Within-Person Prospective Associations Between Disordered Eating, Appearance Dissatisfaction, and Depressive Symptoms From Adolescence to Midlife: A 28-Year Longitudinal Population-Based Study

Abstract

Appearance dissatisfaction and depressive symptoms are considered key risk factors of disordered eating. However, their etiological status is equivocal; previous longitudinal studies have not accounted for time-invariant confounding effects and have not considered potential reverse temporal influences. In addition, whether associations differ between developmental periods and genders has remained untested. To address these issues, we employed a nationwide sample of Norwegian adolescents (N = 2,933; Mage = 15.4 years, 54.2% women) assessed at five time points until midlife. Random-intercept cross-lagged panel models were used to examine the prospective associations between appearance dissatisfaction, depressive symptoms, and disordered eating, net of all unmeasured time-invariant confounding effects. Results showed that high levels of appearance dissatisfaction and depressive symptoms significantly predicted increased disordered eating. Conversely, disordered eating was also a predictor of increased appearance dissatisfaction and depressive symptoms. These reciprocal effects were equal in magnitude across developmental periods and gender. These results suggest that successful interventions to reduce appearance dissatisfaction and depressive symptoms may alleviate disordered eating, while reduced disordered eating may have beneficial effects on appearance dissatisfaction and depressive symptoms, regardless of age or gender.