Social and individual factors associated with eating disorders risk among adolescents in secondary schools of Sicily (south-Italy)

Abstract Eating disorders (EDs) are complex medical conditions that primarily affect adolescents. In Italy, EDs are becoming a serious health concern, but the lack of up-to-date epidemiological data makes it difficult to assess their real impact across the country. Early identification of risk facto...

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Main Authors: Silvia Ruggieri, Rosalba Contentezza, Melania Casella, Achille Cernigliaro, Ilaria Cosentini, Gaspare Drago, Gianluca Lo Coco, Maria Rita Semola, Salvatore Gullo
Format: Article
Language:English
Published: BMC 2025-07-01
Series:Child and Adolescent Psychiatry and Mental Health
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Online Access:https://doi.org/10.1186/s13034-025-00940-2
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author Silvia Ruggieri
Rosalba Contentezza
Melania Casella
Achille Cernigliaro
Ilaria Cosentini
Gaspare Drago
Gianluca Lo Coco
Maria Rita Semola
Salvatore Gullo
author_facet Silvia Ruggieri
Rosalba Contentezza
Melania Casella
Achille Cernigliaro
Ilaria Cosentini
Gaspare Drago
Gianluca Lo Coco
Maria Rita Semola
Salvatore Gullo
author_sort Silvia Ruggieri
collection DOAJ
description Abstract Eating disorders (EDs) are complex medical conditions that primarily affect adolescents. In Italy, EDs are becoming a serious health concern, but the lack of up-to-date epidemiological data makes it difficult to assess their real impact across the country. Early identification of risk factors is crucial for timely intervention. A multicenter cross-sectional survey was conducted among 1,740 students aged 14–16 years in Sicily. Data on socio-demographic factors, EDs behaviors, social media usage, body appreciation, and bullying were collected through an electronic questionnaire. Regression models were used to test the role of gender and interaction effects with key risk factors. Based on Eating Disorder Examination-Questionnaire (EDE-Q) scores, 72.8% of participants were classified as “not at risk”, 17.9% as “at risk” and 9.3% as “at higher risk” of developing EDs using gender-related cut-offs. Girls were overrepresented in the at-risk and higher-risk groups (p < 0.01). Analysis revealed that lower Body Appreciation Scale (BAS) scores, higher BMI, and body comparison on social media predicted higher EDE-Q scores (p < 0.01). Gender interacted with several risk factors, including body appreciation (ß = 0.30. p < 0.01), alcohol use (ß = − 0.14, p < 0.01), and the perceived impact of the COVID-19 pandemic (ß = − 0.06, p < 0.05), with females showing stronger associations. This study highlights the increasing concern about EDs among Italian adolescents and emphasizes the need for targeted screening and early intervention. Understanding the interplay between gender, body image, and social behaviors is key to preventing EDs mitigating their long-term consequences.
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spelling doaj-art-d17a106143d14634873d79af2e8a6c882025-08-20T03:45:45ZengBMCChild and Adolescent Psychiatry and Mental Health1753-20002025-07-0119111610.1186/s13034-025-00940-2Social and individual factors associated with eating disorders risk among adolescents in secondary schools of Sicily (south-Italy)Silvia Ruggieri0Rosalba Contentezza1Melania Casella2Achille Cernigliaro3Ilaria Cosentini4Gaspare Drago5Gianluca Lo Coco6Maria Rita Semola7Salvatore Gullo8Institute for Biomedical Research and Innovation, National Research Council of ItalySicilian Order of PsychologistsInstitute for Biomedical Research and Innovation, National Research Council of ItalyIntegrated Operative Unit of Clinical Pathology, Department of Services and Radiological Sciences, Sant’Antonio Abate Hospital, Trapani Provincial Health AuthorityInstitute for Biomedical Research and Innovation, National Research Council of ItalyInstitute for Biomedical Research and Innovation, National Research Council of ItalyDepartment of Psychology, Educational Science and Human Movement, University of PalermoDepartment of Psychology, Educational Science and Human Movement, University of PalermoDepartment of Psychology, Educational Science and Human Movement, University of PalermoAbstract Eating disorders (EDs) are complex medical conditions that primarily affect adolescents. In Italy, EDs are becoming a serious health concern, but the lack of up-to-date epidemiological data makes it difficult to assess their real impact across the country. Early identification of risk factors is crucial for timely intervention. A multicenter cross-sectional survey was conducted among 1,740 students aged 14–16 years in Sicily. Data on socio-demographic factors, EDs behaviors, social media usage, body appreciation, and bullying were collected through an electronic questionnaire. Regression models were used to test the role of gender and interaction effects with key risk factors. Based on Eating Disorder Examination-Questionnaire (EDE-Q) scores, 72.8% of participants were classified as “not at risk”, 17.9% as “at risk” and 9.3% as “at higher risk” of developing EDs using gender-related cut-offs. Girls were overrepresented in the at-risk and higher-risk groups (p < 0.01). Analysis revealed that lower Body Appreciation Scale (BAS) scores, higher BMI, and body comparison on social media predicted higher EDE-Q scores (p < 0.01). Gender interacted with several risk factors, including body appreciation (ß = 0.30. p < 0.01), alcohol use (ß = − 0.14, p < 0.01), and the perceived impact of the COVID-19 pandemic (ß = − 0.06, p < 0.05), with females showing stronger associations. This study highlights the increasing concern about EDs among Italian adolescents and emphasizes the need for targeted screening and early intervention. Understanding the interplay between gender, body image, and social behaviors is key to preventing EDs mitigating their long-term consequences.https://doi.org/10.1186/s13034-025-00940-2Eating disordersRisk factorsEDE-QAdolescentGender roleBody image
spellingShingle Silvia Ruggieri
Rosalba Contentezza
Melania Casella
Achille Cernigliaro
Ilaria Cosentini
Gaspare Drago
Gianluca Lo Coco
Maria Rita Semola
Salvatore Gullo
Social and individual factors associated with eating disorders risk among adolescents in secondary schools of Sicily (south-Italy)
Child and Adolescent Psychiatry and Mental Health
Eating disorders
Risk factors
EDE-Q
Adolescent
Gender role
Body image
title Social and individual factors associated with eating disorders risk among adolescents in secondary schools of Sicily (south-Italy)
title_full Social and individual factors associated with eating disorders risk among adolescents in secondary schools of Sicily (south-Italy)
title_fullStr Social and individual factors associated with eating disorders risk among adolescents in secondary schools of Sicily (south-Italy)
title_full_unstemmed Social and individual factors associated with eating disorders risk among adolescents in secondary schools of Sicily (south-Italy)
title_short Social and individual factors associated with eating disorders risk among adolescents in secondary schools of Sicily (south-Italy)
title_sort social and individual factors associated with eating disorders risk among adolescents in secondary schools of sicily south italy
topic Eating disorders
Risk factors
EDE-Q
Adolescent
Gender role
Body image
url https://doi.org/10.1186/s13034-025-00940-2
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