Evaluation of disordered eating tendencies in young adults

  • Nevin SanlierEmail author
  • Semra Navruz Varli
  • M. Sedanur Macit
  • Hande Mortas
  • Tugba Tatar
Original Article
Part of the following topical collections:
  1. Food and Addiction



It was aimed to determine the prevalence of high disordered eating tendencies and its relationship with food addiction, emotional eating and self esteem in participants at 18 and 33 years age group.


This study was planned as a cross-sectional study and conducted with 1359 young adult volunteers (M = 386, F = 973) with an average age of 22.4 ± 2.84 years. Eating Attitudes Test-26 (EAT-26), Yale Food Addiction Scale (YFAS), Emotional Appetite Questionnaire (EMAQ) and Rosenberg Self-Esteem Scale (RSES) were used. EAT-26 score above 20 was considered as eating disorders risk cutoff.


Participants with disordered eating tendencies have higher rates (22.4%) of food addiction compared to participants without high disordered eating tendencies (7.2%). There is no difference for EMAQ and YFAS scores; however, there is a significant difference for RSES and EAT-26 scores according to gender. A positive association of EAT-26 with YFAS and EMAQ-negative scores and a negative association of EAT-26 with RSES and EMAQ-positive were found.


There is association among EAT-26, YFAS, and Rosenberg Self-Esteem Scale, and Emotional Appetite Questionnaire scores. This study provides information for future studies about high disordered eating tendencies, food addiction and mood that are thought to be important in young adults.

Level of evidence

Level V (cross-sectional descriptive study).


Eating attitudes Food addiction Emotional eating Self esteem 



The authors thank all individuals who devoted their time to participate in this study. They are warmly acknowledged for their help and whole hearted cooperation.

Compliance with ethical standards

Conflict of interest

Nevin Sanlier declares that she has no conflict of interest. Semra Navruz Varli declares that she has no conflict of interest. M. Sedanur Macit declares that she has no conflict of interest. Hande Mortas declares that she has no conflict of interest. Tugba Tatar declares that she has no conflict of interest.

Ethical approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards. The study protocol was approved by the Ethical Committee of the Gazi University of Ankara/Turkey (27/01/2016, Decision no: 11663).

Informed consent

Informed consent was obtained from all individual participants included in the study.


