Brechan Inge, Kvalem Ingela Lundin
Department of Psychology, University of Oslo, P.O. Box 1094 Blindern, NO-0317 Oslo, Norway.
Department of Psychology, University of Oslo, P.O. Box 1094 Blindern, NO-0317 Oslo, Norway.
Eat Behav. 2015 Apr;17:49-58. doi: 10.1016/j.eatbeh.2014.12.008. Epub 2014 Dec 11.
The purpose of this study was to investigate the hypothesis that the effect of body dissatisfaction on disordered eating behavior is mediated through self-esteem and depression. If the effect of body dissatisfaction on disordered eating can be explained by self-esteem and depression, treatment may benefit from focusing more on self-esteem and depression than body dissatisfaction. We also hypothesized body image importance to be associated with lower self-esteem, stronger symptoms of depression, and more disordered eating. The results showed that the effect of body dissatisfaction on disorder eating was completely mediated, whereas the effect of body image importance was partly mediated. Both self-esteem and depression were significant mediators. Body image importance and self-esteem had a direct effect on restrained eating and compensatory behavior. Depression had a direct effect on binge eating. This effect was significantly stronger among women. Depression also had a direct effect on restrained eating. This effect was positive among women, but negative among men. The results support emotion regulation and cognitive behavioral theories of eating disorders, indicating that self-esteem and depression are the most proximal factors, whereas the effect of body dissatisfaction is indirect. The results point out the importance of distinguishing between different symptoms of bulimia. Depression may cause binge eating, but compensatory behavior depends on self-esteem and body image importance. The results suggest that women may turn to both binge eating and restrained eating to escape awareness of negative emotions, whereas men focus on eating to a lesser extent than women. Existing treatment focuses on eating behavior first and mechanisms such as self-esteem and depression second. The results from this study suggest that an earlier focus on self-esteem and depression may be warranted in the treatment of disordered eating.
身体不满对饮食失调行为的影响是通过自尊和抑郁介导的。如果身体不满对饮食失调的影响可以用自尊和抑郁来解释，那么治疗可能会从更多地关注自尊和抑郁而非身体不满中受益。我们还假设身体形象重要性与较低的自尊、更强的抑郁症状以及更紊乱的饮食有关。结果表明，身体不满对饮食失调的影响完全由中介因素介导，而身体形象重要性的影响部分由中介因素介导。自尊和抑郁都是显著的中介因素。身体形象重要性和自尊对节制饮食和代偿行为有直接影响。抑郁对暴饮暴食有直接影响。这种影响在女性中显著更强。抑郁对节制饮食也有直接影响。这种影响在女性中是正向的，但在男性中是负向的。这些结果支持饮食失调的情绪调节和认知行为理论，表明自尊和抑郁是最直接的因素，而身体不满的影响是间接的。结果指出区分贪食症不同症状的重要性。抑郁可能导致暴饮暴食，但代偿行为取决于自尊和身体形象重要性。结果表明，女性可能会通过暴饮暴食和节制饮食来逃避负面情绪的意识，而男性在饮食方面的关注程度低于女性。现有的治疗首先关注饮食行为，其次关注自尊和抑郁等机制。本研究的结果表明，在治疗饮食失调时，可能有必要更早地关注自尊和抑郁。
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