Abstract
BackgroundEating disorder symptoms (EDs) have been discussed as a prominent problem among late adolescent girls with serious health risks and long-term consequences. However, there is a lack of population-based evidence on EDs comprising the age range from early adolescence to emerging adulthood as well as considering both females and males equally. Additionally, the differential role of a comprehensive set of several relevant risk factors and particularly weight- and appearance-related discrimination warrants further attention. Thus, we aimed to contribute to a better understanding of sex- and age-related differences in associations between discrimination experience and other relevant personal risk factors (body image, social media use, self-efficacy, social support) with EDs. Furthermore, we were interested in the exploration of underlying mechanisms enhancing the risk of EDs by taking discrimination experience into account.MethodsBased on a logistic regression model, we investigated associations between weight- and appearance-related discrimination and EDs while controlling for other relevant personal risk factors in a subsample of N = 8504 adolescents and emerging adults (54.4% female, mean age = 20.71 years, SD = 4.32 years) drawn from a German representative health survey (KiGGS Wave 2). In a second step, we investigated the mediating role of discrimination experience between the other risk factors and EDs with the help of a path model.ResultsWhile controlling for other relevant personal risk factors, weight- and appearance-related discrimination was significantly related to EDs. Whereas the risk of EDs was significantly enhanced in males and emerging adults frequently experiencing weight-related discrimination, adolescents showed a higher risk of EDs when experiencing appearance-related discrimination. Moreover, discrimination experience partly explained the associations between body image dissatisfaction, low self-efficacy, high media use and ED symptoms.ConclusionsThe results highlight weight- and appearance-related discrimination as one central factor to be considered in the pathogeneses of EDs and underpin the need for discrimination prevention as well as the promotion of adaptive coping with discrimination experience to reduce the risk of developing ED symptoms. Males and emerging adults need particular attention when facing weight-related discrimination whereas risk constellations and EDs particularly affecting females need further investigation.
Highlights
Eating disorder symptoms (EDs) have been discussed as a prominent problem among late adolescent girls with serious health risks and long-term consequences
In line with H1, the results from logistic regression suggest that the odds of ED symptoms are 1.57 to 2.05 respectively 1.26 to 2.15 times higher in adolescents and emerging adults with weight- and appearance-related discrimination experiences than in those without such experiences (Table 2, Model 1)
In the case of often to very often weight-related discrimination, the odds of ED symptoms were higher for males and emerging adults, suggesting that these groups need particular attention and care to avoid ED manifestations
Summary
Eating disorder symptoms (EDs) have been discussed as a prominent problem among late adolescent girls with serious health risks and long-term consequences. While the worldwide incidence rate of eating disorders (EDs) has remained relatively stable at approximately 1 to 4% over the past 20 years, there has been an increase in subthreshold symptomatology (i.e., the presence of symptoms without reaching clinical significance) in general and among late-adolescent girls in particular [3, 4]). Explanatory approaches highlight the role of social media in the development and maintenance of body image norms and corresponding eating disorder symptoms by endorsing a thin ideal in late adolescent and emerging adult females [6, 7]. The role of age and sex for developing eating disorder symptoms In general, evidence suggests that EDs most commonly develop during adolescence with an age at onset between 13 and 18 years but often occur even earlier for anorexia nervosa and later for bulimia nervosa and binge eating [1, 8]. If already present during adolescence, ED symptoms have a relatively high risk of persisting or worsening in transition to emerging adulthood [8, 11]
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