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Influence of personal and family variables on eating disorders

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Rev Esp Public Health. 2021; Vol. 95: December 22 e1-13. www.mscbs.es/resp

Received: April 21, 2021

ORIGINAL Accepted: October 14, 2021

Published: December 22, 2021

INFLUENCE OF PERSONAL AND FAMILY VARIABLES

IN EATING DISORDERS(*)

Paula Frieiro (1) [ORCID: https://orcid.org/0000-0001-5888-6674], Rubén González-Rodríguez (1) [ORCID: https://orcid.org/
0000-0003-1806-1103] and José Domínguez Alonso (1) [ORCID: https://orcid.org/0000-0002-1844-000X]

(1) University of Vigo. Faculty of Education and Social Work. Ourense. Spain.

The authors declare that there is no conflict of interest.

(*) Financing: Research carried out with the help of the University of Vigo for the hiring of predoctoral research personnel in
training.

SUMMARY ABSTRACT
Background: Eating disorders (ED) normally Influence of personal and
begin during puberty and adolescence, when family variables on eating disorders
attention should be paid to the factors that influence
Background: Eating disorders (EDs) usually
the development of the disease. The objective of
begin during puberty and adolescence, at a time
this work was to evaluate attitudes towards food
when attention should be paid to the factors that
and the risk of suffering from eating disorders, taking
influence the development of the disease. The aim
into account personal and family variables in a
of this study was to assess attitudes towards eating
population of secondary school students.
and the risk of developing EDs, taking into account
personal and family variables in a population of
Methods: A total of 790 Compulsory Secondary secondary school students.
Education (ESO) students enrolled in the 2019/2020
academic year in institutes in the autonomous Methods: A total of 790 Compulsory Secondary
School students enrolled in the 2019/2020 academic
community of Galicia participated, of which 410 were
year in secondary schools in the Autonomous
men and 380 women (M=13.84; SD =1.37).
Community of Galicia participated, of whom 410
In this descriptive-cross-sectional study, EDs were
were male and 380 female (M=13.84; SD=1.37). In
assessed using Garner's Eating Attitudes Test
this descriptive-cross-sectional study, eating
(EAT-26), in the version adapted to Spanish
disorders were assessed using Garner's Eating
subjects. The statistical treatment of the data was
developed through a multivariate analysis of Attitudes Test (EAT-26), adapted to Spanish
subjects. The statistical treatment of the data was
variance (MANOVA), which was reflected through
carried out by means of a multivariate analysis of
frequency analysis and contingency tables.
variance (MANOVA), which took the form of
Results: Considering the personal variables
analyzed, no statistically significant differences frequency analysis and contingency tables.
Results: With regard to the personal variables
were found in eating disorders in the gender of the
analyzed, no significant differences in eating
adolescents (p>0.05), but there were differences in
disorders were found across adolescents' gender
age (p<0.001). school year (p<0.001) and use of
(p>0.05), but there were significant differences in
social networks (p<0.05). Similarly, the data did
age (p<0.001), school year (p<0.001) and use of
present statistically significant differences in eating
social networks (p<0.05). Similarly, the data did
disorders according to the families' level of education
show significant differences in eating disorders
(p<0.01) and their family relationship (p<0.001).
according to the level of studies of the families
Conclusions: The results obtained in the (p<0.01) and their family relationship (p<0.001).
Conclusions: The results obtained in this search
research verify an influence of personal and family
confirm an influence of personal and family variables
variables on the attitudes associated with eating in attitudes associated with EDs. Further investigation
disorders. Continuing to delve deeper into these
of these variables may facilitate better intervention,
variables can facilitate better intervention, as well as
as well as improve the design of preventive
improve the design of preventive strategies.
Keywords: Adolescents, Disorders of the strategies.
Key words: Teenagers, Eating disorders, Family,
Eating behavior, Family, Social networks. Social networks.