  1. 1.
    Lee HJ, Park S, Kim CI, Choi DW, Lee JS, Oh SM et al (2013) The association between disturbed eating behavior and socioeconomic status: the Online Korean Adolescent Panel Survey (OnKAPS). PLoS One 8:e57880. doi: 10.1371/journal.pone.0057880 CrossRefPubMedPubMedCentralGoogle Scholar
  2. 2.
    Preti A, Girolamo Gd, Vilagut G, Alonso J, Graaf Rd, Bruffaerts R et al (2009) The epidemiology of eating disorders in six European countries: results of the ESEMeD-WMH project. J Psychiatr Res 43:1125–1132. doi: 10.1016/j.jpsychires.2009.04.003 CrossRefPubMedGoogle Scholar
  3. 3.
    Anderson C, Petrie TA (2012) Prevalence of disordered eating and pathogenic weight control behaviors among NCAA division I female collegiate gymnasts and swimmers. Res Q Exerc Sport 83:120–124. doi: 10.1080/02701367.2012.10599833 CrossRefPubMedGoogle Scholar
  4. 4.
    Lee S, Lee AM (2000) Disordered eating in three communities of China: a comparative study of female high school students in Hong Kong, Shenzhen, and rural Hunan. Int J Eat Disord 27:317–327CrossRefGoogle Scholar
  5. 5.
    Chang WW, Nie M, Kang YW, He LP, Jin YL, Yao YS (2015) Subclinical eating disorders in female medical students in Anhui, China: a cross-sectional study. Nutr Hosp 31:1771–1777. doi: 10.3305/nh.2015.31.4.8456 CrossRefPubMedGoogle Scholar
  6. 6.
    Garfinkel PE, Newman A (2001) The eating attitudes test: twenty-five years later. Eat Weight Disord 6:1–24CrossRefGoogle Scholar
  7. 7.
    Chisuwa N, O’Dea JA (2010) Body image and eating disorders amongst Japanese adolescents. A review of the literature. Appetite 54:5–15. doi: 10.1016/j.appet.2009.11.008 CrossRefPubMedGoogle Scholar
  8. 8.
    Pedro TM, Micklesfield LK, Kahn K, Tollman SM, Pettifor JM, Norris SA (2016) Body image satisfaction, eating attitudes and perceptions of female body silhouettes in rural south African adolescents. PLoS One 11:e0154784. doi: 10.1371/journal.pone.0154784 CrossRefPubMedPubMedCentralGoogle Scholar
  9. 9.
    Alpaslan AH, Soylu N, Avci K, Coşkun KŞ, Kocak U, Taş HU (2015) Disordered eating attitudes, alexithymia and suicide probability among Turkish high school girls. Psychiatry Res 226:224–229. doi: 10.1016/j.psychres.2014.12.052 CrossRefPubMedGoogle Scholar
  10. 10.
    American Rosen DS, Academy of Pediatrics Committee on Adolescence (2010) Identification and management of eating disorders in children and adolescents. Pediatrics 126:1240–1253. doi: 10.1542/peds.2010-2821 CrossRefGoogle Scholar
  11. 11.
    Gitau TM, Micklesfield LK, Pettifor JM, Norris SA (2014) Eating attitudes, body image satisfaction and self-esteem of South African Black and White male adolescents and their perception of female body silhouettes. J Child Adolesc Ment Health 26(3):193–205. doi: 10.2989/17280583 CrossRefPubMedGoogle Scholar
  12. 12.
    Fortes Lde S, Kakeshita IS, Almeida SS, Gomes AR, Ferreira ME (2014) Eating behaviours in youths: a comparison between female and male athletes and non-athletes. Scand J Med Sci Sports 24(1):e62–e68. doi: 10.1111/sms.12098 CrossRefPubMedGoogle Scholar
  13. 13.
    Ghaderi A, Scott B (1999) Prevalence and psychological correlates of eating disorders among females aged 18–30 in the general population. Acta Psychiatr Scand 99:261–266CrossRefGoogle Scholar
  14. 14.
    Musaiger AO, Al-Mannai M, Al-Lalla O (2014) Risk of disordered eating attitudes among male adolescents in five Emirates of the United Arab Emirates. Int J Eat Disord 47(8):898–900. doi: 10.1002/eat.22256 CrossRefPubMedGoogle Scholar
  15. 15.
