Eating Disorder and Depressive Symptoms in the General Public: The Mediating Influence of Weight and Shape Concerns

Abstract

Of the roughly 14 million people worldwide with an eating disorder, up to 51% are estimated to have comorbid major depressive disorder, but only about a third are detected by healthcare services. Comorbidity has serious negative consequences, such as mental and physiological problems, high economic burden and diminished quality of life. Obtaining information from community-based samples plays a significant role in the improvement of diagnosis and treatment of ED with comorbid MDD. Currently, several theories exist on the high comorbidity between ED and MDD, such as the escape model of binge eating, but not much research has been performed on the role of shape and weight concerns. This study investigates the relationship between eating disorder symptoms and depressive symptoms in the general public, and examines if this relationship is mediated by shape concerns and weight concerns. A total of 465 participants filled in the ED-15, PHQ-9 and EDE-Q subscales shape concerns and weight concerns. A regression analysis revealed a large positive relationship between ED and MDD, emphasizing the need for early detection to improve treatment outcomes. Shape concerns and weight concerns were both found to significantly partially mediate this relationship, with medium-sized indirect effects. This highlights the need to refine existing theoretical models and expand treatment protocols to improve treatment efficacy. Future studies are needed to replicate these results and confirm and advance knowledge on the relationship between ED, MDD, shape concerns and weight concerns, so that the detection and treatment of ED with comorbid MDD can be improved.