Risk Factors and Temporal Patterns of Disordered Eating Differ in Adolescent Boys and Girls: Testing Gender-specific Appearance Anxiety Models

Adolescent dieting and disordered eating (DE) are risks for clinical eating disorders. In this five-wave longitudinal study, we tested gender-specific models linking early risk factors to temporal patterns of DE, considering appearance anxiety as a mediator. Participants were 384 Australian students (age 10 to 13; 45% boys) who reported their purging and skipping meals, experience with appearance-related teasing, media pressure, and appearance anxiety. Parents reported pubertal maturation and height/weight was measured. Gender differences in temporal patterns of DE were found and predictive models were tested using latent-variable growth curve and path models. Boys' DE was generally stable over time; girls showed stability in purging but an average increase in skipping meals. Peer teasing, media pressure, and pubertal maturation were associated with more elevated initial DE in girls, and pubertal maturation was associated with a steeper increase in DE. For boys, body mass index had a direct positive association with DE. Appearance anxiety was associated with more DE, but there was only one significant indirect effect via anxiety, which was for boys' pubertal maturation. Findings support the dominant role of social interactions and messages, as well as pubertal maturation, for girls' DE and the prominence of physical risk factors for explaining boys' DE.