The bidirectional relationship between quality of life and eating disorder symptoms: a 9-year community-based study of Australian women

Mitchison, Deborah, Morin, Alexandre, Mond, Jonathan, Slewa-Younan, Shameran, and Hay, Phillipa (2015) The bidirectional relationship between quality of life and eating disorder symptoms: a 9-year community-based study of Australian women. PLoS One, 10 (3). e0120591. pp. 1-18.

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Objective: Studies that have investigated quality of life (QoL) in eating disorders (EDs) have been focussed on the impact of the ED on QoL and little is known regarding the possible reciprocal impact of QoL on EDs. The aim of this study was to provide a first-time investigation of possible bidirectional relationships between EDs and both health-related QoL (HRQoL) and psychological distress (PD).

Method: Structural equation modeling was applied to longitudinal data collected from a community sample of Australian women (N = 828) surveyed at baseline, five annual follow-ups, and again after nine years. Participants reported height and weight (from which body mass index, BMI, was calculated) and completed measures of ED symptoms (Eating Disorder Examination Questionnaire), HRQoL (12-item Medical Outcomes Study Short Form), and PD (Kessler Psychological Distress Scale).

Results: Overall, evidence was found for a bidirectional relationship, whereby ED symptoms predicted reduced HRQoL and greater PD over time, while lower levels of HRQoL and greater PD in turn predicted increased levels of ED symptoms. These relationships were stable, observable within 12 months, and remained observable over a time period of at least four years. However, also observed were some inconsistent findings where ED symptoms predicted a short term (one year) improvement in mental HRQoL. This short term boost was not sustained at longer follow-ups.

Conclusions: Not only do ED symptoms impact on HRQoL and PD, but perceived poor HRQoL and PD also contribute to ED symptom development or exacerbation. This supports a movement away from symptom-centric approaches whereby HRQoL is conceptualized as a passive outcome expected to be rectified by addressing ED symptoms. Improvement in QoL and PD might rather be viewed as targets to be pursued in their own right under broader approaches in the treatment of EDs.

Item ID: 41985
Item Type: Article (Research - C1)
ISSN: 1932-6203
Keywords: eating disorder symptoms, Australian women, health indicators, mental health, quality of life
Additional Information:

© 2015 Mitchison et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

Funders: Australian Rotary Health Research Fund (ARHRF)
Projects and Grants: ARHRF Mental Health Project Grant
Date Deposited: 08 Dec 2015 18:42
FoR Codes: 11 MEDICAL AND HEALTH SCIENCES > 1111 Nutrition and Dietetics > 111199 Nutrition and Dietetics not elsewhere classified @ 40%
17 PSYCHOLOGY AND COGNITIVE SCIENCES > 1701 Psychology > 170105 Gender Psychology @ 20%
11 MEDICAL AND HEALTH SCIENCES > 1103 Clinical Sciences > 110319 Psychiatry (incl Psychotherapy) @ 40%
SEO Codes: 92 HEALTH > 9202 Health and Support Services > 920204 Evaluation of Health Outcomes @ 30%
92 HEALTH > 9202 Health and Support Services > 920209 Mental Health Services @ 30%
92 HEALTH > 9205 Specific Population Health (excl. Indigenous Health) > 920507 Womens Health @ 40%
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