Which distinct body image concerns and emotion dysregulation dimensions predict the onset and persistence of disordered eating behaviors among Iranian adolescents? A longitudinal study.

Disordered eating (DE) behaviors are common during adolescence and linked to emotion dysregulation and maladaptive body image cognitions; however, prospective evidence from non-Western contexts remains limited. Guided by emotion dysregulation theory and cognitive-behavioral models of eating disorders, this study examined whether emotion dysregulation and body image concerns predict the onset and persistence of DE behaviors among Iranian adolescents over a short-term, one-month follow-up period. Iranian adolescents aged 10-19 years (M = 15.31) completed self-report scales assessing emotion dysregulation, DE behaviors, and body image concerns at baseline (N = 1243) and again one month later (n = 856). Univariate logistic regressions tested whether baseline body image concerns, dimensions of emotion dysregulation, and global emotion dysregulation predicted the onset of binge eating, fasting, and compensatory behaviors in adolescents without symptoms. Additional analyses tested whether these same factors predicted the persistence of DE behaviors in adolescents who were symptomatic at baseline. Multivariate regressions identified which predictors remained significant when considered together. Univariate analyses showed that both body image concerns and emotion dysregulation dimensions at baseline were positive predictors of DE onset and persistence. However, in multivariate analyses, higher baseline desire to lose weight predicted the onset of binge eating, fasting, and compensatory behaviors, while preoccupation with weight/shape predicted the persistence of these DE behaviors. Emotion dysregulation dimensions were not consistent predictors in the multivariate models. These findings highlight the potential importance of targeting weight- and shape-related cognitions in prevention and early intervention efforts, although conclusions regarding specific treatment approaches should be interpreted with caution given the study design.