The enemy within: the association between self-image and eating disorder symptoms in healthy, non help-seeking and clinical young women

BACKGROUND: Previous research has shown self-image according to the interpersonal Structural Analysis of Social Behavior model, to relate to and predict eating disorder symptoms and outcomes. METHODS: We examined associations between self-reported self-image and ED symptoms in three groups of 16–25 year old females: healthy (N = 388), non help-seeking (N = 227) and clinical (N = 6384). Analyses were divided into age groups of 16–18 and 19–25 years, and the patient sample was divided into diagnostic groups. RESULTS: Stepwise regressions with self-image aspects as independent variables and eating disorder symptoms as dependent showed that low self-love/acceptance and high self-blame were associated with more eating disorder symptoms in all groups, except older patients with bulimia nervosa where self-hate also contributed. Associations were generally weaker in the healthy groups and the older samples. CONCLUSIONS: We put forward that older age, low desirability of symptoms, poorly working symptoms, and being acknowledged as ill, may weaken the association, with implications for treatment and prevention.