5 - (IOP 33) Weight Stigma, Body Dissatisfaction, and Eating Disorder Behaviors in Iranian Adolescents: A Longitudinal Study

Eating disorders (EDs) are a critical global health issue, with profound physical and mental health consequences that can persist for years, even leading to mortality. Body dissatisfaction, a key risk factor for EDs, is robustly associated with experienced and internalized weight stigma, which are known to exacerbate ED behaviors. While much research on EDs and body dissatisfaction has focused predominantly on Western samples, EDs and related comorbidities are increasingly recognized cross-culturally, including in Iran. Cross-sectional findings highlight the prevalence of ED among Iranian adolescents but are limited in their ability to temporally order variables and identify mechanisms of change. Experienced and internalized weight stigma have been identified as predictors of EDs and negative body image, yet their role in these associations over time is not well understood in Iranian adolescents. The current study employed a three-month longitudinal design to examine how experienced weight stigma (EWS) influences ED behaviors through internalized weight stigma (IWS) and body dissatisfaction. Adolescent participants completed measures of EWS, IWB, body dissatisfaction, and ED behaviors at three time-points: baseline (T1; n = 1,243), after one month (T2; n = 856) and after three-months (T3; n = 639). EWS was found to indirectly predict an increase in binging, purging, restriction, excessive exercise, and maladaptive muscle-building behaviors through IWB, suggesting that more EWS at an earlier time point contributed to elevated IWB, which in turn led to greater engagement in these disordered eating and exercise behaviors. After accounting for IWB, EWS’s direct effects on restriction, excessive exercise, and muscle building were no longer significant, indicating that the relationship between EWS and these behaviors was primarily driven by IWB. Similar mediation effects were observed for body dissatisfaction, demonstrating that body dissatisfaction also played a role in linking weight-stigmatizing experiences to ED outcomes. Overall, our findings suggest that targeting IWB and body dissatisfaction in clinical interventions may help reduce the impact of EWS on ED behaviors, offering potential treatment avenues for adolescents struggling with ED symptoms. Early identification and therapeutic strategies that address these psychosocial mechanisms could enhance intervention effectiveness and prevent the escalation of ED behaviors. Future studies should examine how factors such as gender, sociocultural influences, and personality traits may mediate these relations, providing insights for more tailored interventions.