Prospective associations between loneliness and disordered eating from early adolescence to adulthood

Abstract

Objective Despite findings from numerous cross‐sectional studies suggesting a substantial association between loneliness and different types of disordered eating, much remains unknown about the impact of confounding, the order of cause and effect, and gender differences in the relationship. Thus, this study followed a large, population‐based, mixed‐gender sample through adolescence and young adulthood, applying a random intercept cross‐lagged panel model (RI‐CLPM) approach to examine the bidirectional prospective associations between loneliness and disordered eating while ruling out the effect of unmeasured time‐invariant confounders. Method A Norwegian sample of N = 2933 adolescents (54.2% female) was examined across four time points (T1, Mage = 15.44, grades 7–12; T2, Mage = 16.93; T3, Mage = 21.84; and T4, Mage = 28.33) from 1992 to 2005 using RI‐CLPMs for overall disordered eating and specific forms for disordered eating (dieting and bulimic symptoms). Multigroup structural equation models were used to assess gender differences. Results For male participants, high levels of loneliness at T1 predicted more overall disordered eating and more dieting at T2. Meanwhile, among female participants, disordered eating and bulimic symptoms at T2 predicted more loneliness at T3, whereas loneliness at T3 predicted more disordered eating and bulimic symptoms at T4, and vice versa. Discussion The findings suggest a pattern of bidirectional associations between loneliness and disordered eating that varies by time points, gender, and type of eating problem. Preventive interventions and treatment should consider social factors involved in the onset and maintenance of eating problems in male adolescents and young adult women. Public Significance This study contributes to the existing knowledge by examining for the first time the dynamic nature of the association between loneliness and disordered eating while accounting for all time‐invariant confounding. Our findings reveal a pattern of bidirectional associations between loneliness and disordered eating that appears to vary by developmental period, gender, and type of eating problem. Our findings suggest that social factors have to be taken into account when designing prevention strategies aimed at disordered eating.

Loneliness in adolescence and prescription of psychotropic drugs in adulthood: 23-year longitudinal population-based and registry study

“… 16 The fifth item, ‘I feel lonely’, assesses loneliness directly. The five-item measure used in this study has been shown to have good face and predictive validity, 10 and has been used in previous longitudinal studies, 17 The reliability of the instrument ranged from α = 0.65 to 0.78 in the present study.…”

Social isolation postweaning alters reward-related dopamine dynamics in a region-specific manner in adolescent male rats

“…Finally, it will be important to examine the impact of the isolation-induced changes in dopamine signaling for its effects on other outcome measures. For instance, the COVID pandemic has been linked to an increased incidence of eating disorders, such as anorexia nervosa, in adolescent children ( Agostino et al, 2021 ; Devoe et al, 2023 ; Haripersad et al, 2021 ), and it has been established that loneliness and eating disorders are bidirectionally related ( Cortes-Garcia et al, 2022 ). Given our observed link between reward-related feeding behaviors and dopamine changes in the mPFC and NAc during social isolation, it is possible that there is a mechanistic link between the increased incidence of eating disorders stemming from the pandemic lockdowns and lack of social interaction (e.g., home confinement vs. traditional school settings) with dopaminergic dysregulation, a contention that will need to be more fully addressed in future studies.…”

“…While chronic social isolation and loneliness have been well established to have a negative impact on physical and mental health, the broad impact of school closures and home confinement during the COVID pandemic brought to the forefront the need to better understand such impacts on the developing brain ( Agostino et al, 2021 ; Cortes-Garcia et al, 2022 ; Hawkley and Cacioppo, 2003 ; Loades et al, 2020 ). Social isolation has been correlated with lower life satisfaction, higher levels of substance abuse, depression, anxiety, and increased stress in humans ( Clair et al, 2021 ; Loades et al, 2020 ).…”

An account of loneliness while living with an eating disorder

“…Considerable research effort has been dedicated to exploring the link between loneliness and eating disorders. For instance, Cortés‐García et al (2022) reported that in their study, social isolation and loneliness significantly predicted disordered eating patterns with particular predominance in male adolescents and young adult women. Feelings of social exclusion and loneliness may also be experienced by those affected by Avoidant Restrictive Food Intake Disorder (ARFID) along with disruptions to functioning due to hospitalisations and medical needs (Görmez et al, 2018).…”