Bidirectional Relations Between Disordered Eating, Internalization of Beauty Ideals, and Self-Esteem: A Longitudinal Study With Adolescents

Abstract

Associations between disordered eating, internalization of beauty ideals, and self-esteem have been mainly studied in a unidirectional way. Therefore, this study explored the potential bidirectional associations between these three aspects, in a sample of 303 adolescents aged 12 to 15 (140 females and 163 males), in a 16-month longitudinal prospective study. Participants self-reported disordered eating, internalization of beauty ideals, and self-esteem. Autoregressive cross-lagged analyses showed bidirectional associations between self-esteem and disordered eating and unidirectional links between internalization of beauty ideals and disordered eating and lower self-esteem. All cross-lagged effects were equivalent across genders, except that the effect of internalization of beauty ideals at baseline on disordered eating 4 months later was higher for females. Temporal stability was moderate for all measures. These results contribute toward completing explanatory models of these problems and suggest that interventions based on the critique of esthetic ideals and on strengthening self-esteem should be implemented in early adolescence.

Self-Esteem and Symptoms of Eating-Disordered Behavior Among Female Adolescents

“…Higher self-esteem indices were associated with a slimmer and distorted body image. It follows that the present pattern of results is at odds with previous findings indicating higher self-esteem to be associated with a more positive body image (Espinoza et al., 2019; Kostanski & Gullone, 1998; Ozmen et al., 2007; Woodward et al., 2019; Zamani Sani et al., 2016; Zhang et al., 2018). The unexpected pattern of results demands a more thorough discussion, to which we will return below.…”

“…Our second hypothesis followed others (Alipour et al. 2015; Espinoza et al., 2019 ; Woodward et al., 2019 ) in anticipating that higher body satisfaction, which is to say an undistorted body image, would be associated with higher indices for physical activity and less eating-disordered behavior. One of two research questions considered whether eating-disordered behavior is associated either with higher or with lower self-esteem.…”

“…Based on the foregoing literature review, the following two hypotheses and two research questions were formulated. First, following others (Espinoza et al., 2019 ; Kostanski & Gullone, 1998; Ozmen et al., 2007; Woodward et al., 2019; Zamani Sani et al., 2016; Zhang et al., 2018), we expected that higher scores for self-esteem would be associated with a more positive and undistorted body image. Our second hypothesis followed others (Alipour et al.…”

“…Espinoza et al. (2019) assessed 303 adolescents (age range: 12-15 years; 53.8% males) longitudinally and found a bidirectional association between self-esteem and eating-disordered behavior. Furthermore, a stronger internalization of beauty ideals predicted disordered eating behavior and lower self-esteem scores.…”

Non-Suicidal Self-Injury and Eating Disordered Behaviors: An Update on What We Do and Do Not Know

“…Apart from the physical risk and societal burden associated with these behaviors, there is growing evidence that NSSI and ED behaviors may also negatively impact the psychosocial development of young people. Researchers have linked NSSI and/or ED behaviors with future risk of mental health problems (especially depression) [ 33 ••, 90 ], impaired family functioning [ 91 , 92 ], decreased emotion regulation capabilities [ 67 ], identity issues [ 93 , 94 ], lower self-esteem and quality of life [ 95 , 96 ], stigma [ 97 , 98 ], and academic failure [ 99 , 100 ]. Hence, much could be learned from future investigations that adopt a broader developmental framework in which risk factors, NSSI and ED behaviors/disorders, and developmental tasks (e.g., identity formation, graduating, and finding work) might influence each other reciprocally throughout adolescence and (emerging) adulthood.…”