An update on the underlying risk factors of eating disorders onset during adolescence: a systematic review

Carmen Varela; Ángela Hoyo; María Eugenia Tapia-Sanz; Ana Isabel Jiménez-González; Benito Javier Moral; Paula Rodríguez-Fernández; Yadirnaci Vargas-Hernández; Luis Jorge Ruiz-Sánchez

doi:10.3389/fpsyg.2023.1221679

An update on the underlying risk factors of eating disorders onset during adolescence: a systematic review

Front Psychol. 2023 Nov 8:14:1221679. doi: 10.3389/fpsyg.2023.1221679. eCollection 2023.

Authors

Carmen Varela^{1

2

3}, Ángela Hoyo³, María Eugenia Tapia-Sanz³, Ana Isabel Jiménez-González³, Benito Javier Moral³, Paula Rodríguez-Fernández⁴, Yadirnaci Vargas-Hernández⁴, Luis Jorge Ruiz-Sánchez³

Affiliations

¹ Universitat de Barcelona, Barcelona, Spain.
² Departamento de Ciencias de la Salud, Facultad de Ciencias de la Salud, Universidad de Burgos, Burgos, Spain.
³ Área de Psicología, Facultad de Ciencias de la Salud, Universidad Isabel I, Burgos, Spain.
⁴ Facultad de Humanidades y Ciencias Sociales, Universidad Isabel I, Burgos, Spain.

Abstract

Introduction: Eating disorders (EDs) are serious psychological problems that affect not only the individual, but also their entire environment. The prevalence rates of EDs are higher among the adolescent population. A better understanding of ED risk factors is essential to design effective prevention and intervention programs that focus beyond the areas of weight and appearance.

Methods: The main objective of this systematic review was to identify the risk factors of EDs and provide a comprehensive approach, analyzing the interplay between individuals, their inner circle, and the society characteristics. The Web of Science, Scopus, CENTRAL and PsycInfo databases were searched.

Results: The initial search produced 8,178 references. After removing duplicates and performing the selection process by three independent reviewers, 42 articles were included in the systematic review according to the pre-specified inclusion criteria. The results suggest the relevance of society and the inner circle on the development of EDs.

Discussion: The internalization of the thin ideal, promoted by the current society, and living in an unsupportive, unaffectionate, non-cohesive environment were associated with the onset of EDs symptomatology. Other associated variables with this ED indicator were poor-quality relationships and feeling judged about appearance. These aspects seem to be essential for the development of individual characteristics like self-esteem or adaptative coping during adolescence. This systematic review has shown the complex etiology of EDs and the relevance of the interplay between the different areas involved. Furthermore, this information could be relevant to improve the design of innovative and more effective prevention and intervention programs.

Systematic review registration: PROSPERO, identifier CRD42022320881.

Keywords: adolescence; eating disorders; prevention; protective factors; risk factors.

Publication types

Systematic Review

Grants and funding

This study is part of a larger project with reference FUI1-014. The project was funded by the “la Caixa” Foundation and the “Caja de Burgos” Foundation, under the agreement LCF/PR/PR18/51130008.