Skip to main content
NCBI home page
Wiley Open Access Collection logoLink to Wiley Open Access Collection
. 2026 Apr 20;59(8):1753–1763. doi: 10.1002/eat.70110

Daily Body (Dis‐)Satisfaction and Dietary Restriction in Women Across the Eating Disorder Spectrum

Michaela R Buehler 1,✉, Ann‐Kathrin Arend 1, Julia Reichenberger 1,2, Jens Blechert 1
PMCID: PMC13446263  PMID: 42007725

ABSTRACT

Objective

Body dissatisfaction is a key risk factor in eating disorder development: It is theorized to promote dietary restriction, thereby contributing to symptom onset. Evidence for this pathway primarily comes from cross‐sectional or multi‐wave questionnaire studies in bulimia nervosa (BN) and anorexia nervosa (AN). Fewer studies have tested day‐to‐day links between body dissatisfaction and dietary restriction, which would indicate their temporal relationships. Using a daily diary design, we examined prospective day‐to‐day associations between these two symptoms across four eating disorder (ED) groups and a non‐ED control group (CG).

Method

One hundred eighty one female participants (14–60 years; M = 28.2, SD = 11.4) were recruited from German‐speaking countries (96% German or Austrian nationals). The sample included patients with BN (n = 40), binge‐eating/purging type AN (ANbp, n = 23), restricting type AN (ANr, n = 24), binge‐eating disorder (BED, n = 36), as well as a non‐ED CG (n = 58). Daily body dissatisfaction and dietary restriction were assessed on eight consecutive evenings. Day‐to‐day associations were tested using multilevel (mixed‐effects) lagged regression models.

Results

In patients with BN and ANbp, days with higher body dissatisfaction preceded days with higher dietary restriction. This association was not observed in patients with ANr, BED, or in the non‐ED CG. Dietary restriction did not predict next day's body dissatisfaction.

Discussion

Prospective links between body dissatisfaction and restriction mainly characterize patients with BN and ANbp. Hence, intervention targets at both the group level and the symptom level (body dissatisfaction rather than dietary restriction) seem necessary. In these subgroups, intervening on days characterized by high body dissatisfaction may help reduce dietary restriction on the following day.

Keywords: ambulatory assessment, anorexia nervosa binge‐eating/purging type, body image, bulimia nervosa, daily diary analysis

Summary

  • Body dissatisfaction is commonly thought to trigger dietary restriction.

  • Although both phenomena occur in daily life, their day‐to‐day relationship has rarely been tested.

  • Using daily diary data, we examined which symptom comes first across different eating disorder groups and a control group.

  • Body dissatisfaction predicted next‐day dietary restriction mainly in bulimia nervosa and anorexia nervosa, binge‐eating/purging type.

  • In these groups, daily interventions on body dissatisfaction may be useful.

1. Introduction

Approximately half of women in Western countries report dissatisfaction with their bodies (Buhlmann et al. 2010; Choate 2005). As individuals are constantly confronted with body‐related cues in daily life, dissatisfaction with one's own body can become a pervasive concern (Mond et al. 2013; Sala et al. 2021). This may be particularly pronounced among individuals with eating disorders (EDs) (Prnjak et al. 2022), who may rely on maladaptive coping strategies such as body checking, purging behaviors (e.g., self‐induced vomiting, laxative use), dietary restriction, or excessive exercise (Goeden et al. 2023; Lavender et al. 2013).

Psychological theories of ED onset have proposed a link between body dissatisfaction and dietary restriction. Frameworks such as the dual pathway model (Stice 1994) and the tripartite influence model (Thompson et al. 1999), among others (Brytek‐Matera and Czepczor 2017; Pennesi and Wade 2016), propose a unidirectional pathway: internalization of the thin ideal is assumed to foster body dissatisfaction, which in turn promotes dietary restriction. In these frameworks, dietary restriction predicts the emergence of bulimic‐spectrum disorder symptoms, mediating the link between body dissatisfaction and disordered eating behaviors (Stice and Van Ryzin 2019). This pathway has received support from both cross‐sectional and longitudinal questionnaire‐based studies (Brytek‐Matera and Czepczor 2017; Pennesi and Wade 2016; Stice et al. 2002; Stice and Van Ryzin 2019; Urvelyte and Perminas 2015; Yamamiya and Stice 2024). However, further research has yielded a differentiated picture: a recent 8 year longitudinal study found that body dissatisfaction preceded restrictive eating patterns and predicted the development of bulimia nervosa (BN) and purging disorder, but not anorexia nervosa (AN) or binge‐eating disorder (BED), suggesting that the pathway may be limited to specific ED diagnoses (Yamamiya and Stice 2024). Furthermore, other researchers have reported no support for the restriction pathway (Puccio et al. 2016; Strien et al. 2005) or only partial support, particularly among adolescent girls (Morrissey et al. 2020).

Thus, more research on this link across different EDs is needed. Most existing research has examined relatively stable relationships between body dissatisfaction and dietary restriction using questionnaires. However, the association between these two constructs might be highly dynamic at the micro‐level within and across days. For example, specific meals (e.g., high in calories or fat) or thin‐ideal confrontation (Wyssen et al. 2020) might directly trigger body dissatisfaction. However, there might also be cross‐day links. Meals and calorie intake may be evaluated or summarized across the day, and body‐related evaluations by oneself or others may make certain days particularly salient (e.g., weight teasing; Menzel et al. 2010). In this context, body dissatisfaction might motivate dietary restriction on the following day. Furthermore, while most existing research has relied on questionnaires covering relatively long time intervals, the actual interplay of these symptoms might unfold dynamically across days, a pattern that traditional questionnaires do not capture well. Such day‐to‐day level associations might constitute an interesting intermediate position between macro‐ and intra‐day level associations. They can complement questionnaire and laboratory approaches by capturing ED symptoms and their immediate context as they unfold in participants' natural environments. In particular, EMA and daily diary approaches are well suited for assessing ED symptoms and their proximal antecedents and consequences close to their occurrence. They reduce reliance on long retrospective recall and related distortions and help establish temporal precedence in dynamic processes (e.g., short‐lived antecedents, time‐of‐day effects, and lagged associations) that are difficult to evaluate with cross‐sectional or widely spaced multi‐wave designs (Engel et al. 2016; Smyth et al. 2001).

Mapping daily body dissatisfaction–dietary restriction associations may also reveal diagnostic differences in their strength and direction, as well as their distinctiveness across different ED groups relative to a non‐ED control group (CG). More broadly, EMA studies in EDs have shown that momentary symptoms and behaviors are meaningfully linked to proximal antecedents such as stressful events, negative affect, anxiety, and appearance‐related stress (e.g., Goldschmidt et al. 2014; Schaefer et al. 2020). Regarding the variables central to the present study, namely body dissatisfaction and dietary restriction, initial EMA research also provides important context: In a non‐clinical sample of college women without EDs, Sala et al. (2021) found no momentary associations between state body dissatisfaction and weight control behaviors within the same day. In a female sample of individuals with different ED diagnoses, Mason et al. (2021) found that appearance concerns predicted food‐related thoughts, but not dietary restriction within the same day. Among women with AN, appearance‐related stress predicted subsequent purging behavior within the same day, with this association mediated by anxiety (Mason et al. 2018). Taken together, existing EMA findings suggest that body‐related experiences are relevant to ED symptoms, but they leave open whether body dissatisfaction predicts dietary restriction from 1 day to the next. To address this question, the present study examined day‐to‐day associations between body dissatisfaction and dietary restriction across the ED spectrum.

