Ma Runping, Min Kaiyuan, Meng Ziyan, Yang Juntao, Zhang Hui, Li Qing
School of Health Policy and Management, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China.
Plastic Surgery Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China.
BMC Public Health. 2025 Jul 7;25(1):2401. doi: 10.1186/s12889-025-23608-0.
The prevalence of eating disorders among youth has increased in recent decades, with significant health consequences. Depression, loneliness and social anxiety are associated with eating disorders. However, the underlying mechanisms of these associations remain insufficiently explored. Considering the possibility that mental disorders increase the risk of smartphone addiction and that smartphone addiction is associated with eating disorder in adolescents, this study aims to investigate whether smartphone addiction mediates the association between mental disorders and eating disorders.
Between October and November 2023, we conducted an online survey among youth across 31 provincial-level administrative divisions (PLADs) in China. To align our sample composition with official statistics for each PLAD in terms of gender and school type, we applied sample weights to each respondent. Structural equation modeling (SEM) was used to examine the mediating effects. To assess the consistency of these results, we also performed analyses for each gender and age group.
Among 10,000 weighted participants, 51.7% are male, with a median age of 16 years (IQR: 14-19). About 40% of youth experienced eating disorders. Smartphone addiction partially mediated the association between depression, loneliness, social anxiety, and eating disorders, contributing 24.69% (95% confidence interval: 20.60%-28.79%), 32.33% (95% CI: 27.53%-37.12%), and 37.35% (95% CI: 31.79%-42.91%) of the total effects, respectively. No heterogeneity was observed when analyses were stratified by gender and age group.
Smartphone addiction must be taken into account when designing strategies to prevent eating disorders in adolescents, which requires the cooperation of schools, parents and the government.
近几十年来，青少年饮食失调的患病率有所上升，对健康造成了重大影响。抑郁、孤独和社交焦虑与饮食失调有关。然而，这些关联的潜在机制仍未得到充分探索。考虑到精神障碍会增加智能手机成瘾的风险，且智能手机成瘾与青少年饮食失调有关，本研究旨在调查智能手机成瘾是否介导了精神障碍与饮食失调之间的关联。
2023年10月至11月期间，我们在中国31个省级行政区的青少年中开展了一项在线调查。为使我们的样本构成在性别和学校类型方面与每个省级行政区的官方统计数据一致，我们对每位受访者应用了样本权重。采用结构方程模型（SEM）来检验中介效应。为评估这些结果的一致性，我们还对每个性别和年龄组进行了分析。
在10000名加权参与者中，51.7%为男性，中位年龄为16岁（四分位间距：14 - 19岁）。约40%的青少年经历过饮食失调。智能手机成瘾部分介导了抑郁、孤独、社交焦虑与饮食失调之间的关联，分别占总效应的24.69%（95%置信区间：20.60% - 28.79%）、32.33%（95%CI：27.53% - 37.12%）和37.35%（95%CI：31.79% - 42.91%）。按性别和年龄组进行分层分析时未观察到异质性。
在设计预防青少年饮食失调的策略时，必须考虑智能手机成瘾问题，这需要学校、家长和政府的合作。
