Prospective Associations of Gastrointestinal Symptoms With Eating Disorder Psychopathology in Chinese Men and Women

Previous literature has primarily employed cross-sectional designs to investigate associations between gastrointestinal (GI) symptoms and eating disorder (ED) psychopathology, a closely correlated, potentially bidirectional phenomenon; yet few studies have examined the longitudinal directionality of these relationships. This study examined the bidirectional associations between GI symptoms and ED psychopathology in cisgender Chinese adults.

Using a two-wave, 6-month longitudinal design, data were collected from 400 men (M _age = 31.86 years at baseline) and 400 women (M _age = 29.71 years at baseline) via online self-reported questionnaires. GI symptoms and three types of ED psychopathology were measured at baseline (T1) and 6 months later (T2). Data analyses were conducted separately for men and women. Pearson correlation analyses were used to examine bivariate correlations among the variables. Cross-lagged models examined the bidirectional associations of GI symptoms with three types of ED psychopathology, after adjusting for demographic covariates and baseline levels of ED psychopathology.

Thinness-oriented disordered eating (βs = 0.12-0.16) and avoidant/restrictive food intake disorder (ARFID) symptoms (βs = 0.12-0.13) were found to have positive bidirectional associations with GI symptoms in men. No significant bidirectional associations were identified in women. However, in women, thinness- and muscularity-oriented ED psychopathology significantly predicted more GI symptoms, and GI symptoms significantly predicted more ARFID symptoms.

Findings provide valuable insights for potential intervention strategies that target GI symptoms to reduce thinness-oriented ED psychopathology and ARFID symptoms in men. For women, the non-significant bidirectional results also underscore the need for future research to further clarify associations between GI symptoms and ED psychopathology.