What Role Does Body Image in Relationship between Level of Health Literacy and Symptoms of Eating Disorders in Adolescents?

Zuzana Boberová,Daniela Husárová

doi:10.3390/ijerph18073482

Abstract

(1) Background: The aim of this study was to explore the associations between health literacy and symptoms for eating disorders among adolescents, taking into consideration age and gender and whether this association is mediated by body image. (2) Methods: We used data on 5054 adolescents (mean age = 13.9, 51.7% boys) from the Health Behaviour in School-Aged Children study conducted in 2018 in Slovakia. We used logistic regression models to examine associations between level of health literacy and symptoms for eating disorders mediated by body image. (3) Results: Adolescents with low and medium levels of health literacy had a higher occurrence of reporting two or more symptoms of eating disorders (odds ratio (OR)/95% CI: 2.25/1.78–2.84 and 1.37/1.15–1.65). Adjustment for body image reduced the significance of association between low level of health literacy and symptoms for eating disorders by 26.4%, and association between medium level of health literacy and symptoms for eating disorders by 29.7%. (4) Conclusions: Adolescents who have a low health literacy level were found to have a higher probability of having symptoms for eating disorders, especially when they perceive themselves as fat. The study refers to potential theoretical frameworks for health literacy intervention that may provide guidelines for the intervention design and materials.

Highlights

Weight reduction behaviour as behavioural changeswith the purpose of reducing body weight or changing body shape is the one factor compromising or benefiting the health of children and adolescents
Adolescents who had low or medium level of health literacy were more likely to report two or more symptoms of eating disorders in comparison with those who had a high level of health literacy
The association between health literacy and symptoms of eating disorders remained statistically significant after additional adjustment for body image (Model 2)

Summary

Introduction

Weight reduction behaviour as behavioural changes (dieting, physical activity, etc.). With the purpose of reducing body weight or changing body shape is the one factor compromising or benefiting the health of children and adolescents. Weight reduction behaviour in terms of unhealthy dieting behaviour, excessive weight control, and exercise and body image disturbance are considered as the risk factors for eating disorders in adolescents [9]. The Diagnostic and Statistical Manual of Mental Disorders, 5th edition (DSM-5) classifies five main categories of eating disorders, namely, anorexia nervosa, bulimia nervosa, binge eating disorders, night eating syndrome and purging disorder, and avoidant-restrictive food intake disorder [10]. Bulimia nervosa, and binge eating disorders are characterised by disturbed eating behaviour associated with concerns about weight and shape or by disinterest in food, phobic avoidance, or

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