Bridging eating disorder and muscle dysmorphia symptoms: The role of fear

Eating disorders (EDs) and muscle dysmorphia (MD) are impairing conditions shaped by sociocultural trends that increasingly emphasize both thinness and muscularity. Despite their overlap, little is known about their symptom-level connections or how body- and eating-related fears are related to both disorders. This pre-registered study used network analysis to explore these associations. A sample of 1432 university students (68.72% women; 47.91% White; M age = 20.36) completed self-report measures of ED and MD symptoms and fears. Following rigorous item selection, two networks were estimated at the item level using regularized partial correlations: one with ED and MD symptoms and another including fears. Central and bridge symptoms were identified using strength and expected influence indices. Networks were re-estimated separately for women and men and compared using the Network Comparison Test. Across both networks, body image concerns, exercise-related guilt, and weight gain-related fears were most central. Bridge symptoms linking ED and MD were body fat dissatisfaction, counting calories, overvaluation of food, and fear of social eating. Gender-stratified analyses revealed differences in network structure, but not global strength, between women and men. Findings highlight cognitive and affective symptoms, particularly shape concerns, as central to eating pathology across genders. Bridge symptoms, including fear of social eating, point to transdiagnostic factors that may be associated with the co-occurrence or transition between EDs and MD. Future longitudinal research is needed to clarify causal pathways, informing assessment, prevention, and treatment strategies targeting both thinness- and muscularity-oriented eating pathology.