Objective Family dysfunction and self‐esteem play an important role in the development of eating disorders (EDs), but this role has not been sufficiently examined regarding eating pathology and psychosocial quality of life (QoL), which often remains unchanged even after ED symptoms reduce. The purpose of this study was to therefore assess the mediating role of self‐esteem between family dysfunction and both eating pathology and psychosocial QoL in ED patients and controls. Method One hundred and fifty four female adult ED patients and 154 female healthy adult controls were recruited from Athens, Greece, and self‐reported measures were used to assess family dysfunction, eating pathology, self‐esteem, and psychosocial QoL. Structural equation modelling (SEM) was employed to test the mediation hypotheses. Results For both the ED and control groups, family dysfunction levels did impact eating pathology, but only through self‐esteem. Family dysfunction, self‐esteem, and eating pathology had a direct effect on both groups' psychosocial QoL. Conclusion Self‐esteem's important role in EDs was confirmed in both groups, along with its sensitivity to family dysfunction. We propose a parsimonious yet comprehensive theoretical model of the role of family dysfunction and self‐esteem in EDs which future studies should further investigate longitudinally and in other population groups.

Eating Disorders are a heterogeneous group of complex psychiatric disorders that affect physical and psychological functioning, thus compromising life itself. They are often characterized by extreme preoccupation with food, caloric intake and expenditure as well as bodily weight and shape. Additionally, individuals present several forms of recurrent compulsive behavior, such as frequent weighting, body checking, and eating rituals. In many cases food consumption is considered a" failure" and its presence in the body "harmful and even "toxic" leading the individual to adopt a wide variety of purging behaviors in order to achieve a state of mental and physical "cleanliness" Two cases of compulsive bowel emptying, one suffering from Anorexia Nervosa and one suffering from Bulimia Nervosa, are presented. The compulsive bowel emptying behavior compromised of repeated and/or prolonged voluntary tension of the abdominal and pelvic muscles as well as insertion of the figure in the rectum to "check" if the bowel has been completely empty of its content. The purpose of this behavior was to alleviate intense anxiety caused by obsessive thoughts that the individual would get "fat" and/or "dirty/intoxicated" if the bowel was not completely vacated of the stools. In both cases the compulsive behavior facilitated the manifestation of rectum prolapse that reinforced the vicious circle of the obsessive-compulsive symptomatology. diet pills and anxiolytic) overdosing are the main causative factors of ED medical complications.