    Constain GA, Rodríguez-Gázquez ML, Ramírez Jiménez GA, Gómez Vásquez GM, Mejía Cardona L, Cardona Vélez J (2014) Diagnostic validity and usefulness of the Eating Attitudes Test-26 for the assessment of eating disorders risk in a Colombian male population (abstract). Aten Primaria 46(6):283–289. doi: 10.1016/j.aprim.2013.11.009 CrossRefPubMedGoogle Scholar
  16. 16.
    Maslow AH, Frager R, Fadiman J, McReynolds C, Cox R (1970) Motivation and personality. Harper and Row, New YorkGoogle Scholar
  17. 17.
    Wu X, Kirk SF, Ohinmaa A, Veugelers P (2016) Health behaviours, body weight and self-esteem among grade five students in Canada. Springerplus 5:1099. doi: 10.1186/s40064-016-2744-x CrossRefPubMedPubMedCentralGoogle Scholar
  18. 18.
    Tin SP, Ho DS, Mak KH, Wan KL, Lam TH (2012) Association between television viewing and self-esteem in children. J Dev Behav Pediatr 33:479–485. doi: 10.1097/DBP.0b013e31825ab67d CrossRefPubMedGoogle Scholar
  19. 19.
    Danielsen YS, Stormark KM, Nordhus IH, Mæhle M, Sand L, Ekornås B (2012) Factors associated with low self-esteem in children with overweight. Obes Facts 5:722–733. doi: 10.1159/000338333 CrossRefPubMedGoogle Scholar
  20. 20.
    Orth U, Robins RW, Widaman KF, Conger RD (2014) Is low self-esteem a risk factor for depression? Findings from a longitudinal study of Mexican-origin youth. Dev Psychol 50:622–633. doi: 10.1037/a0033817 CrossRefPubMedGoogle Scholar
  21. 21.
    Iorgulescu G (2010) Low self-esteem in women with eating disorders and alcohol abuse as a psycho-social factor to be included in their psychotherapeutic approach. J Med Life 3:458–464PubMedPubMedCentralGoogle Scholar
  22. 22.
    O’Dea JA (2004) Evidence for a self esteem approach in the prevention of body image and eating problems among children and adolescents. Eat Disord 12:225–229. doi: 10.1080/10640260490481438 CrossRefPubMedGoogle Scholar
  23. 23.
    Brytek-Matera A (2011) Exploring the factors related to body image dissatisfaction in the context of obesity. Arch Psychiatr Psychother 1:63–70Google Scholar
  24. 24.
    Daniali S, Azadbakht L, Mostafavi F (2013) Relationship between body satisfaction with self esteem and unhealthy body weight management. J Educ Health Promot 2:29. doi: 10.4103/2277-9531.115804 CrossRefPubMedPubMedCentralGoogle Scholar
  25. 25.
    Davis C, Curtis C, Levitan RD, Carter JC, Kaplan AS, Kennedy JL (2011) Evidence that ‘food addiction’ is a valid phenotype of obesity. Appetite 57:711–717. doi: 10.1016/j.appet.2011.08.017 CrossRefPubMedGoogle Scholar
  26. 26.
    Gearhardt AN, Boswell RG, White MA (2014) The association of “food addiction” with disordered eating and body mass index. Eat Behav 15:427–433. doi: 10.1016/j.eatbeh.2014.05.001 CrossRefPubMedPubMedCentralGoogle Scholar
  27. 27.
    Pedram P, Wadden D, Amini P, Gulliver W, Randell E, Cahill F et al (2013) Food addiction: its prevalence and significant association with obesity in the general population. PLoS One 8:e74832. doi: 10.1371/journal.pone.0074832 CrossRefPubMedPubMedCentralGoogle Scholar
  28. 28.
    Gearhardt AN, White MA, Masheb RM, Morgan PT, Crosby RD, Grilo CM (2012) An examination of the food addiction construct in obese patients with binge eating disorder. Int J Eat Disord 45:657–663. doi: 10.1002/eat.20957 CrossRefPubMedGoogle Scholar
  29. 29.
    Nolan LJ, Geliebter A (2016) “Food addiction” is associated with night eating severity. Appetite 98:89–94. doi: 10.1016/j.appet.2015.12.025 CrossRefPubMedGoogle Scholar
  30. 30.
    Izard CE (2000) Organizational and motivational functions of discrete emotions. Guilford Press, New YorkGoogle Scholar
  31. 31.