1.1. The Present Study

The present study reanalyzed a large EMA dataset that included sufficiently large subsamples of female participants for each major ED diagnosis (BN, ANbp, ANr, BED) as well as a non‐ED CG (all publications related to this dataset can be found in Supporting Information: Appendix A, Table S1). Beyond addressing a gap in prior literature, our daily diary design clarifies the day‐to‐day temporal ordering of body dissatisfaction and dietary restriction and tests whether it aligns with prominent etiological and maintenance models of ED emergence and persistence. Moreover, our sample allows us to examine this ordering across multiple ED groups and the non‐ED CG. If increases in body dissatisfaction precede increases in dietary restriction in some or all ED groups, body dissatisfaction would represent a potentially modifiable antecedent with practical relevance for preventing subsequent dietary restriction in daily life. More broadly, this design advances our understanding of predictors of dietary restriction in naturalistic contexts.

We expected that the diagnostic group would moderate prospective body dissatisfaction–dietary restriction associations across consecutive days. While BN patients should show positive associations (Brytek‐Matera and Czepczor 2017; Pennesi and Wade 2016; Stice et al. 2002; Stice and Van Ryzin 2019), findings in AN are more mixed (Mason et al. 2021; Urvelyte and Perminas 2015; Yamamiya and Stice 2024). Mixed results in AN might be due to different subtypes, which we were able to differentiate here: in participants with ANbp, we expected a pattern more in line with BN due to the presence of purging behavior, which is a compensatory behavior as dietary restriction is one. For participants with ANr, by contrast, dietary restriction may represent a general strategy for regulating daily food intake, applied irrespective of the degree of body dissatisfaction and not used as a compensatory strategy. If the concept of compensation (i.e., through purging or dietary restriction) links body dissatisfaction and dietary restriction, this relationship should be absent in individuals with BED and in the non‐ED CG.

To further evaluate whether the association is primarily unidirectional—from body dissatisfaction to dietary restriction—we also examined the alternative temporal ordering, as dietary restriction could plausibly contribute to increased body dissatisfaction, for example via heightened self‐surveillance (Fitzsimmons‐Craft et al. 2015).

2. Materials and Methods

2.1. Participants

For the original project (data collection 2015–2021), patients with EDs were recruited in two ways: the main way was the inpatient treatment waiting list of the Roseneck Clinic in Prien, Germany, where 88 participants of our final sample were recruited. An additional 35 participants of our final sample—mostly from the BED group—were recruited through mailing lists and social media posts. As for the control group, all (n = 58) were recruited from the general public through the same mailing lists and social media posts as the additional ED patients. On the advertisements, the original study was presented as a study on the influence of emotions on eating behavior using EMA methods. This study was approved both by the ethics committees of the University of Salzburg and the medical ethics committee of Ludwig‐Maximilian University Munich. Signed informed consent by all participants was part of the study protocol.

Requirements for including participants from the original study in this re‐analysis were: answering more than 50% of EMA prompts overall, completing more than two end‐of‐day assessments, a complete interview‐based ED diagnosis and unambiguous assignment to one of the diagnostic groups or the non‐ED CG. Overall, 181 participants were included and categorized into the following diagnostic groups: CG (n = 58), ANr (n = 24), ANbp (n = 23), BN (n = 40), and BED (n = 36). All participants self‐identified as female; 69.6% reported being German nationals, 26.5% Austrian nationals and 3.9% nationals of other countries (e.g., Italy, Turkey, Russia). All participants were German‐speaking and resided in German‐speaking countries. Age ranged from 14 to 60 years (M = 28.2, SD = 11.4). The sample comprised university students (38.7%), employees (31.9%), and participants in other employment categories (29.4%; e.g., self‐employed, apprentices, homemakers).

Patients fulfilled the DSM‐5 criteria for current ANr, ANbp, BN, or BED. To assess the presence or absence of ED diagnoses, both the structured clinical interview for DSM‐IV (SCID; Wittchen et al. 1997) and the Eating Disorder Examination (EDE; Hilbert et al. 2004) were used. The EDE was administered in addition to the SCID because it provides a standardized definition of binge eating, including loss of control and the consumption of an objectively large amount of food, before assessing its occurrence. This reduces ambiguity, supports reliable differentiation between ED subtypes, and enabled us to define loss of control prior to the EMA phase to facilitate consistent responses to daily EMA items assessing binge‐eating episodes—which was relevant for other studies in the project. The ED groups' exclusion criteria included meeting diagnostic criteria for other specified feeding or eating disorders, unspecified feeding or eating disorders, or having missing information on participants' clinical status. Current or lifetime EDs, a BMI below 18.5 kg/m2 or above 24.9 kg/m2, and a positive screening for psychoses were exclusion criteria for the CG. The mean Eating Disorder Examination‐Questionnaire (EDE‐Q; Hilbert et al. 2007) global score in the total sample was 2.70 (SD = 1.60; range = 0.16–5.70). ED groups showed higher scores (Ms = 3.00–4.20; SDs = 0.90–1.10) than the CG (M = 1.20, SD = 1.00; see Table S2 in Supporting Information: Appendix B for detailed group differences). As expected, BMI differences were observed among the groups (BED > BN > CG > ANbp and ANr; see Table 1). Moreover, the BED group had a higher mean age compared to the other groups (see Table 1). See Table 1 for an overview of descriptive statistics for sociodemographic, trait questionnaires, and daily diary measures, reported separately for each group.

TABLE 1.

Sociodemographic characteristics and trait and daily diary self‐report measures by group.

