Abstract
Eating disorders (EDs) are a complex group of psychiatric conditions that involve dysfunctional eating patterns, nutritional alterations, and other comorbid psychopathologies. Some women with EDs may develop problematic internet use while they attempt to get information on dieting/weight control or get online support from people with similar problems. They may also drift toward tobacco smoking as a method to regulate their weight or to cope with their weight-related dysphoria. The occurrence of these conditions in EDs may prolong disease course and impede recovery. This study used structural equation modeling to investigate nutritional status (noted by body mass index, BMI), depression psychopathology, internet addiction (depicted by the Internet Addiction Test), Facebook addiction (depicted by the Bergen Facebook Addiction Scale), and smoking among 123 Spanish women diagnosed with EDs (mean age = 27.3 ± 10.6 years). History of hospitalization, marital status, age, and the level of education predicted BMI in certain ED groups. BMI did not predict depression, but it predicted internet addiction, Facebook addiction, and smoking in certain ED groups. Depression did not predict BMI, internet/Facebook addition, or smoking in any ED group. Some sociodemographic and clinical variables had indirect effects on depression, internet addiction, and Facebook addiction while age was the only variable expressing a direct effect on all outcome measures. Age, education, and history of prolonged treatment predicted smoking in certain ED patients. The findings signify that a considerable target for interventional strategies addressing nutritional and addictive problems in EDs would be women with high BMI, history of hospitalization, history of prolonged treatment, who are particularly young, single, and less educated. Replication studies in larger samples, which comprise various subtypes of EDs from both genders, are warranted to define the exact interaction among the addressed variables.
Highlights
Eating disorders (EDs) are a complex group of psychiatric conditions entailing dysfunctional eating patterns that are associated with other mental and physical symptoms [1,2,3]
Marital status and internet addiction showed a trend toward significance χ
The non-significant χ 2 index of overall model fit resulting from maximum likelihood (ML) with bootstrap analysis shown in Table 3 indicates that the used models fitted the data on a global basis
Summary
Eating disorders (EDs) are a complex group of psychiatric conditions entailing dysfunctional eating patterns that are associated with other mental and physical symptoms [1,2,3]. BMI is an indicator of nutritional status, which is obviously altered in EDs due to excessive dieting (e.g., underweight in patients with AN) or overweight/obesity due to excessive intake of calories in response to aversive environmental stimuli [e.g., in patients with BED and addictive eating disorders; [1, 4, 5]]. The latter involve less control over eating, frequent thinking about food, eating when not hungry, and even withdrawal-like symptoms when some foods (e.g., non-nutritive sugar and processed food) are not available [1]. The interaction between BMI and dysphoric mood is complex entailing an interplay among several dietary, psychological, sociodemographic, and medication factors [2, 8, 13, 15,16,17]
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