The association between generalized anxiety disorder and disordered eating symptoms among Lebanese adults with the moderating effect of self esteem

Abstract Our study aims to assess the moderating effect of self-esteem in the association between generalized anxiety disorder and disordered eating symptoms among a sample of Lebanese adults. The study engaged a cohort of 629 participants, who were recruited in May 2023, utilizing a snowball sampli...

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Main Authors: Ralph Abdallah, Melyssa Assaf, Diana Malaeb, Fouad Sakr, Mariam Dabbous, Sami El-Khatib, Feten Fekih-Romdhane, Souheil Hallit, Sahar Obeid
Format: Article
Language:English
Published: Nature Portfolio 2025-05-01
Series:Scientific Reports
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Online Access:https://doi.org/10.1038/s41598-025-02985-x
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author Ralph Abdallah
Melyssa Assaf
Diana Malaeb
Fouad Sakr
Mariam Dabbous
Sami El-Khatib
Feten Fekih-Romdhane
Souheil Hallit
Sahar Obeid
author_facet Ralph Abdallah
Melyssa Assaf
Diana Malaeb
Fouad Sakr
Mariam Dabbous
Sami El-Khatib
Feten Fekih-Romdhane
Souheil Hallit
Sahar Obeid
author_sort Ralph Abdallah
collection DOAJ
description Abstract Our study aims to assess the moderating effect of self-esteem in the association between generalized anxiety disorder and disordered eating symptoms among a sample of Lebanese adults. The study engaged a cohort of 629 participants, who were recruited in May 2023, utilizing a snowball sampling technique. Data were collected via a questionnaire that included socio-demographic variables and the following scales: the Generalized Anxiety Disorder Scale (GAD-5), the Eating Attitudes Test (EAT-7), and the Single Item Self-Esteem Scale (SISE). Higher GAD-5 scores (Beta = 0.01; p = .004) were significantly associated with higher EAT-7 scores. The interaction generalized anxiety disorder by self-esteem was also significantly associated with EAT-7 scores (Beta = − 0.003; p = .019), indicating that self-esteem moderates the relationship between GAD and disordered eating symptoms. At low (Beta = 0.006; p = .001) and moderate (Beta = 0.003; p = .007) levels of self-esteem, higher GAD-5 scores were significantly associated with higher EAT-7 scores (more severe disordered eating symptoms). In contrast, at high levels of self-esteem, the association was not significant (Beta = 0.001; p = .812), indicating that higher self-esteem may act as a protective factor, reducing the impact of GAD on disordered eating symptoms. While an association between anxiety and disordered eating symptomatology has been reported, this study adds to the body of literature by indicating that the strength of this association may vary with an individual’s level of self-esteem, which underscores the importance of integrating self-esteem-building strategies into therapeutic interventions aimed at reducing disordered eating in individuals facing anxiety. Future studies would allow for a more dynamic and nuanced understanding of the causal pathways between anxiety, self-esteem, and eating behaviors.
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spelling doaj-art-259dde0db1d742a18bc3d56b6be21d062025-08-20T01:53:22ZengNature PortfolioScientific Reports2045-23222025-05-0115111010.1038/s41598-025-02985-xThe association between generalized anxiety disorder and disordered eating symptoms among Lebanese adults with the moderating effect of self esteemRalph Abdallah0Melyssa Assaf1Diana Malaeb2Fouad Sakr3Mariam Dabbous4Sami El-Khatib5Feten Fekih-Romdhane6Souheil Hallit7Sahar Obeid8Faculty of Arts and Sciences, University of TorontoDepartment of Biology, Faculty of Arts and Sciences, Holy Spirit University of KaslikCollege of Pharmacy, Gulf Medical UniversitySchool of Pharmacy, Lebanese International UniversitySchool of Pharmacy, Lebanese International UniversityDepartment of Biomedical Sciences, School of Arts and Sciences, Lebanese International UniversityThe Tunisian Center of Early Intervention in Psychosis, Department of Psychiatry “Ibn Omrane”, Razi hospitalSchool of Medicine and Medical Sciences, Holy Spirit University of KaslikDepartment of Psychology and Education, School of Arts and Sciences, Lebanese American UniversityAbstract Our study aims to assess the moderating effect of self-esteem in the association between generalized anxiety disorder and disordered eating symptoms among a sample of Lebanese adults. The study engaged a cohort of 629 participants, who were recruited in May 2023, utilizing a snowball sampling technique. Data were collected via a questionnaire that included socio-demographic variables and the following scales: the Generalized Anxiety Disorder Scale (GAD-5), the Eating Attitudes Test (EAT-7), and the Single Item Self-Esteem Scale (SISE). Higher GAD-5 scores (Beta = 0.01; p = .004) were significantly associated with higher EAT-7 scores. The interaction generalized anxiety disorder by self-esteem was also significantly associated with EAT-7 scores (Beta = − 0.003; p = .019), indicating that self-esteem moderates the relationship between GAD and disordered eating symptoms. At low (Beta = 0.006; p = .001) and moderate (Beta = 0.003; p = .007) levels of self-esteem, higher GAD-5 scores were significantly associated with higher EAT-7 scores (more severe disordered eating symptoms). In contrast, at high levels of self-esteem, the association was not significant (Beta = 0.001; p = .812), indicating that higher self-esteem may act as a protective factor, reducing the impact of GAD on disordered eating symptoms. While an association between anxiety and disordered eating symptomatology has been reported, this study adds to the body of literature by indicating that the strength of this association may vary with an individual’s level of self-esteem, which underscores the importance of integrating self-esteem-building strategies into therapeutic interventions aimed at reducing disordered eating in individuals facing anxiety. Future studies would allow for a more dynamic and nuanced understanding of the causal pathways between anxiety, self-esteem, and eating behaviors.https://doi.org/10.1038/s41598-025-02985-xGeneralized anxiety disorderDisordered eatingSelf-esteemLebanon
spellingShingle Ralph Abdallah
Melyssa Assaf
Diana Malaeb
Fouad Sakr
Mariam Dabbous
Sami El-Khatib
Feten Fekih-Romdhane
Souheil Hallit
Sahar Obeid
The association between generalized anxiety disorder and disordered eating symptoms among Lebanese adults with the moderating effect of self esteem
Scientific Reports
Generalized anxiety disorder
Disordered eating
Self-esteem
Lebanon
title The association between generalized anxiety disorder and disordered eating symptoms among Lebanese adults with the moderating effect of self esteem
title_full The association between generalized anxiety disorder and disordered eating symptoms among Lebanese adults with the moderating effect of self esteem
title_fullStr The association between generalized anxiety disorder and disordered eating symptoms among Lebanese adults with the moderating effect of self esteem
title_full_unstemmed The association between generalized anxiety disorder and disordered eating symptoms among Lebanese adults with the moderating effect of self esteem
title_short The association between generalized anxiety disorder and disordered eating symptoms among Lebanese adults with the moderating effect of self esteem
title_sort association between generalized anxiety disorder and disordered eating symptoms among lebanese adults with the moderating effect of self esteem
topic Generalized anxiety disorder
Disordered eating
Self-esteem
Lebanon
url https://doi.org/10.1038/s41598-025-02985-x
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