CGA n = 58 ANrB n = 24 ANbpC n = 23 BND n = 40 BEDE n = 36
BMI (kg/m2) 20.7 (1.5)B,C,D,E 15.8 (1.8)A,D,E 16.3 (1.5)A,D,E 23.0 (3.1)A,B,C,E 30.4 (7.1)A,B,C,D
Age (years) 24.0 (8.1)D,E 27.1 (13.6)E 26.0 (11.8)D,E 29.7 (10.4)A,C,E 36.3 (11.0)A,B,C,D
Years of education 14.7 (2.5)B 13.4 (5.6)A,D,E 14.2 (3.0) 14.8 (3.8)A 15.3 (4.6)A
EDE‐Q restraint 0.9 (1.2)B,C,D,E 3.0 (1.5)A,C,D,E 4.4 (1.0)A,B,D,E 3.5 (1.3)A,B,C,E 2.2 (1.4)A,B,C,D
EDE‐Q shape and weight concern 1.7 (1.3)B,C,D,E 3.5 (1.1)A,C,D,E 4.5 (1.2)A,B,E 4.8 (0.9)A,B,E 3.9 (1.3)A,B,C,D
Daily diary dietary restriction 18.3 (20.9)B,C,D 42.4 (21.0)A 54.8 (17.0)A,E 49.1 (21.2)A,E 31.7 (19.9)C,D
Daily diary body dissatisfaction 42.7 (23.9)B,C,D,E 66.4 (17.5)A 73.9 (15.2)A 73.3 (15.8)A 69.0 (17.3)A
Daily diary compliance 85.6 (15.3) 81.1 (15.7) 84.4 (20.5) 81.2 (18.7) 80.2 (19.5)
Open in a new tab

Note: Values are presented as M (SD). Superscript letters indicate significant Scheffé post hoc tests relative to the following groups: A = CG: control group without an eating disorder; B = ANr, anorexia nervosa restricting type; C = ANbp, anorexia nervosa binge‐eating/purging type; D = BN, bulimia nervosa; E = BED, binge‐eating disorder. BMI = body mass index. EDE‐Q restraint = restraint subscale of the Eating Disorder Examination‐Questionnaire. EDE‐Q shape and weight concern = combined shape concern and weight concern subscales of the Eating Disorder Examination‐Questionnaire. Daily diary measures were first aggregated at the participant level and then at the group level. Daily diary compliance was defined as the proportion of the eight scheduled end‐of‐day questionnaires completed by participants.

2.2. Measures

2.2.1. Sociodemographic Variables

An online questionnaire was used to assess participants' relevant sociodemographic (i.e., age, weight, height, years of education) and psychometric data (see trait questionnaires). Age was assessed in years. Self‐reported weight (kg) and height (cm) were used to calculate body mass index (BMI; kg/m2). Nationality was assessed via an open‐ended text field. Education was indexed as years of education. Current occupation was assessed with the item, “What occupation are you currently engaged in?” with six response options: (university) student, apprentice, homemaker, employee, self‐employed, and other.

2.2.2. Clinical Diagnostic Interviews

Participants took part in both the structured clinical interview for DSM‐IV (SCID; Wittchen et al. 1997) and the Eating Disorder Examination (EDE; Hilbert et al. 2004). These interviews were adapted to align with DSM‐5 diagnostic criteria, such as requiring one binge‐eating episode per week for 3 months instead of two episodes per week over the same period. Since no DSM‐5‐compliant interviews were available in German at the start of the study in 2015, this adaptation was necessary. The diagnostic assessments were conducted by trained female researchers, who were either master's‐level students, graduates or postdoctoral researchers.

2.2.3. Daily Diary Measures

For eight successive days, participants received six EMA signals per day assessing affect and eating behaviors. For this study only the last EMA signal (end of the day assessment, 9:30 p.m.) was relevant.

2.2.3.1. End of the Day Body (Dis‐)Satisfaction

Daily body dissatisfaction was assessed as participants' degree of agreement with the statement “Today I was satisfied with my body weight and figure,” rated on a visual analogue scale ranging from 0 to 100 (0 = “not at all”; 100 = “very much/a lot”). The item was later inverted for statistical analysis.

2.2.3.2. End of the Day Dietary Restriction

Participants responded to the question, “How much did you consciously eat less or restrict your food intake in order to influence your weight today?” Responses were recorded on a visual analogue scale ranging from 0 to 100 (0 = “not at all”; 100 = “very much/a lot”). We selected a dimensional operationalization intended to capture restrictive eating behaviors that could occur across all diagnostic groups included in the study, rather than limiting the assessment to severe forms of restriction characteristic of restrictive ED pathology. Accordingly, the item may also capture comparatively mild forms of restriction (e.g., refraining from eating sweets after a regular meal) as well as forms that may not necessarily be maladaptive in all contexts (e.g., abstaining from binge eating in BED). Within this dimensional framework, higher scores indicate greater self‐reported dietary restriction and are therefore more likely to reflect clinically relevant or pathological restriction.

2.2.4. Trait Questionnaires

2.2.4.1. Eating Disorder Examination‐Questionnaire (EDE‐Q; Hilbert et al. 2007)

The EDE‐Q measures eating disorder psychopathology over the past 28 days. It consists of four subscales and 28 items. Every item can be answered on a scale from 0 (on 0 days) to 6 (everyday). For each subscale, a mean score—ranging from 0 to 6—is calculated, with higher scores indicating higher ED pathology. For our research question, we used the following three subscales:

2.2.4.1.1. Restraint Subscale

It consists of five items related to dietary restriction. The internal consistency was good (α = 0.88).

2.2.4.1.2. Shape Concern Subscale

It consists of eight items related to concerns about weight (gain) and general body shape concerns. The internal consistency was good (α = 0.85).

2.2.4.1.3. Weight Concern Subscale

This subscale consists of five items related to concerns about weight. The internal consistency was acceptable considering the brevity of the scale (α = 0.68).

To capture similar constructs in questionnaire variables and daily diary variables we used the EDE‐Q restraint subscale as a counterpart to dietary restriction (daily diary) and used a combination of the EDE‐Q shape and the EDE‐Q weight concern subscale means as a counterpart to body dissatisfaction (daily diary). Questionnaire measures were used to describe trait‐level characteristics of the sample and were chosen for their established validation and psychometric properties. Due to one overlapping item, the combined subscale consists of 11 items. The internal consistency of the combined shape and weight concerns subscale was excellent, with Cronbach's α = 0.94.

2.3. Procedure

Before the start of the study, informed consent was acquired from all participants. Consenting participants were then asked to fill out an online questionnaire consisting of trait measures and questions on sociodemographic data, such as age, BMI, or occupation. Next, participants were asked to take part in a clinical diagnostic telephone interview and instructions on using and installing PsyDiary on their smartphones—a customized App for this study. The call lasted between one and two hours.

Via PsyDiary, participants were prompted with short EMA‐questionnaires at six fixed time points during the day (9:00 a.m., 11:30 a.m., 2:00 p.m., 4:30 p.m., 7:00 p.m., and 9:30 p.m.) over a period of 9 days. Questionnaires were available for 1 h after the prompt. The first day was used as a trial day to get participants to familiarize themselves with the App and items and the data from that day was discarded.

As a reward for participation, all participants received personalized feedback on their EMA data after the study. Depending on whether they were psychology students at the University of Salzburg or not, participants either received one to two course credits or 10–25 €, depending on their compliance/response rate in the EMA questionnaire.

