Healthy and restrictive eating as mediators between appearance evaluations and BMI reduction in healthy adolescents

Abstract

Background: Perceptions of one’s appearance are among key determinants of eating disorders, which may lead to underweight, serious health consequences, or death. This study tested the relationships between appearance evaluations and body mass index mediated by healthy or restrictive eating in a non-clinical sample of underweight and normal weight adolescents. Methods: Data were collected twice, with a eleven-month interval between Time 1 (T1) and Time 2 (T2). Underweight and normal weight adolescents (N = 922) aged 13-20 filled out The Multidimensional Body-Self Relations Questionnaire, assessing appearance evaluations and restrictive eating, and answered the questions evaluating their eating behaviors. Body weight and height were measured objectively. Findings: Restrictive eating (T2) mediated the relationship between appearance evaluations (T1) and BMI (T2). No mediating effects of healthy eating (T2) were found. Discussion: Lower levels of appearance evaluations predicted restricted dieting (but not healthy eating), which in turn predicted adolescents’ lower body mass index. Weight reduction in adolescents with underweight and normal body weight may lead to serious health consequences. Appearance evaluations should be carefully considered in screening for eating disorders among adolescents and during the development of eating disorder prevention programs.