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. 2022 Nov 10;8(11):e11422. doi: 10.1016/j.heliyon.2022.e11422

Table 1.

Highlights and controversies in the seven theories and major covariates upon explaining disordered eating.

Theory Highlights & Controversies
1. Self-esteem Intrapersonal motivation factor; A vicious cycle of low self-esteem, body dissatisfaction, and disordered eating; Bidirectional mediation impact on disordered eating
2. Interpersonal Social factor; Stress from relationships; Conflict and negative interpersonal evaluations; Mediates the impact of social anxieties upon disordered eating symptomatology
3. Emotion regulation Stress reactivity factor; Overall affect; Numb negative emotions through binge eating/compensatory behaviours; Enhance self-regulation through restrictive dieting
4. Executive function (EF) Cognitive and neurological factor; Impulsivity, decision-making, mental flexibility/shifting capacities, global processing, attention; Directional ambiguity between executive function deficits and problematic eating behaviour
5. Social neuroscience Biological component; Neural mechanisms and activation of certain brain regions during social processing; Impact upon body shape concerns and unstable eating behaviours
6. Theory of mind (ToM) Developmental factor on perspective taking; Capacity to decode the mental states, thoughts, beliefs and emotions of others; Mixed results pertaining to ToM deficits in those with disordered eating
7. Transdiagnostic Shared factors impacting both restrictive and binge eating; Psychological, neurological and cognitive transdiagnostic mechanisms involved in explaining the spectrum of various eating behaviours
Covariate
1. Depression Comorbid mood issues; indirect effect with concurrent low self-esteem through body dissatisfaction; impaired EF such as set shifting; transdiagnostic between binge and restrictive eating disorders.
2. Anxiety Comorbid mental disturbance; diminished mental flexibility as in depression; inability to regulate eating; underlying neurotic tendency
3. Social norms Socio-cultural standards and normative pressure on body image; perceived descriptive and injunctive social norms impacting on eating behaviour; interpersonal and social appraisals; norm-based clinical interventions addressing internalised needs.
4. Family functioning Main clinical streams of family-based intervention and rehabilitation; family communication, cohesion, and conflict factors; family interaction patterns and psychological distress; mixed evidence on the difference between binge and restrictive eating disorders.