2.4. Statistical Analyses

A multilevel modeling (MLM) approach was used to account for nesting of within‐person (daily diary signals, level 1) and between‐person (individuals, level 2) variance (Bliese 2022). Dietary restriction on the next day was the dependent variable. Day 1 body dissatisfaction was modeled as a predictor of Day 2 dietary restriction and therefore time‐lagged (t−1) and person‐mean centered. Moreover, we adjusted for autoregression of dietary restriction. Only pairs of consecutive daily assessments (day t to day t + 1) were included in the lagged analyses; longer‐interval lags were not estimated. ‘Group’ was modeled as a categorical level 2 predictor (coded as: CG = 0, ANr = 1, ANbp = 2, BN = 3, BED = 4). MLMs with random intercepts (‘ID’) and random slopes (‘Body Dissatisfaction’) were tested in addition to the models with fixed effects ‘body dissatisfaction’ and ‘group’, and their interaction, to model variance between and within individuals. The model with random intercepts but fixed slopes had a better model fit (BIC: 7522) as compared to the model with random intercepts and random slopes (BIC: 7531). So, we used this model for further analysis. Another addition was the reversal of our main model: Day 1 dietary restriction was modeled as a predictor of Day 2 body dissatisfaction and for that purpose time‐lagged (t−1) and person‐mean centered; it was also adjusted for autoregression of body dissatisfaction.

Multilevel models were calculated in (R Core Team 2025) using the package lme4 (Bates et al. 2015) and results examined using lmerTest (Kuznetsova et al. 2017). Omnibus tests were used to test for significant ‘Group*Body Dissatisfaction’ interactions, and significant interactions were followed up with pairwise comparisons of the simple slopes per group. Simple slope tests can be found in Table S3 in Supporting Information: Appendix C, and pairwise comparisons of simple slopes in Table 2.

TABLE 2.

Pairwise contrasts of significant interaction effects from the multilevel model on ‘Dietary Restriction (next day)’ predicted by ‘Body Dissatisfaction’ and ‘Group’ adjusted for autoregression of dietary restriction.

Compared groups Estimate (SE) p
CG vs. ANr −0.17 (0.17) 0.33
CG vs. ANbp −0.39 (0.17) 0.02
CG vs. BN −0.32 (0.14) 0.02
CG vs. BED 0.23 (0.14) 0.11
ANr vs. ANbp −0.21 (0.21) 0.31
ANr vs. BN −0.15 (0.19) 0.43
ANr vs. BED 0.40 (0.19) 0.03
ANbp vs. BN −0.07 (0.18) 0.72
ANbp vs. BED 0.62 (0.19) 0.001
BN vs. BED 0.55 (0.16) 0.001
pseudo‐R2 Marginal 0.20
pseudo‐R2 conditional 0.61
Open in a new tab

Note: SE, standard error; Groups: CG, non‐ED control group; ANr, anorexia nervosa restricting type; ANbp = anorexia nervosa binge‐eating/purging type; BN, bulimia nervosa; BED, binge‐eating disorder. p values are Tukey adjusted for multiple comparisons.

3. Results

3.1. Body Dissatisfaction and Dietary Restriction

ED groups exhibited higher scores on the combined shape and weight concern subscale, as well as on the restraint subscale of the EDE‐Q, compared to the CG. BN and ANbp reported the highest shape and weight concerns, followed by BED and ANr (see Figure 1 and Table 1). Similarly, ED groups showed higher daily body dissatisfaction (daily diary) compared to the CG, without subgroup differences among ED groups. All ED groups differed significantly from the CG on the restraint subscale of the EDE‐Q, with ANbp reporting the highest scores, followed by BN and ANr (no significant difference), BED, and the CG. Daily reported dietary restriction (daily diary) was high in ANr, ANbp, and BN, followed by lower scores in BED and the lowest scores in the CG. For more details, see Table 1 and Figure 1.

FIGURE 1.

FIGURE 1

Open in a new tab

Boxplots of body dissatisfaction and dietary restriction per group. Note: Groups: CG, non‐ED control group; ANr, anorexia nervosa restricting type; ANbp, anorexia nervosa binge‐eating/purging type; BN, bulimia nervosa; BED, binge‐eating disorder.

3.2. Group Differences in the Association of Body Dissatisfaction With Dietary Restriction on the Following Day

Main effects of group (F (4, 164.1) = 16.1, p < 0.001) and body dissatisfaction (F (1, 6.5) = 661.4, p < 0.01) as well as their interaction (F (4, 658.5) = 4.4, p < 0.01) were significant (see Table 3) and attributable to group specific slopes (Figure 2, for more details check Table 2 and Table S3 in Supporting Information: Appendix C): a positive association was found in patients with ANbp and BN, where more body dissatisfaction on 1 day preceded more dietary restriction on the next day. There was no significant difference between the ANbp and BN slopes (t (648) = 0.37, p = 0.71), but both differed from the CG (CG–ANbp: t (649) = 2.27, p = 0.02; CG–BN: t (645) = 2.25, p = 0.03; see Table 2). Figure 1 suggests that ANr follows a similar pattern, but ANr did not differ from the CG (t (688) = 1.00, p = 0.32) and showed no significant positive slope (b = 0.188, p = 0.22). Patients with BED showed a descriptively opposite pattern and differed significantly from ANr, ANbp, and BN (ANr–BED: t (681) = 2.10, p = 0.040; ANbp–BED: t (648) = 3.30, p = 0.001; BN–BED: t (644) = 3.43, p = 0.001), but not from the CG (CG–BED: t (645) = 1.58, p = 0.116). As for the CG, dietary restriction was not associated with body dissatisfaction, descriptively showing an almost flat slope (b = 0.015, p = 0.88).

TABLE 3.

Test of fixed effects, random effects, model fit indices for the main model adjusted for autoregression of dietary restriction.

Fixed effects Sum of squares Mean square dfNum. dfDen. F p
Body dissatisfaction a 2438.0 2438.0 1 661.4 6.5 < 0.005
Group 24091.8 6022.9 4 164.1 16.1 < 0.001
Dietary restriction a autoregression 68.9 68.9 1 653.9 0.2 0.668
Body dissatisfaction a group 6565.2 1641.3 4 657.5 4.4 < 0.001
Random effects Variance SD
Intercept 381.7 19.5
Residual 374.0 19.3
Model fit indices AIC BIC R2 marginal R2 conditional
7460.7 7521.9 0.2 0.6
Open in a new tab

Note: Intercept, the intercept refers to the random effects part of the model, where the data are nested in participants. lme4 formula: Restriction today~Body Dissatisfaction a x Group + Body Dissatisfaction a + (1| ID).

Abbreviations: AIC, Akaike information criterion; BIC, Bayesian information criterion; dfNum., numerator degrees of freedom; dfDen., denominator degrees of freedom; ID, participant identifier; SD, standard deviation; R2marginal, marginal coefficient of determination; R2conditional, conditional coefficient of determination.

a

Lagged and person mean centered variable.

FIGURE 2.

FIGURE 2

Open in a new tab

Simple slopes of the ‘Body Dissatisfaction Day 0*Group’ interaction on ‘Dietary Restriction’ Day 1. Note: Groups: CG, non‐ED control group; ANr, anorexia nervosa restricting type; ANbp, anorexia nervosa binge‐eating/purging type; BN, bulimia nervosa; BED, binge‐eating disorder.

