Quality of Life Research

, Volume 25, Issue 10, pp 2603–2610 | Cite as

Eating disorder features and quality of life: Does gender matter?

  • Allison F. Wagner
  • Emily C. Stefano
  • David C. Cicero
  • Janet D. Latner
  • Jonathan M. Mond



This study examined whether gender moderates the associations between eating disorder features and quality-of-life impairment and whether eating disorder features can explain gender differences in quality of life in a sample of undergraduate students.


The SF-12 Physical and Mental Component Summary Scales were used to measure health-related quality of life (HRQoL), and the Eating Disorders Examination Questionnaire (EDE-Q) was used to quantify eating disorder behaviors and cognitions. These self-report forms were completed by undergraduate men and women (n = 709).


Gender was a significant predictor of mental HRQoL, such that women in this sample reported poorer mental HRQoL than men. Eating disorder cognitions were the strongest predictor of undergraduate students’ mental and physical HRQoL, while binge eating negatively predicted their physical HRQoL only. Gender was not found to moderate the associations between eating disorder features and HRQoL, and eating disorder cognitions were found to mediate the association between gender and mental HRQoL such that a proportion of the difference between undergraduate men and women’s mental HRQoL was attributable to eating disorder cognitions.


This study provided further evidence of the significant impact of eating disorder features, particularly eating disorder cognitions, on HRQoL. The finding that gender did not moderate the relationships between eating disorder features and HRQoL indicates the importance of investigating these features in both men and women in future research.


Eating disorders Quality of life Eating disorder behaviors Eating disorder cognitions 


