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Association Between Eating Disorder Symptoms and Weight Status in Midwestern US Army ROTC Cadets (P16-015-19).

Objectives
The prevalence of eating disorder symptoms and obesity has been high amongst young adults (18-25 y), who comprise an important demographic in the US military. Current approaches to prevent obesity may lead to an overemphasis on weight and body image, as well as adoption of strict dieting for weight loss, increasing risk for obesity and eating disorder symptoms. Body image dissatisfaction and dieting have been implicated as important shared risk factors in the onset of both obesity and eating disorder symptoms. While current cognitive behavioral approaches to obesity and eating disorder management are the gold standard of treatment, these interventions often don't consider shared risk factors between obesity and eating disorder symptoms. Newer approaches, such as Acceptance and Commitment Therapy (ACT) and the ACT construct of psychological flexibility, focus on changing problematic behaviors, such as bingeing and compensatory behaviors like dieting, through awareness of these behaviors as coping mechanisms for problematic thoughts, such as body image dissatisfaction. Understanding the role of ACT processes in the relation between eating disorder symptoms and obesity may offer potential new targets for treatments that consider shared risk factors, such as strict dieting and body image dissatisfaction. Given ongoing evidence of both obesity and eating disorders in the military, the aim of this study was to determine whether eating disorder symptoms were associated with weight status and whether the effect of eating disorder symptoms on weight status was mediated by body image flexibility and psychological flexibility related to dieting.


Methods
The present cross-sectional study included 205 US Army ROTC Cadets (18-32 y).


Results
Results revealed a significant indirect effect of eating disorder symptoms on weight status through psychological flexibility related to dieting, and a significant indirect effect of eating disorder symptoms on weight status through psychological flexibility related to body image for male but not female ROTC Cadets.


Conclusions
These findings suggest psychological flexibility is an important mechanism in understanding the relation between eating disorder symptoms and obesity in military-related populations.


Funding Sources
RAMSCA Endowment for Scholarly Activity.