When reversing the model—assigning dietary restriction (day 1) and group as the predictors—and body dissatisfaction (day 2) on the next day as the dependent variable, no significant interaction between dietary restriction and group emerged (F (4, 653.1) = 0.6, p = 0.65; see Table 4). Moreover, only a significant main effect of group (F (4, 166) = 16.1, p < 0.001; underlining descriptive findings on body dissatisfaction shown in Figure 1) and no significant main effect of restriction (F (1, 657) = 1.3, p = 0.25) emerged.

TABLE 4.

Test of fixed effects, random effects, model fit indices for the reversed model adjusted for autoregression of body dissatisfaction.

Fixed effects Sum of squares Mean square dfNum. dfDen. F p
Dietary restriction a 286.2 286.2 1 655 1.3 0.255
Group 15063.5 3765.9 4 165.9 16.1 < 0.001
Body dissatisfaction a autoregression 0.0 0.0 1 646.0 0.0 0.996
Dietary restriction a,b group 547.4 136.9 4 652.0 0.6 0.648
Random effects Variance SD
Intercept 374.6 19.4
Residual 220.4 14.9
Model fit indices AIC BIC R 2 marginal R 2 conditional
7108.4 7169.6 0.2 0.7
Open in a new tab

Note: Intercept, the intercept refers to the random effects part of the model, where the data are nested in participants. lme4 formula: Body Dissatisfaction~Restriction today a x Group + Body Dissatisfaction a + (1| ID2).

Abbreviations: AIC, Akaike information criterion; BIC, Bayesian information criterion; dfNum., numerator degrees of freedom; dfDen., denominator degrees of freedom; ID, participant identifier; SD, standard deviation; R 2marginal, marginal coefficient of determination; R 2conditional, conditional coefficient of determination.

a

Lagged and person mean centered variable.

Additionally, we calculated alternative models that do not control for the autoregression of the dependent variable in both models (see Tables S4 and S6 in Supporting Information: Appendix D) as well as simple slope tests and pairwise comparisons of simple slopes for significant interactions (see Table S5 in Supporting Information: Appendix D). The result patterns were similar to the models reported here, with a slightly better model fit. Moreover, we calculated an additional model for the reversal of our main model excluding the interaction term, which also yields similar results to the model reported here (see Table S7 in Supporting Information: Appendix E).

4. Discussion

To our knowledge, this is the first study to investigate prospective, day‐to‐day associations between body dissatisfaction and dietary restriction across all major ED groups. Daily diary data were the focus of the analysis, alongside corresponding trait questionnaire measures. We expected group (ED groups, CG) to moderate prospective day‐to‐day associations between body dissatisfaction and dietary restriction, with the clearest linkage in BN and ANbp, weaker or absent associations in ANr, and no such linkage in BED and the CG.

At a descriptive level, both daily diary and questionnaire data indicated elevated body dissatisfaction across all ED groups relative to the CG, whereas elevated dietary restriction was observed in ANr, ANbp, and BN compared with BED and the CG. Our daily diary findings further showed that in participants with BN and ANbp, worse feelings about their body were followed by more reported dietary restriction on the next day. Also consistent with predictions, the direction of the association flipped in BED, differing significantly from the other ED groups, although not from the CG. Results for ANr were inconclusive, placing this group “in between” ANbp/BN and the CG and differing significantly only from BED.

4.1. Interpretation by Diagnostic Group

Our findings for BN and ANbp are largely consistent with models of ED emergence such as the dual pathway model of eating disorders (Stice 1994) and the tripartite influence model (Thompson et al. 1999) as well as with extensions of these models to AN and related empirical findings (Mason et al. 2018; Urvelyte and Perminas 2015). Notably, both ANbp and BN also showed the highest shape and weight concern scores on the EDE‐Q among all groups (see Table 1). Since the common factor between both diagnostic groups seems to be purging behavior, future research could examine purging behavior in more detail. This might aid in characterizing these two groups better and in differentiating them from ANr and BED. Our results further suggest that daily associations between body dissatisfaction and dietary restriction may reflect potential maintenance‐related processes in BN and ANbp. This is consistent with longitudinal findings in at‐risk youth showing that a similar pattern may also function as a risk factor for ED onset (Stice and Van Ryzin 2019; Yamamiya and Stice 2024). Taken together, these findings suggest that the link between body dissatisfaction and dietary restriction appears to be relevant at multiple stages of ED symptomatology and may therefore represent a worthwhile target for intervention.

Within the ANr group, the day‐to‐day pattern was not clearly apparent (see Table S3 in Supporting Information: Appendix C). Thus, our data do not allow a clear conclusion as to whether the body dissatisfaction–dietary restriction link is meaningfully weaker in ANr, absent, or comparable to that in BN/ANbp. Further clarifying this pattern—ideally in larger ANr samples (our ANr subgroup was N = 24) – is therefore an important avenue for future research.

Individuals with BED showed an almost reversed pattern with higher body dissatisfaction preceding lower dietary restriction. Potentially, participants with BED may have interpreted our dietary restriction item differently than participants in other ED groups or the CG: Instead of a maladaptive restrictive pattern, they might have seen dietary restriction as an attempt to maintain control over their binge‐eating episodes and therefore as an adaptive behavior (Stewart et al. 2022).

4.2. Temporal Directionality and Timescale

While body dissatisfaction predicted next‐day dietary restriction in BN and ANbp, we found no evidence for the reverse lagged association, that is, from dietary restriction to body dissatisfaction. This pattern supports the temporal ordering of body dissatisfaction preceding dietary restriction and is consistent with a directional interpretation. However, the present design does not permit causal conclusions and other unmeasured influences, such as the internal or external context of a given day, may also have contributed to this association. Future research should therefore examine this relationship and potential causality more directly, for example using cross‐lagged panel analyses or lagged networks (Kahveci et al. 2025), as well as experimental manipulation of body dissatisfaction.

Interestingly, findings from our day‐to‐day design differ from studies using shorter (i.e., within‐day) intervals. Studies using mixed ED or non‐clinical female samples showed that within a day, body dissatisfaction did not predict subsequent restriction (Mason et al. 2021; Sala et al. 2021). This points to both the importance of the time‐scale used (day‐to‐day vs. intra‐day) and the importance of differentiating ED subgroups.

4.3. Clinical Implications

The unidirectional association between body dissatisfaction and dietary restriction suggests that body dissatisfaction may be a particularly relevant treatment target in ANbp and BN. This could be addressed with interventions using body image exposure (Butler and Heimberg 2020), media literacy (Kurz et al. 2022), or self‐compassion exercises (Braun et al. 2016; Rahimi Ardabili et al. 2018). Some of these methods might also be provided through mHealth formats (e.g., Buehler et al. 2026; Nahum‐Shani et al. 2018; Smith et al. 2019). Additionally, such interventions might not be uniformly effective in reducing maladaptive restriction across all EDs alike. Our results suggest that individuals with ANbp and BN might particularly benefit from such interventions while BED and ANr might need alternative interventions.