  1. 1.
    DeJong, H., Odershaw, A., Sternheim, L., et al. (2013). Quality of life in anorexia nervosa, bulimia nervosa, and eating disorder not-otherwise-specified. Journal of Eating Disorders, 1(43), 1–8.Google Scholar
  2. 2.
    Jenkins, P. E., Hoste, R. R., Meyer, C., & Blissett, J. M. (2011). Eating disorders and quality of life: A review of the literature. Clinical Psychology Review, 31(1), 113–121.CrossRefPubMedGoogle Scholar
  3. 3.
    Bijl, R. V., & Ravelli, A. (2000). Current and residual functional disability associated with psychopathology- Findings from the Netherlands Mental Health Survey and Incidence Study (NEMESIS). Psychological Medicine, 30(3), 657–668.CrossRefPubMedGoogle Scholar
  4. 4.
    Bentley, C., Mond, J., & Rodgers, B. (2014). Sex differences in psychosocial impairment associated with eating-disordered behavior: What if there aren’t any? Eating Behaviors, 15(4), 609–614.CrossRefPubMedGoogle Scholar
  5. 5.
    Mond, J., Mitchison, D., Latner, J., Hay, P., Owen, C., & Rodgers, B. (2013). Quality of life impairment associated with body dissatisfaction in a general population sample of women. BMC Public Health, 13, 920.CrossRefPubMedPubMedCentralGoogle Scholar
  6. 6.
    Jenkins, P. E., Hoste, R. R., Doyle, A. C., et al. (2014). Health-related quality of life among adolescents with eating disorders. Journal of Psychosomatic Research, 76(1), 1–5.CrossRefPubMedGoogle Scholar
  7. 7.
    Latner, J. D., Mond, J. M., Vallance, J. K., Gleaves, D. H., & Buckett, G. (2013). Quality of life impairment and the attitudinal and behavioral features of eating disorders. Journal of Nervous and Mental Disease, 201(7), 592–597.CrossRefPubMedGoogle Scholar
  8. 8.
    Sanftner, J. L. (2011). Quality of life in relation to psychosocial risk variables for eating disorders in women and men. Eating Behaviors, 12(2), 136–142.CrossRefPubMedGoogle Scholar
  9. 9.
    Mitchison, D., & Mond, J. (2015). Epidemiology of eating disorders, eating disordered behaviour, and body image disturbance in males: A narrative review. Journal of Eating Disorders, 3(1). doi: 10.1186/s40337-015-0058-y.
  10. 10.
    Lewinsohn, P. M., Seeley, J. R., Moerk, K. C., & Striegel-Moore, R. H. (2002). Gender differences in eating disorder symptoms in young adults. International Journal of Eating Disorders, 4, 426–440.CrossRefGoogle Scholar
  11. 11.
    Mitchison, D., Mond, J., Slewa-Younan, S., & Hay, P. (2013). Sex differences in health-related quality of life impairment associated with eating disorder features: A general population study. International Journal Eating Disorders, 46(4), 375–380.CrossRefGoogle Scholar
  12. 12.
    Mond, J. M., & Hay, P. J. (2007). Functional impairment associated with bulimic behaviors in a community sample of men and women. International Journal of Eating Disorders, 40(5), 391–398.CrossRefPubMedGoogle Scholar
  13. 13.
    Linzer, M., Spitzer, R., Kroenke, K., et al. (1996). Gender, quality of life, and mental disorders in primary care: Results from the PRIME-MD 10000 study. The American Journal of Medicine, 101, 526–533.CrossRefPubMedGoogle Scholar
  14. 14.
    Fairburn, C. G., & Beglin, S. J. (1994). Assessment of eating disorders: Interview or self-report questionnaire? International Journal of Eating Disorders, 16(4), 363–370.PubMedGoogle Scholar
  15. 15.
    Peterson, C. B., Crosby, R. D., Wonderlich, S. A., et al. (2007). Psychometric properties of the eating disorder examination-questionnaire: Factor structure and internal consistency. International Journal of Eating Disorders, 40(4), 386–389.CrossRefPubMedGoogle Scholar
  16. 16.
    White, H. J., Haycraft, E., Goodwin, H., & Meyer, C. (2014). Eating disorder examination questionnaire: Factor structure for adolescent girls and boys. International Journal of Eating Disorders, 47(1), 99–104.CrossRefPubMedGoogle Scholar
  17. 17.
    Carter, J. C., Aime, A. A., & Mills, J. S. (2001). Assessment of Bulimia Nervosa: A comparison of interview and self-report questionnaire methods. International Journal of Eating Disorders, 30(2), 187–192.CrossRefPubMedGoogle Scholar
  18. 18.
    Luce, K. H., & Crowther, H. J. (1999). The reliability of the Eating Disorder Examination–Self-Report Questionnaire Version (EDE-Q). International Journal of Eating Disorders, 25(3), 349–351.CrossRefPubMedGoogle Scholar
  19. 19.
    Hay, P. J., & Mond, J. M. (2005). How to ‘count the cost’ and measure burden? A review of health-related quality of life in people with eating disorders. Journal of Mental Health, 14(6), 539–552.CrossRefGoogle Scholar
  20. 20.