Correspondence:
Rubén González Rodríguez
University of Vigo
Faculty of Education and Social Work Suggested citation: Frieiro P, González-Rodríguez R, Domínguez Alonso
Campus das Lagoas, s/n J. Influence of personal and family variables on eating disorders. Rev Esp
32004 Ourense, Spain Public Health. 2021; 95: December 22 e202112200.
rubgonzalez@uvigo.es
Machine Translated by Google
Paula Frieiro et al

INTRODUCTION It involves two environmental risk factors

Eating disorders
(ED) are considered serious mental illnesses
that affect millions of people around the
world and have repercussions on a personal,
family and social level(1,2).
The latest conceptualization established by
the American Psychiatric Association (APA),
in the DSM-5 diagnostic manual, establishes
the following classification of EDs: anorexia
nervosa disorders (AN), bulimia nervosa
(BN), binge eating disorder, of eating
behavior not otherwise specified (EDANE),
pica, rumination and eating restriction/
avoidance disorder(3).
Different studies indicate that EDs usually
begin between the beginning of puberty and
the end of adolescence, this being a sensitive
moment of development and a transition
phase of life characterized by physical,
psychological and social changes(4,5 ). The
World Health Organization (WHO) emphasizes perception of one's own body image,
the fact that EDs appear during adolescence
and are more common among women, since
some of them focus their concern about their
image on weight loss(6 , 7). Although there
is agreement that young women constitute
the majority of people with anorexia and
bulimia nervosa, it has been demonstrated
that other pathologies such as binge eating
disorder can occur and be equally common
in both sexes(8). At the same time, they are
increasingly produced in different sociocultural and teachers), the less likely it is that
contexts, due in large part to the globalization adolescents will participate in activities that
of the media, although their development
continues to predominate in Western countries At the same time, EDs and psychopathological
and with higher incomes(9,10,11) .
As for the cause of eating disorders, it is
complex, multifactorial and has not yet been
fully understood. So far it has been proven
that there is such a genetic predisposition
(12,13). Specifying the etiology a little more,
it can be stated that the subtype of restrictive
type disorders is mediated by biological
factors (such as genetic predisposition)(14),
psychological factors (such as personality
traits with obsessive tendencies , excessive
weight control, cognitive rigidity or social
isolation)(7,15) and by sociodemographic
factors (among which socioeconomic and
cultural levels, as well as family relationships,
are considered crucial)(16).
The construct of self-esteem is one of the
most studied in this area, given its inference
with EDs (17). Thus, the interpersonal
formulation of EDs postulates that they can
begin in an attempt to repair self-esteem after
having failed social interactions, at the same
time that eating disorders increase
interpersonal problems(18,19) . In this sense,
the use of social networks and exposure to
attractive peers can produce a negative
becoming a determining factor in its
development or potentially perpetuating the
disease(20,21).
The degree of social and professional
support that adolescent students perceive is
a fundamental factor in coping with or
preventing personal, academic or health
problems. The broader the range of social
support (including parents, family, friends
risk their health and increase their personal stability(22).
symptoms in adolescence can produce
problematic family functioning(23,24).
Due to their prevalence, prognosis and
characteristics, EDs continue to represent a
Public Health challenge. In a large European
review it was determined that the

