Body image, self-esteem, emotion regulation, and eating disorders in adults: a systematic review

This systematic review examines the connections between eating disorders, body image disturbance, self-esteem, and emotion regulation in adults. Following the PRISMA guidelines, a systematic search of PubMed, Scopus, and Web of Science databases was conducted for articles published between 2010 and June 2024. Studies were included if they involved participants aged 18 years and older, employed validated tools for measuring the variables, and presented original research that specifically addressed these psychological factors. Out of 1117 records, six studies met the inclusion criteria, with mostly female samples and a focus on body image, self-esteem, and emotion regulation in relation to eating disorders. The results indicate that body dissatisfaction is closely related to disordered eating behaviors, with a significant link to lower self-esteem and difficulties in emotion regulation. Obese individuals with binge eating disorder (BED) were found to have more negative attitudes toward obesity and greater levels of depression than their non-BED counterparts. Women with bulimia nervosa showed higher emotion-focused coping, which is associated with low self-worth. Differences in gender were evident, with women exhibiting greater vulnerability to body image dissatisfaction and emotion dysregulation. The results show that treatment for adults with eating disorders should focus on the enhancement of self-esteem, the improvement of body image perception, and the development of adaptive emotion regulation strategies. Lastly, practicing self-compassion techniques in psychotherapy could improve the treatment process for patients suffering from eating disorders, low self-esteem, emotion dysregulation, and body image disturbance. Future studies should investigate these variables in various non-Western cultural contexts for better understanding and clinical intervention for the adult population.