    Ware, J. E., Kosinski, M., & Keller, S. (1996). A 12-item short-form health survey: Construction of scales and preliminary reliability and validity. Medical Care, 34(3), 220–233.CrossRefPubMedGoogle Scholar
  21. 21.
    Hays, R. D. (1998). RAND-36 Health Status Inventory. San Antonio: The Psychological Corporation.Google Scholar
  22. 22.
    Mond, J. M., Hay, P. J., Paxton, S. J., et al. (2010). Eating disorders “mental health literacy” in low risk, high risk and symptomatic women: Implications for health promotion programs. Eating Disorders, 18, 267–285.CrossRefPubMedGoogle Scholar
  23. 23.
    Raque-Bogdan, T. L., Ericson, S. K., Jackson, J., Martin, H. M., & Bryan, N. A. (2011). Attachment and mental and physical health: Self-compassion and mattering as mediators. Journal of Counseling Psychology, 58(2), 272–278.CrossRefPubMedGoogle Scholar
  24. 24.
    Mond, J. M., Hay, P. J., Rodgers, B., & Owen, C. (2011). Mental health impairment associated with eating-disorder features in a community sample of women. Journal of Mental Health, 20(5), 456–466.CrossRefPubMedGoogle Scholar
  25. 25.
    Mond, J. M., Hay, P. J., Rodgers, B., & Owen, C. (2007). Recurrent binge eating with and without the “undue influence of weight or shape on self-evaluation”: Implications for the diagnosis of binge eating disorder. Behaviour Research and Therapy, 45, 929–938.CrossRefPubMedGoogle Scholar
  26. 26.
    Hayes, A. F. (2014). PROCESS macro (Version 2.13) [Software].
  27. 27.
    Baron, R. M., & Kenny, D. A. (1986). The moderator-mediator variable distinction in social psychological research: Conceptual, strategic, and statistical considerations. Journal of Personality and Social Psychology, 51(6), 1173–1182.CrossRefPubMedGoogle Scholar
  28. 28.
    Mond, J. M., Hay, P. J., Rodgers, B., & Owen, C. (2006). Eating Disorder Examination Questionnaire (EDE-Q): Norms for young adult women. Behaviour Research and Therapy, 44, 53–62.CrossRefPubMedGoogle Scholar
  29. 29.
    Heck, R., & Thomas, S. (2015). An introduction to multilevel modeling techniques: MLM and SEM approaches using Mplus (3rd ed.). New York: Routledge.Google Scholar
  30. 30.
    Rubin, D. B. (1987). Multiple imputation for nonresponse in surveys. New York: Wiley.CrossRefGoogle Scholar
  31. 31.
    Gamma, A., & Angst, J. (2001). Concurrent psychiatric comorbidity and multimorbidity in a community study: Gender differences and quality of life. European Archives of Psychiatry and Clinical Neuroscience, 251(2), 43–46.CrossRefGoogle Scholar
  32. 32.
    Garner, R. E., Feeny, D. H., Thompson, A., et al. (2012). Bodyweight, gender, and quality of life: A population-based longitudinal study. Quality of Life Research, 21(5), 813–825.CrossRefPubMedGoogle Scholar
  33. 33.
    White, S., Reynolds-Malear, J. B., & Cordero, E. (2011). Disordered eating and the use of unhealthy weight control methods in college students: 1995, 2002, and 2008. Eating Disorders: Journal of Treatment and Prevention, 19(4), 323–334.CrossRefGoogle Scholar
  34. 34.
    Wilfley, D. E., Schwartz, M. B., Spurrell, E. B., & Fairburn, C. G. (1997). Assessing the specific psychopathology of binge eating disorder patients: Interview or self-report? Behaviour Research and Therapy, 35(12), 1151–1159.CrossRefPubMedGoogle Scholar
  35. 35.
    Mitchison, D., Hay, P. J., Morin, A., Slewa-Younan, S., & Mond, J. M. (2015). The bidirectional relationship between quality of life and eating disorder symptoms: A 9-year community-based study of Australian women. PLoS One, 10(3), e0120591. doi: 10.1371/journal.pone.0120591.
  36. 36.
    Mond, J. M., Hay, P. J., Rodgers, B., Owen, C., & Beumont, P. J. V. (2005). Assessing quality of life in eating disorder patients. Quality of Life Research, 14, 171–178.CrossRefPubMedGoogle Scholar
  37. 37.
    Engel, S. G., Wittrock, D. A., Crosby, R. D., Wonderlich, S. A., Mitchell, J. E., & Kolotkin, R. L. (2006). Development and validation of an eating-disorder specific health-related quality of life instrument. International Journal of Eating Disorders, 39(1), 62–71.CrossRefPubMedGoogle Scholar
  38. 38.
    Bohn, K., & Fairburn, C. G. (2008). Clinical Impairment Assessment Questionnaire (CIA 3.0) Cognitive Behavior Therapy and Eating disorders. New York: Guilford Press.Google Scholar

Copyright information

© Springer International Publishing Switzerland 2016

Authors and Affiliations

  • Allison F. Wagner
    • 1
  • Emily C. Stefano
    • 1
  • David C. Cicero
    • 1
  • Janet D. Latner
    • 1
  • Jonathan M. Mond
    • 2
  1. 1.Department of PsychologyUniversity of Hawai`i at ManoaHonoluluUSA
  2. 2.Macquarie UniversitySydneyAustralia

Personalised recommendations