2 Rev Esp Public Health. 2021; 95: December 22 e202112200

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INFLUENCE OF PERSONAL AND FAMILY VARIABLES ON EATING DISORDERS
Prevalence of the most common EDs are, first of all,
anorexia (<1–4%), followed by binge eating disorder
(<1–4%) and bulimia nervosa (<1–2%)(25). In
another systematic review analysis between 2000
and 2018, a clear increase in the prevalence of EDs
in recent years was revealed. The weighted
averages of prevalence in the period 2000-2006
were 3.5%, rising to 7.8% in the period 2013-2018,
which highlighted a challenge for Public Health and
for healthcare providers. care resources(26).
Likewise, the morbidity and severity of anorexia
and bulimia are characterized by medical
complications that cause a large part of the mortality
rate and by a decrease of between ten to twenty
years in life expectancy, also highlighting the high
rate and risk of suicide(27,28). Specifically, the
mortality rate is almost twice as high for people with
EDs than for the general population, with mortality
in AN being higher than in other EDs(8,28,29).
Education and University, they were contacted by
email. The centers that expressed their willingness
Due to the aforementioned, the use of agile
instruments that identify possible symptoms and
risk behaviors regarding EDs contribute to early
diagnosis and the development of prevention
programs that, without a doubt, report improvements
in psychosocial intervention(18).
Without effective early diagnosis and treatment,
the course of these disorders is prolonged through/
leading to physical, psychological, and social
morbidity and with high mortality(2).
The objective of the study was to evaluate
attitudes towards eating and the risk of suffering
from eating disorders in a community sample.
Through the use of the EAT-26, different personal
and family variables that could be determinants in
the development of the disease were considered.
To achieve this objective, two hypotheses were
established:
i) That the personal variables age, gender, academic
year and use of social networks
Rev Esp Public Health. 2021; 95: December 22 e202112200
significantly influenced attitudes and risk of suffering
from eating disorders.
ii) That the family variables level of education and
degree of family relationship were determinants for
the development of attitudes and risk of suffering
from eating disorders.
SUBJECTS AND METHODS
Participants and procedure. To contrast the
formulated hypotheses, an investigation was carried
out with Compulsory Secondary Education (ESO)
students, enrolled during the 2019/2020 school
year in the autonomous community of Galicia
(northwestern Spain). In relation to obtaining the
sample, the students enrolled in Secondary School
during the 2018/2019 school year in Galicia were
taken into account, which corresponded to 92,285
students. After consulting the public database of
educational centers of the Department of Culture,
to participate received a telephone communication
to further specify the research and thus agree on a
face-to-face visit to the center. An intentional
selection was made from all of them, determining
that the four provinces were represented and
guaranteeing that 50% of the centers were located
in urban and rural areas, respectively.
The total sample was made up of 790 subjects
which, with the population size described (92,285
students), represented a margin of error of 3.47%
for a 95% confidence level. The average age of the
sample was 13.84 years, with a standard deviation
of 1.37.
A gender balance was intended, although there was
a slight predominance of men (410, who represented
51.9%) over women (380, 48.1%).
3
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Paula Frieiro et al
Data collection took place between the
months of September and March of the
2019/2020 school year. For this, the
collaboration of the participating educational
centers was requested, to which the letter of
presentation of the research was delivered. In
it, the relevance of the study, the objectives to
be achieved were explained to them and their
collaboration was requested for the
authorization of informed consent by the legal
guardians of the minor students, informing
them of the procedures that would be carried out. carried
The application of the questionnaire was
carried out during school hours at the
educational center, with one of the researchers
always present. In the classroom, the voluntary
nature of the questions was emphasized
again, with the option of not answering said questionnaire.
All personal data included in the study were
processed and managed in accordance with the 2 as 2, 3 as 1 and from 4 to 6 as 0. The range
Organic Law 3/2018, of December 5, on the
protection of personal data and guarantee of
digital rights. The study procedure was
