Beyond symptom reduction: The longitudinal relationship between eating disorder symptoms and mental wellbeing in...

Eating disorder (ED) symptoms and mental wellbeing are related but distinct dimensions of mental health. However, little is known about their longitudinal relationship, which is essential for understanding prevention and intervention targets. This study examined temporal relationships between ED symptoms and mental wellbeing over 12 months in young women, including which wellbeing dimensions (psychological, emotional, social) most strongly predicted ED symptoms.

Young women (n = 552) completed measures of ED symptoms and mental wellbeing at three timepoints over 12 months. Latent growth curve and cross-lagged panel models examined change trajectories and temporal dynamics.

ED symptoms and mental wellbeing showed moderate baseline correlation (16% shared variance) with 86% of change trajectories operating independently. Cross-lagged analyses revealed asymmetric bidirectional relationships: ED symptoms predicted wellbeing (T1 → T2: β = -.10, p = .039), then wellbeing predicted ED symptoms (T2 → T3: β = -.14, p = .001). Only psychological wellbeing showed bidirectional relationships with ED symptoms.

In young women, ED symptoms predicted subsequent reductions in mental wellbeing, which in turn predicted later symptom worsening. Mental wellbeing, particularly psychological wellbeing, may therefore contribute to symptom persistence if depleted. The findings suggest that mental wellbeing and its relationship to ED symptoms may warrant consideration alongside symptom reduction in research and intervention contexts.