The bidirectional associations between self‐esteem and problematic eating behaviors in adolescents.

Objective: Theories propose that low self‐esteem and problematic eating behaviors (PEBs) negatively impact each other. While previous studies suggested bidirectional associations between self‐esteem and PEBs, they did not separate within‐person from between‐person associations. Therefore, this prospective study investigated the within‐person bidirectional associations between self‐esteem and four PEBs in adolescence, while accounting for between‐person differences. Method: We used two independent longitudinal samples of Dutch adolescents, each including three annually collected waves of data. Sample 1 consisted of 1856 adolescents (Baseline: 50.4% males; Mage = 13.79 years, SDage = 0.72), with measures of self‐esteem, emotional eating, restrained eating, and loss of control (LOC) while overeating. Sample 2 consisted of 555 adolescents (Baseline: 49.7% males; Mage = 13.13 years, SDage = 0.68), with measures of self‐esteem and LOC eating. The data were analyzed using random intercept cross‐lagged panel models (CLPMs). Results: Within persons, lower self‐esteem was associated with higher emotional and restrained eating (both Sample 1) one year later, and vice versa. Self‐esteem did not predict, nor was predicted by, LOC while overeating (Sample 1) or LOC eating (Sample 2). Between persons, self‐esteem was negatively correlated with all PEBs (Samples 1 and 2). Discussion: We found within‐person bidirectional associations between low self‐esteem and emotional and restrained eating (but not LOC while overeating/LOC eating), and between‐person correlations between low self‐esteem and all PEBs. These results have theoretical and practical implications. Within‐person processes clarify underlying mechanisms that explain the occurrence of PEBs; between‐person associations are important to identify adolescents at risk of PEBs. Public Significance: While theories indicate that low self‐esteem and PEBs are inversely associated within individuals, empirical studies have not disentangled within‐person processes from between‐person differences. This study addressed this disparity, finding that lower self‐esteem was bidirectionally associated with higher emotional and restrained eating (but not LOC eating) within persons. These findings suggest that enhancing self‐esteem is a viable option for prevention and intervention. [ABSTRACT FROM AUTHOR]