    Fredrickson BL (1998) What good are positive emotions? Rev General Psychol 2:300–319CrossRefGoogle Scholar
  32. 32.
    Gibson EL (2006) Emotional influences on food choice: sensory, physiological and psychological pathways. Physiol Behav 89:53–61. doi: 10.1016/j.physbeh.2006.01.024 CrossRefPubMedGoogle Scholar
  33. 33.
    van Strien T, Ouwens MA (2007) Effects of distress, alexithymia and impulsivity on eating. Eat Behav 8:251–257. doi: 10.1016/j.eatbeh.2006.06.004 CrossRefPubMedGoogle Scholar
  34. 34.
    Macht M (2008) How emotions affect eating: a five-way model. Appetite 50:1–11. doi: 10.1016/j.appet.2007.07.002 CrossRefPubMedGoogle Scholar
  35. 35.
    Nolan LJ, Halperin LB, Geliebter A (2010) Emotional appetite questionnaire. Construct validity and relationship with BMI. Appetite 54:314–319. doi: 10.1016/j.appet.2009.12.004 CrossRefPubMedGoogle Scholar
  36. 36.
    Garner DM, Olmsted MP, Bohr Y, Garfinkel PE (1982) The eating attitudes test: psychometric features and clinical correlates. Psychol Med 12:871–878CrossRefGoogle Scholar
  37. 37.
    Rosenberg M (1965) Society and adolescent self-image. Princeton University Press, New JerseyCrossRefGoogle Scholar
  38. 38.
    Gearhardt AN, Corbin WR, Brownell KD (2009) Preliminary validation of the Yale Food Addiction Scale. Appetite 52:430–436. doi: 10.1016/j.appet.2008.12.003 CrossRefPubMedGoogle Scholar
  39. 39.
    Demirel B, Yavuz KF, Karadere ME, Şafak Y, Türkçapar MH (2014) Duygusal İştah Anketi’nin Türkçe geçerlik ve güvenilirliği, beden kitle indeksi ve duygusal şemalarla ilişkisi. JCBPR 3:171–181. doi: 10.5455/JCBPR.44046 CrossRefGoogle Scholar
  40. 40.
    Savaşır I, Erol N (1989) Yeme tutum testi: anoreksiya nervoza belirtileri indeksi. Psikoloji Dergisi 7:19–25Google Scholar
  41. 41.
    Çuhadaroğlu F (1986) Adölesanlarda Benlik Saygısı. Yayınlanmamış Uzmanlık Tezi, Hacettepe ÜniversitesiGoogle Scholar
  42. 42.
    American Psychiatric Association (2000) Diagnostic and statistical manual of mental disorders, 4th edn, USAGoogle Scholar
  43. 43.
    Bayraktar F, Erkman F, Kurtuluş E (2012) Adaptation study of Yale Food Addiction Scale. Klinik Psikofarmakoloji Bulteni 22:38Google Scholar
  44. 44.
    WHO expert consultation (2004) Appropriate body-mass index for Asian populations and its implications for policy and intervention strategies. Lancet 363(9403):157–163. doi: 10.1016/S0140-6736(03)15268-3 CrossRefGoogle Scholar
  45. 45.
    Hone-Blanchet A, Fecteau S (2014) Overlap of food addiction and substance use disorders definitions: analysis of animal and human studies. Neuropharmacology 85:81–90. doi: 10.1016/j.neuropharm.2014.05.019 CrossRefPubMedGoogle Scholar
  46. 46.
    Mäkinen M, Puukko-Viertomies LR, Lindberg N, Siimes MA, Aalberg V (2012) Body dissatisfaction and body mass in girls and boys transitioning from early to mid-adolescence: additional role of self-esteem and eating habits. BMC Psychiatry. doi: 10.1186/1471-244X-12-35 CrossRefPubMedPubMedCentralGoogle Scholar
  47. 47.
    Balhara YP, Mathur S, Kataria DK (2012) Body shape and eating attitudes among female nursing students in India. East Asian Arch Psychiatry 22:70–74PubMedGoogle Scholar
  48. 48.
    Rouzitalab T, Pourghassem Gargari B, Amirsasan R, Asghari Jafarabadi M, Farsad Naeimi A, Sanoobar M (2015) The relationship of disordered eating attitudes with body composition and anthropometric indices in physical education students. Iran Red Crescent Med J 17:e20727. doi: 10.5812/ircmj.20727 CrossRefPubMedPubMedCentralGoogle Scholar
  49. 49.