4.4. Limitations

Several limitations of the present study should be acknowledged. First, the sample included female participants only and did not cover other EDs, such as pica and avoidant/restrictive food intake disorder. This limits generalizability and future research should broaden the sample characteristics. Second, BMI was derived from self‐reported data and may therefore be subject to reporting bias. While our results are unlikely to have been influenced by self‐report bias, assignment to a diagnostic group (e.g., AN vs. atypical AN) may rely on accurate BMI reports. However, most participants with AN were recruited from a waitlist for an inpatient stay, where AN had already been diagnosed for referral to the clinic. In addition, diagnostic group assignment was informed by two diagnostic interviews. Nevertheless, future research should incorporate objectively measured height and weight to strengthen diagnostic accuracy. Third, we decided to assess body dissatisfaction and dietary restriction only at the end of the day to tap into an intermediate process between intraday (micro‐level) and questionnaire‐based (macro‐level) associations. Future studies could complement our day‐to‐day‐level models with similar intra‐day measurements as in the studies discussed above (Mason et al. 2021; Sala et al. 2021). It would be especially interesting to test whether individuals with BN and ANbp—who showed the clearest day‐to‐day relationships in the present study—also display similar patterns at shorter, intra‐day time intervals. Another limitation of our study is that we could not meaningfully characterize racial or ethnic diversity, as categories commonly used in US‐based research are not routinely assessed and are not readily transferable to German‐speaking contexts. Although most participants reported German or Austrian nationality, nationality does not map directly onto race or ethnicity. Future research should assess race and ethnicity in more detail.

5. Conclusion

In sum, we found evidence for a central role of body dissatisfaction in female participants with ANbp and BN. This supports an interventional focus on body dissatisfaction in these groups and further research on the potential maladaptive link between body dissatisfaction and dietary restriction.

Author Contributions

Ann‐Kathrin Arend: writing – review and editing, resources, supervision, data curation, conceptualization, investigation, project administration, visualization, formal analysis. Michaela R. Buehler: conceptualization, formal analysis, data curation, visualization, writing – original draft, writing – review and editing. Julia Reichenberger: writing – review and editing, resources, investigation, project administration. Jens Blechert: supervision, conceptualization, writing – review and editing, funding acquisition.

Lived Experience Involvement Statement

No specific efforts were undertaken to involve persons with lived experience in the study design or execution, or in the preparation of this manuscript.

Funding

This work was supported by the Federal Ministry of Education, Science and Research of Austria; the Innovation Foundation for Education Research (Innovationsstiftung für Bildungsforschung) of Austria; H2020 European Research Council, ERC‐StG‐2014 639445 NewEat.

Conflicts of Interest

The authors declare no conflicts of interest.

Supporting information

Data S1: EMAbodydat.

Data S2: MichaelaOSFCode.

Table S1: Papers focusing on other parts of the ‘NewEat’ project.

Table S2: Means and standard deviations of the EDE‐Q and two EDE‐Q subscales by group.

Table S3: Slopes by group for the association between body dissatisfaction (day 0) and dietary restriction (day 1), adjusted for autoregression in dietary restriction.

Table S4: Test of fixed effects, random effects, model fit indices for the main model.

Table S5: Pairwise contrasts of significant interaction effects from multilevel model on ‘Dietary Restriction (next day)’ predicted by ‘body dissatisfaction’ and ‘group.’

Table S6: Test of fixed effects, random effects, and model fit indices for the reversed model without the interaction term.

Table S7: Omnibus test of fixed effects, random effects, model fit indices for the reversed model without interaction.

EAT-59-1753-s001.zip (191KB, zip)

Acknowledgments

We used ChatGPTversion GPT‐5.2 by OpenAI to assist with language editing (grammar/style), to support literature search (keywords/candidate articles), and to suggest/debug R code used in data processing and analysis. All AI‐assisted outputs were reviewed and verified by the authors. Open Access funding provided by Paris Lodron Universitat Salzburg/KEMÖ.

Buehler, M. R. , Arend A.‐K., Reichenberger J., and Blechert J.. 2026. “Daily Body (Dis‐)Satisfaction and Dietary Restriction in Women Across the Eating Disorder Spectrum.” International Journal of Eating Disorders 59, no. 8: 1753–1763. 10.1002/eat.70110.

Action Editor: Anja Hilbert

Data Availability Statement

The data that supports the findings of this study are available in the Supporting Information of this article.

