Differences in severity of eating disorder symptoms between adults with depression and adults with anxiety



Anxiety and depression are both considered maintaining factors for eating disorders (ED) but it is still unclear if one is more strongly associated with ED symptoms than the other. We examined differences in severity of ED symptoms among adults with either, both, or neither depression and anxiety.


Volunteers (N = 3,780) to the project implicit mental health website (https://implicit.harvard.edu/) self-reported their ED status (current ED: n = 374, past ED: n = 436; no ED: n = 2,970), their current depression/anxiety status, and their ED symptoms (using the Eating Attitudes Test). ANOVAs with post hoc comparisons were used to examine relationships between ED symptoms and comorbid depression/anxiety status among currently ill, recovered, and never ill individuals.


Participants without comorbidities had the least and participants with both comorbidities had the most severe ED symptoms (p = .021). Participants with anxiety alone had more severe ED symptoms relative to those with depression alone across groups (current ED: p = .024; past ED: p = .019; no EDs: p = .021).


These findings demonstrate, in contrast with an earlier study among youth with EDs (Hughes et al., 2013), that comorbid anxiety may be linked with more severe ED symptoms relative to comorbid depression. It is possible that anxiety serves as a maintaining factor for ED symptoms such that dieting and other ED-related behaviors may function to modulate symptoms of anxiety.

Level of evidence

Level III, case-control analytic study.

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Data availability statement

Approval to use the data was obtained from Dr. Bethany A Teachman (PhD) from the University of Virginia (USA). Data available on request from the first author (REB).


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Correspondence to Roni Elran-Barak.

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Dr. Bethany A Teachman (PhD) from the University of Virginia (USA) was responsible for data collection. This study was approved by the University of Virginia Institutional Review Board for the Social and Behavioral Sciences.

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Informed consent was obtained from all individual participants included in the study.

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Elran-Barak, R., Goldschmidt, A.B. Differences in severity of eating disorder symptoms between adults with depression and adults with anxiety. Eat Weight Disord (2020). https://doi.org/10.1007/s40519-020-00947-y

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  • Eating disorders
  • Depression
  • Anxiety
  • Comorbidity