Risk of Disordered Eating Among a Sample of Indian Adolescents: The Role of Online Activity, Social Anxiety and Social Support

Abstract

Background: Although the concept of a slim body was first introduced in Western societies, body dissatisfaction and disordered eating became a globalized issue, and appeared in India and other Asian cultures as well. However, we know much less about the background variables in this region. Aim: To further examine potential risk and protective factors for disordered eating, we aimed to detect the role of online activity (smartphone addiction, time spent online), social anxiety and social support as well as Body Mass Index (BMI), academic performance, and sociodemographics in elevating the risk of disordered eating among a sample of Indian adolescents. Methods: This study employed 112 high school students (aged between 14–18 years; mean age = 16.01 years; SD = 1.08; 47.3% females) from a private high school located in Vadodara, India. Besides sociodemographics, weight and height (Body Mass Index, BMI), academic performance, and average screen time on weekdays/weekends) were asked. We used four different instruments for exploring the psychological variables: Eating Attitudes Test (EAT-26), Smartphone Addiction Scale – Short Version (SAS-SV), The Kutcher Generalized Social Anxiety Scale for Adolescents (K-GSADS-A), and Multidimensional Scale of Perceived Social Support (MSPSS). Results: Using a cut-off score of 20 points, 9.8% of the students were evaluated as being at risk for disordered eating. Besides time spent online on weekdays, smartphone addiction, social anxiety and avoidance, and higher BMI scores elevated the risk of disordered eating in bivariate logistic regressions, while social support served as a protection. In the final multivariate model, only two factors remained significant contributors: being online on weekdays (risk) and being online on weekends (protection). Conclusion: These findings highlight the different roles of Internet use in the risk of disordered eating (weekdays: risky, weekend: protective) among this sample of Indian adolescents which can be explained by a possible shift in students’ social connections (from peers to family) during the different period of the week.

An update on the underlying risk factors of eating disorders onset during adolescence: a systematic review

“…In fact, peer support could be a protective factor of the appearance of EDs symptoms for adolescents whose parents own a controlling parenting style. These individuals perceive the positive reinforcement they need in their equal relationships (Pace et al, 2018;Piko et al, 2023). On the contrary, low-quality relationships based on lack of support, feeling alienated or less self-validation have been identified as risk factors of EDs (Sharpe et al, 2014;Beckers et al, 2023).…”

“…Regarding interpersonal relationships, seven studies identified the influence of these variables on eating behaviors. Perceived peer support was identified as a protective moderator in the relationship between paternal achievement oriented psychological control and EDs symptomatology (Pace et al, 2018;Piko et al, 2023). However, characteristics related with low-quality friendships such as conflicts among friends (Beckers et al, 2023), provide less self-validations, feelings of alienation and perception of less helpful friendships are associated with more probabilities of presenting symptoms of EDs (Sharpe et al, 2014).…”

“…Finally, Kaewpradub et al (2017) conducted a study to analyze the influence of internet and social network use in EDs symptomatology. Moreover, Piko et al (2023) found that adolescents with smartphone addiction presented more probabilities of developing EDs symptoms. Table 1 showed significant associations between these variables with eating problems, binge eating, purging behavior and taking laxatives.…”