    Mason SM, Flint AJ, Roberts AL, AgnewBlais J, Koenen KC, Rich-Edwards JW (2014) Posttraumatic stress disorder symptoms and food addiction in women, by timing and type of trauma exposure. JAMA Psychiatry 71(11):1271–1278. doi: 10.1001/jamapsychiatry.2014.1208 CrossRefPubMedPubMedCentralGoogle Scholar
  50. 50.
    Clark SM, Saules KK (2013) Validation of the Yale Food Addiction Scale among a weight-loss surgery population. Eat Behav 14:216–219. doi: 10.1016/j.eatbeh.2013.01.002 CrossRefPubMedGoogle Scholar
  51. 51.
    Arigo D, Schumacher L, Martin LM (2014) Upward appearance comparison and the development of eating pathology in college women. Int J Eat Disord 47:467–470. doi: 10.1002/eat.22240 CrossRefPubMedGoogle Scholar
  52. 52.
    Mayfield K, Tang LR, Bosselman R (2014) Nutrition labeling for restaurant menu items: college students’ preferences for nutrition information and its influence on purchase intention. J Qual Assur Hosp Tour 15:310–325. doi: 10.1080/1528008X.2014.921775 CrossRefGoogle Scholar
  53. 53.
    Martyn-Nemeth P, Penckofer S, Gulanick M, Velsor-Friedrich B, Bryant FB (2009) The relationships among self-esteem, stress, coping, eating behavior, and depressive mood in adolescents. Res Nurs Health 32:96–109. doi: 10.1002/nur.20304 CrossRefPubMedGoogle Scholar
  54. 54.
    Brewerton TD (2017) Food addiction as a proxy for eating disorder and obesity severity, trauma history, PTSD symptoms, and comorbidity. Eat Weight Disord 22(2):241–247CrossRefGoogle Scholar
  55. 55.
    Innamorati M, Imperatori C, Manzoni GM, Lamis DA, Castelnuovo G, Tamburello A et al (2015) Psychometric properties of the Italian Yale Food Addiction Scale in overweight and obese patients. Eat Weight Disord 20(1):119–127CrossRefGoogle Scholar
  56. 56.
    Flint AJ, Gearhardt AN, Corbin WR, Brownell KD, Field AE, Rimm EB (2014) Food addiction scale measurement in two cohorts of middleaged and older women. Am J Clin Nutr 99:578–586. doi: 10.3945/ajcn.113.068965 CrossRefPubMedPubMedCentralGoogle Scholar
  57. 57.
    Gearhardt AN, Yokum S, Orr PT, Stice E, Corbin WR, Brownell KD (2011) Neural correlates of food addiction. Arch Gen Psychiatry 68:808–816. doi: 10.1001/archgenpsychiatry.2011.32 CrossRefPubMedPubMedCentralGoogle Scholar
  58. 58.
    Davis C, Loxton NJ, Levitan RD, Kaplan AS, Carter JC, Kennedy JL (2013) Food addiction’ and its association with a dopaminergic multilocus genetic profile. Physiol Behav 118:63–69. doi: 10.1016/j.physbeh.2013.05.014 CrossRefPubMedGoogle Scholar
  59. 59.
    Meule A, Rezori V, Blechert J (2014) Food addiction and bulimia nervosa. Eur Eat Disord Rev 22:331–337. doi: 10.1002/erv.2306 CrossRefPubMedGoogle Scholar
  60. 60.
    Eichen DM, Lent MR, Goldbacher E, Foster GD (2013) Exploration of “food addiction” in overweight and obese treatment-seeking adults. Appetite 67:22–24. doi: 10.1016/j.appet.2013.03.008 CrossRefPubMedPubMedCentralGoogle Scholar
  61. 61.
    Burmeister JM, Hinman N, Koball A, Hoffmann DA, Carels RA (2013) Food addiction in adults seeking weight loss treatment. Implications for psychosocial health and weight loss. Appetite 60:103–110. doi: 10.1016/j.appet.2012.09.013 CrossRefPubMedGoogle Scholar
  62. 62.
    Murphy CM, Stojek MK, MacKillop J (2014) Interrelationships among impulsive personality traits, food addiction, and body mass index. Appetite 73:45–50. doi: 10.1016/j.appet.2013.10.008 CrossRefPubMedPubMedCentralGoogle Scholar
  63. 63.
    Meule A, Vögele C, Kübler A (2012) German translation and validation of the Yale Food Addiction Scale. Diagnostica 58:115–126. doi: 10.1026/0012-1924/a000047 CrossRefGoogle Scholar
  64. 64.
