The Link Between Low Self-Esteem and Eating Disorders: A Meta-Analysis of Longitudinal Studies

In this meta-analysis, we synthesized the available longitudinal evidence on prospective effects between self-esteem and eating pathology (i.e., restrained eating, bulimic behavior, binge eating, eating concern, negative body image, and drive for thinness). The analyses were based on 48 independent samples, including 19,187 participants. Mean age was 19.3 years (range = 7–48). As effect-size measure, we used standardized regression coefficients, controlled for prior levels of the predicted variables. Results suggested reciprocal prospective effects between low self-esteem and eating pathology. Self-esteem negatively predicted total eating pathology over time (β = −.08), and total eating pathology negatively predicted self-esteem over time (β = −.09). Overall, results for specific categories of eating pathology were similar. Moderator analyses indicated that the effects did not differ across age, gender, sample type (clinical vs. nonclinical), and time lag between assessments. In sum, the results support a reciprocal relations model of low self-esteem and eating disorders.