References

  1. Bates, D. , Mächler M., Bolker B., and Walker S.. 2015. “Fitting Linear Mixed‐Effects Models Using lme4.” Journal of Statistical Software 67, no. 1: 1–48. 10.18637/jss.v067.i01. [DOI] [Google Scholar]
  2. Bliese, P. D. 2022. Multilevel Modeling in R (2.7): A Brief Introduction to R, the Multilevel Package and the Nlme Package. Comprehensive R Archive Network (CRAN). https://cran.r‐project.org/doc/contrib/Bliese_Multilevel.pdf. [Google Scholar]
  3. Braun, T. D. , Park C. L., and Gorin A.. 2016. “Self‐Compassion, Body Image, and Disordered Eating: A Review of the Literature.” Body Image 17: 117–131. 10.1016/j.bodyim.2016.03.003. [DOI] [PubMed] [Google Scholar]
  4. Brytek‐Matera, A. , and Czepczor K.. 2017. “Models of Eating Disorders: A Theoretical Investigation of Abnormal Eating Patterns and Body Image Disturbance.” Archives of Psychiatry and Psychotherapy 19, no. 1: 16–26. 10.12740/APP/68422. [DOI] [Google Scholar]
  5. Buehler, M. R. , Kolar D. R., Ertl S., Mata J., and Blechert J.. 2026. “Combining Social Media Literacy With Self‐Compassion: Testing the SoSelf mHealth Training.” Body Image 56: 102041. 10.1016/j.bodyim.2026.102041. [DOI] [PubMed] [Google Scholar]
  6. Buhlmann, U. , Glaesmer H., Mewes R., et al. 2010. “Updates on the Prevalence of Body Dysmorphic Disorder: A Population‐Based Survey.” Psychiatry Research 178, no. 1: 171–175. 10.1016/j.psychres.2009.05.002. [DOI] [PubMed] [Google Scholar]
  7. Butler, R. M. , and Heimberg R. G.. 2020. “Exposure Therapy for Eating Disorders: A Systematic Review.” Clinical Psychology Review 78: 101851. 10.1016/j.cpr.2020.101851. [DOI] [PubMed] [Google Scholar]
  8. Choate, L. H. 2005. “Toward a Theoretical Model of Women's Body Image Resilience.” Journal of Counseling & Development 83, no. 3: 320–330. 10.1002/j.1556-6678.2005.tb00350.x. [DOI] [Google Scholar]
  9. Engel, S. G. , Crosby R. D., Thomas G., et al. 2016. “Ecological Momentary Assessment in Eating Disorder and Obesity Research: A Review of the Recent Literature.” Current Psychiatry Reports 18, no. 4: 37. 10.1007/s11920-016-0672-7. [DOI] [PubMed] [Google Scholar]
  10. Fitzsimmons‐Craft, E. E. , Bardone‐Cone A. M., Wonderlich S. A., Crosby R. D., Engel S. G., and Bulik C. M.. 2015. “The Relationships Among Social Comparisons, Body Surveillance, and Body Dissatisfaction in the Natural Environment.” Behavior Therapy 46, no. 2: 257–271. 10.1016/j.beth.2014.09.006. [DOI] [PMC free article] [PubMed] [Google Scholar]
  11. Goeden, A. V. , Schaefer L. M., Crosby R. D., et al. 2023. “Examining the Momentary Relationships Between Body Checking and Eating Disorder Symptoms in Women With Anorexia Nervosa.” Eating Behaviors 50: 101751. 10.1016/j.eatbeh.2023.101751. [DOI] [PMC free article] [PubMed] [Google Scholar]
  12. Goldschmidt, A. B. , Wonderlich S. A., Crosby R. D., et al. 2014. “Ecological Momentary Assessment of Stressful Events and Negative Affect in Bulimia Nervosa.” Journal of Consulting and Clinical Psychology 82, no. 1: 30–39. 10.1037/a0034974. [DOI] [PMC free article] [PubMed] [Google Scholar]
  13. Hilbert, A. , Karwautz A., Niederhofer H., and Munsch S.. 2007. “Eating Disorder Examination‐Questionnaire: Evaluation der Deutschsprachigen Übersetzung [Eating Disorder Examination‐Questionnaire: Evaluation of the German‐Language Translation].” Diagnostica 53: 144–154. 10.1026/0012-1924.53.3.144. [DOI] [Google Scholar]
  14. Hilbert, A. , Tuschen‐Caffier B., and Ohms M.. 2004. “Eating Disorder Examination: Deutschsprachige Version Des Strukturierten Essstörungsinterviews [Eating Disorder Examination: A German Version of the Structured Eating Disorder Interview].” Diagnostica 50: 98–106. 10.1026/0012-1924.50.2.98. [DOI] [Google Scholar]
  15. Kahveci, S. , Reichenberger J., Arend A., et al. 2025. “Temporal Relationships Between Mood and Eating Across Eating Disorders: A Network Approach.” OSF Preprints. 10.31234/osf.io/f7svd_v1. [DOI] [PMC free article] [PubMed] [Google Scholar]
  16. Kurz, M. , Rosendahl J., Rodeck J., Muehleck J., and Berger U.. 2022. “School‐Based Interventions Improve Body Image and Media Literacy in Youth: A Systematic Review and Meta‐Analysis.” Journal of Prevention 43, no. 1: 5–23. 10.1007/s10935-021-00660-1. [DOI] [PubMed] [Google Scholar]
  17. Kuznetsova, A. , Brockhoff P. B., and Christensen R. H. B.. 2017. “lmerTest Package: Tests in Linear Mixed Effects Models.” Journal of Statistical Software 82, no. 13: 1–26. 10.18637/jss.v082.i13. [DOI] [Google Scholar]
  18. Lavender, J. M. , Wonderlich S. A., Crosby R. D., et al. 2013. “A Naturalistic Examination of Body Checking and Dietary Restriction in Women With Anorexia Nervosa.” Behaviour Research and Therapy 51, no. 8: 507–511. 10.1016/j.brat.2013.05.004. [DOI] [PMC free article] [PubMed] [Google Scholar]
  19. Mason, T. B. , Lavender J. M., Wonderlich S. A., et al. 2018. “Examining a Momentary Mediation Model of Appearance‐Related Stress, Anxiety, and Eating Disorder Behaviors in Adult Anorexia Nervosa.” Eating and Weight Disorders ‐ Studies on Anorexia, Bulimia and Obesity 23, no. 5: 637–644. 10.1007/s40519-017-0404-y. [DOI] [PMC free article] [PubMed] [Google Scholar]
  20. Mason, T. B. , Smith K. E., Crosby R. D., Engel S. G., and Wonderlich S. A.. 2021. “Examination of Momentary Maintenance Factors and Eating Disorder Behaviors and Cognitions Using Ecological Momentary Assessment.” Eating Disorders 29, no. 1: 42–55. 10.1080/10640266.2019.1613847. [DOI] [PMC free article] [PubMed] [Google Scholar]
  21. Menzel, J. E. , Schaefer L. M., Burke N. L., Mayhew L. L., Brannick M. T., and Thompson J. K.. 2010. “Appearance‐Related Teasing, Body Dissatisfaction, and Disordered Eating: A Meta‐Analysis.” Body Image 7, no. 4: 261–270. 10.1016/j.bodyim.2010.05.004. [DOI] [PubMed] [Google Scholar]
  22. Mond, J. , Mitchison D., Latner J., Hay P., Owen C., and Rodgers B.. 2013. “Quality of Life Impairment Associated With Body Dissatisfaction in a General Population Sample of Women.” BMC Public Health 13, no. 1: 920. 10.1186/1471-2458-13-920. [DOI] [PMC free article] [PubMed] [Google Scholar]
  23. Morrissey, R. A. , Gondoli D. M., and Corning A. F.. 2020. “Reexamining the Restraint Pathway as a Conditional Process Among Adolescent Girls: When Does Dieting Link Body Dissatisfaction to Bulimia?” Development and Psychopathology 32, no. 3: 1031–1043. 10.1017/S0954579419001287. [DOI] [PubMed] [Google Scholar]
  24. Nahum‐Shani, I. , Smith S. N., Spring B. J., et al. 2018. “Just‐In‐Time Adaptive Interventions (JITAIs) in Mobile Health: Key Components and Design Principles for Ongoing Health Behavior Support.” Annals of Behavioral Medicine 52, no. 6: 446–462. 10.1007/s12160-016-9830-8. [DOI] [PMC free article] [PubMed] [Google Scholar]