    Kozak AT, Davis J, Brown R, Grabowski M (2016) Are overeating and food addiction related to distress tolerance? An examination of residents with obesity from a US metropolitan area. Obes Res Clin Pract 11:287–298CrossRefGoogle Scholar
  65. 65.
    Koball AM, Clark MM, Collazo-Clavell M, Kellogg T, Ames G, Ebbert J et al (2016) The relationship among food addiction, negative mood, and eating-disordered behaviors in patients seeking to have bariatric surgery. Surg Obes Relat Dis 12(1):165–170CrossRefGoogle Scholar
  66. 66.
    Gargari BP, Khadem-Haghighian M, Taklifi E, Hamed-Behzad M, Shahraki M (2010) Eating attitudes, self-esteem and social physique anxiety among Iranian females who participate in fitness programs. J Sports Med Phys Fit 50:79–84Google Scholar
  67. 67.
    Thomas J, Khan S, Abdulrahman AA (2010) Eating attitudes and body image concerns among female university students in the United Arab Emirates. Appetite 54:595–598. doi: 10.1016/j.appet.2010.02.008 CrossRefPubMedGoogle Scholar
  68. 68.
    Sanlier N, Yabanci N, Alyakut O (2008) An evaluation of eating disorders among a group of Turkish university student. Appetite 51(3):641–645CrossRefGoogle Scholar
  69. 69.
    Memon AA, Adil SE, Siddiqui EU, Naeem SS, Ali SA, Mehmood K (2012) Eating disorders in medical students of Karachi, Pakistan-a cross-sectional study. BMC Res Notes 5:84CrossRefGoogle Scholar
  70. 70.
    Grilo CM, Masheb RM, Brody M, Burke-Martindale CH, Rothschild BS (2005) Binge eating and self-esteem predict body image dissatisfaction among obese men and women seeking bariatric surgery. Int J Eat Disord 37:347–351. doi: 10.1002/eat.20130 CrossRefPubMedGoogle Scholar
  71. 71.
    Brechan I, Kvalem IL (2015) Relationship between body dissatisfaction and disordered eating: mediating role of self-esteem and depression. Eat Behav 17:49–58. doi: 10.1016/j.eatbeh.2014.12.008 CrossRefPubMedGoogle Scholar
  72. 72.
    Moksnes UK, Espnes GA (2013) Self-esteem and life satisfaction in adolescents-gender and age as potential moderators. Qual Life Res 22:2921–2928. doi: 10.1007/s11136-013-0427-4 CrossRefPubMedGoogle Scholar
  73. 73.
    Gezgin UB, Ann Dev VC (2014) Of Kate moss & Marilyn monroe: body dissatisfaction and its relation to media consumption, body mass index and self-esteem in Malaysian College Women. Akdeniz Üniversitesi İletişim Fakültesi Dergisi 22:190–201CrossRefGoogle Scholar
  74. 74.
    Kristjánsson AL, Sigfúsdóttir ID, Allegrante JP (2010) Health behavior and academic achievement among adolescents: the relative contribution of dietary habits, physical activity, body mass index, and self-esteem. Health Educ Behav 37:51–64. doi: 10.1177/1090198107313481 CrossRefPubMedGoogle Scholar
  75. 75.
    Chen G, Tang Z, Guo G, Liu X, Xiao S (2015) The Chinese version of the Yale Food Addiction Scale: an examination of its validation in a sample of female adolescents. Eat Behav 18:97–102CrossRefGoogle Scholar
  76. 76.
    Wiss DA, Brewerton TD (2017) Incorporating food addiction into disordered eating: the disordered eating food addiction nutrition guide (DEFANG). Eat Weight Disord 22(1):49–59CrossRefGoogle Scholar

Copyright information

© Springer International Publishing AG 2017

Authors and Affiliations

  • Nevin Sanlier
    • 2
    Email author
  • Semra Navruz Varli
    • 1
  • M. Sedanur Macit
    • 1
  • Hande Mortas
    • 1
  • Tugba Tatar
    • 1
  1. 1.Department of Nutrition and Dietetics, Faculty of Health SciencesGazi UniversityAnkaraTurkey
  2. 2.Department of Nutrition and Dietetics, Health Science FacultyBiruni UniversityIstanbulTurkey

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