short-term change.
Level of evidence
Level I, evidence obtained from a properly designed randomized controlled trial.
KeywordsWeight/shape concern Comorbidity Eating disorder College-age women
This research was supported by R01 MH081125, R01 MH100455, T32 HL007456, and F32 HD089586 from the National Institutes of Health and T32 HS00078 from the Agency for Healthcare Research and Quality.
Compliance with ethical standards
Conflict of interest
On behalf of all authors, the corresponding author states that there is no conflict of interest. The datasets during and/or analyzed during the current study are available from the corresponding author on reasonable request.
All procedures performed in this study were in accordance with the ethical standards of the institutional review boards of the coordinating institutions and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.
Informed consent was obtained from all individual participants included in the study.
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