Association of perceived stress, social support and self-esteem with disordered eating due to Alexithymia

Introduction: Stress, negative emotional states, emotional disorders, low self-esteem, and feelings of loneliness and isolation are among contributing factors, which can trigger disordered eating behaviors. Aim: The present study aimed to investigate the association of perceived stress, social support, and self-esteem with disordered eating due to alexithymia. Method: In this correlational study with structural equation modeling, the statistical population consisted of individuals, who were referred to Baraka Obesity Treatment Clinic in Tehran, Iran, during 2021-2022. A total of 303 people with a body mass index above 30 kg/m2 were selected using the convenience sampling method. Data were collected using the Perceived Stress Questionnaire by Cohen et al. (1983), Perceived Social Support Scale by Zimmet et al. (1988), Rosenberg's Self-Esteem Scale (1965), Alexithymia Scale by Bagby et al. (1994), and Eating Behavior Questionnaire by Van Stein and colleagues (1986). The structural equation modeling method was used to analyze the data. Results: The results of the structural equation modeling indicated the significant direct effects of perceived stress (β=0.22, P<0.01), social support (β=-0.25, P<0.01), and self-esteem (β=-0.21, P<0.01) on disordered eating. Also, the indirect effects of perceived stress (Z=7.69, P<0.01), social support (Z=-6.13, P<0.01), and self-esteem (Z=-6.46, P<0.01) were significant on disordered eating through alexithymia. Conclusion: The results of the present study showed that factors, such as the level of stress, social support, self-esteem, and identifying and expressing one's emotions, can affect disordered eating behaviors. Therefore, by reducing stress and alexithymia and improving social support and self-esteem, disordered eating behaviors are speculated to decrease in obese people.