  25. Pennesi, J.‐L. , and Wade T. D.. 2016. “A Systematic Review of the Existing Models of Disordered Eating: Do They Inform the Development of Effective Interventions?” Clinical Psychology Review 43: 175–192. 10.1016/j.cpr.2015.12.004. [DOI] [PubMed] [Google Scholar]
  26. Prnjak, K. , Jukic I., Mitchison D., Griffiths S., and Hay P.. 2022. “Body Image as a Multidimensional Concept: A Systematic Review of Body Image Facets in Eating Disorders and Muscle Dysmorphia.” Body Image 42: 347–360. 10.1016/j.bodyim.2022.07.006. [DOI] [PubMed] [Google Scholar]
  27. Puccio, F. , Kalathas F., Fuller‐Tyszkiewicz M., and Krug I.. 2016. “A Revised Examination of the Dual Pathway Model for Bulimic Symptoms: The Importance of Social Comparisons Made on Facebook and Sociotropy.” Computers in Human Behavior 65: 142–150. 10.1016/j.chb.2016.08.018. [DOI] [Google Scholar]
  28. R Core Team . 2025. R: A Language and Environment for Statistical Computing [Software]. R Foundation for Statistical Computing. https://www.R‐project.org/. [Google Scholar]
  29. Rahimi Ardabili, H. , Reynolds R., Vartanian L., McLeod L., and Zwar N.. 2018. “A Systematic Review of the Efficacy of Interventions That Aim to Increase Self‐Compassion on Nutrition Habits, Eating Behaviours, Body Weight and Body Image.” Mindfulness 9: 1–13. 10.1007/s12671-017-0804-0. [DOI] [Google Scholar]
  30. Sala, M. , Linde J. A., Crosby R. D., and Pacanowski C. R.. 2021. “State Body Dissatisfaction Predicts Momentary Positive and Negative Affect but Not Weight Control Behaviors: An Ecological Momentary Assessment Study.” Eating and Weight Disorders ‐ Studies on Anorexia, Bulimia and Obesity 26, no. 6: 1957–1962. 10.1007/s40519-020-01048-6. [DOI] [PMC free article] [PubMed] [Google Scholar]
  31. Schaefer, L. M. , Engel S. G., and Wonderlich S. A.. 2020. “Ecological Momentary Assessment in Eating Disorders Research: Recent Findings and Promising New Directions.” Current Opinion in Psychiatry 33, no. 6: 528–533. 10.1097/YCO.0000000000000639. [DOI] [PMC free article] [PubMed] [Google Scholar]
  32. Smith, J. M. , Whisenhunt B. L., Buchanan E. M., and Hudson D. L.. 2019. “Evaluating the Effectiveness of Ecological Momentary Assessment and Intervention Targeting Body Checking Behaviors.” Eating Disorders 27, no. 6: 521–537. 10.1080/10640266.2018.1560850. [DOI] [PubMed] [Google Scholar]
  33. Smyth, J. , Wonderlich S., Crosby R., Miltenberger R., Mitchell J., and Rorty M.. 2001. “The Use of Ecological Momentary Assessment Approaches in Eating Disorder Research.” International Journal of Eating Disorders 30, no. 1: 83–95. 10.1002/eat.1057. [DOI] [PubMed] [Google Scholar]
  34. Stewart, T. M. , Martin C. K., and Williamson D. A.. 2022. “The Complicated Relationship Between Dieting, Dietary Restraint, Caloric Restriction, and Eating Disorders: Is a Shift in Public Health Messaging Warranted?” International Journal of Environmental Research and Public Health 19, no. 1: 491. 10.3390/ijerph19010491. [DOI] [PMC free article] [PubMed] [Google Scholar]
  35. Stice, E. 1994. “Review of the Evidence for a Sociocultural Model of Bulimia Nervosa and an Exploration of the Mechanisms of Action.” Clinical Psychology Review 14, no. 7: 633–661. 10.1016/0272-7358(94)90002-7. [DOI] [Google Scholar]
  36. Stice, E. , Presnell K., and Spangler D.. 2002. “Risk Factors for Binge Eating Onset in Adolescent Girls: A 2‐Year Prospective Investigation.” Health Psychology 21, no. 2: 131–138. 10.1037/0278-6133.21.2.131. [DOI] [PubMed] [Google Scholar]
  37. Stice, E. , and Van Ryzin M. J.. 2019. “A Prospective Test of the Temporal Sequencing of Risk Factor Emergence in the Dual Pathway Model of Eating Disorders.” Journal of Abnormal Psychology 128, no. 2: 119–128. 10.1037/abn0000400. [DOI] [PMC free article] [PubMed] [Google Scholar]
  38. Strien, T. V. , Engels R. C. M. E., Leeuwe J. V., and Snoek H. M.. 2005. “The Stice Model of Overeating: Tests in Clinical and Non‐Clinical Samples.” Appetite 45, no. 3: 205–213. 10.1016/j.appet.2005.08.004. [DOI] [PubMed] [Google Scholar]
  39. Thompson, J. , Coovert M., and Stormer S.. 1999. “Body Image, Social Comparison, and Eating Disturbance: A Covariance Structure Modeling Investigation.” International Journal of Eating Disorders 26: 43–51. 10.1002/(SICI)1098-108X(199907)26:1<43::AID-EAT6>3.0.CO;2-R. [DOI] [PubMed] [Google Scholar]
  40. Urvelyte, E. , and Perminas A.. 2015. “The Dual Pathway Model of Bulimia: Replication and Extension With Anorexia.” Procedia ‐ Social and Behavioral Sciences 205: 178–183. 10.1016/j.sbspro.2015.09.054. [DOI] [Google Scholar]
  41. Wittchen, H.‐U. , Zaudig M., and Fydrich T.. 1997. SKID: Strukturiertes klinisches Interview für DSM‐IV. Achse I und II. Handanweisung. Hogrefe. [Google Scholar]
  42. Wyssen, A. , Leins J., Reichenberger J., Blechert J., Munsch S., and Steins‐Loeber S.. 2020. “Body‐Related Cognitive Distortions (Thought–Shape Fusion Body) Associated With Thin‐Ideal Exposure in Female Students—An Ecological Momentary Assessment Study.” Clinical Psychology & Psychotherapy 27, no. 2: 220–227. 10.1002/cpp.2421. [DOI] [PubMed] [Google Scholar]
  43. Yamamiya, Y. , and Stice E.. 2024. “Risk Factors That Predict Future Onset of Anorexia Nervosa, Bulimia Nervosa, Binge Eating Disorder, and Purging Disorder in Adolescent Girls.” Behavior Therapy 55, no. 4: 712–723. 10.1016/j.beth.2023.10.002. [DOI] [PMC free article] [PubMed] [Google Scholar]

Associated Data

This section collects any data citations, data availability statements, or supplementary materials included in this article.

Supplementary Materials

Data S1: EMAbodydat.

Data S2: MichaelaOSFCode.

Table S1: Papers focusing on other parts of the ‘NewEat’ project.

Table S2: Means and standard deviations of the EDE‐Q and two EDE‐Q subscales by group.

Table S3: Slopes by group for the association between body dissatisfaction (day 0) and dietary restriction (day 1), adjusted for autoregression in dietary restriction.

Table S4: Test of fixed effects, random effects, model fit indices for the main model.

Table S5: Pairwise contrasts of significant interaction effects from multilevel model on ‘Dietary Restriction (next day)’ predicted by ‘body dissatisfaction’ and ‘group.’

Table S6: Test of fixed effects, random effects, and model fit indices for the reversed model without the interaction term.

Table S7: Omnibus test of fixed effects, random effects, model fit indices for the reversed model without interaction.

EAT-59-1753-s001.zip (191KB, zip)

Data Availability Statement

The data that supports the findings of this study are available in the Supporting Information of this article.

Articles from The International Journal of Eating Disorders are provided here courtesy of Wiley

RESOURCES