developed, at all times, in accordance with the
Declaration of Helsinki.
Instruments and Statistical Analysis. An ad hoc
structured questionnaire was used relating to
the following personal and family variables:
age, gender (female and male), school year
(1st, 2nd, 3rd or 4th of ESO), family relationship
(bad, fair, good or very good), academic level
of the legal guardians (primary, secondary or
university studies) and general use of social
networks (with a profile on social networks or
without a profile on social networks). As a direct
measure of the risks in relation to eating
disorders, the Eating Attitudes Test (EAT) was
administered , opting in this case for its reduced
version of 26 items (EAT-26)(29) with optimal
psychometric qualities ( Cronbach's alpha
between 0.83 and 0.90). The factorial validation
initially proposed by Garner et al(29) is
composed of 3 factors (diet; bulimia and
concern about food; control
4 Rev Esp Public Health. 2021; 95: December 22 e202112200
oral). However, later studies, such as that of
Constaín et al(30) have postulated the
existence of 4 factors (bulimia nervosa; diet;
preoccupation with food; oral control).
This questionnaire is a particularly useful
screening tool for assessing “eating disorder
risk” in high school, college, and other special
risk samples, such as athletes(31). The EAT-26
is not designed to diagnose or assess an eating
disorder and should not be used in place of a
professional
out throughout
diagnosisthe
or entire
consultation.
process.
Items
are presented on a 6-point forced-choice Likert
scale ranging from 1 (“Never”) to 6 (“always”).
The total score is obtained by operationalizing
the scores as follows: scores 1 to 3 are recoded
as 0, score 4 is coded as 1, 5 is coded as 2,
and 6 is coded as 3. The only exception is item
25 whose answers are scored inverted: 1 as 3,
of EAT 26 varies from 0 to 78, with the number
greater than or equal to 20 being established
by Castro et al(32) as a cut-off score from
which there is a risk of suffering from an eating
disorder.
The analysis of the information corresponded
to results of a quantitative, transversal and
descriptive nature based on frequency analysis
and contingency tables. A multivariate analysis
of variance (MANOVA) was also carried out,
taking as a variable the level of risk in relation
to eating disorders and as fixed factors gender,
age, school year, family relationship, academic
level of legal guardians and the general use of
social networks. The Wilks Lambda value was
used to observe if there were statistically
significant differences between all the variables.
The SPSS V.23 computer program for
Windows was used to carry it out. The analyzes
carried out are presented below in the results
block.
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INFLUENCE OF PERSONAL AND FAMILY VARIABLES ON EATING DISORDERS
RESULTS
Multifactorial analysis of personal and family
variables. In the personal variables, the means
and standard deviations obtained by the different
groups (female and male in gender; 12-13 years,
14-15 years, 16-
17-18 years in age; School Year: 1st ESO, 2nd
ESO, 3rd ESO, 4th ESO; Social networks: with and
without) in the scores of the different subscales
that make up the Eating Attitudes Test (EAT) [Diet
(DI), Preoccupation with food (PC), Bulimia (BU),
and Oral control (OC) ] are found in table 1.
At the multivariate level (MANOVA), the results
revealed that there were significant differences
between eating disorders and age [Wilks
Lambda=0.94, F(8, 784)=7.77, p<0.001, ÿ2
p
=0.03, power=1],
the school year [Wilks' Lambda=0.93, F(4,
783)=4.73, p<0.001, ÿ2 p
=0.02, power=1]
and social networks [Wilks' Lambda=0.98, F(4,
785)=3.05, p<0.05, ÿ2 p
=0.015, power
cia=0.807]. Likewise, they showed that there were
no significant differences between the risk of eating
disorders and gender [Wilks Lambda=0.99, F(4,
785)=1.46, p>0.05, ÿ2 p
=0.07,
power=0.46]. From a univariate perspective (Table
2), the existence of significant differences in age,
school year and social networks with the different
subscales of the EAT-26 questionnaire (DI, PC,
BU, CO) was shown. Age differences were not
significant for bulimia [F(2, 787)=2.07, p>0.05, ÿ2
p
=0.005,
power=0.43]; but there were significant differences
in the diet [F(2, 787)=5.47, p<0.01, ÿ2
p
=0.014, power=0.85], concern about
food [F(2, 787)=8.76, p<0.001, ÿ2 p
=0.022,
power=0.97] and oral control [F(2, 787)=10.23,
p<0.001, ÿ2 p=0.025, power=0.99]. The pineapple
Scheffé's post hoc analysis revealed that younger
individuals (12-13 years) had greater concern about
their diet (M=17.05; SD=6.32) than middle-aged
individuals.
Rev Esp Public Health. 2021; 95: December 22 e202112200
(14-15 years: M=5.83; SD=6.37) and older age
(16-17-18 years: M=15.06; SD=4.85); Younger
individuals were more concerned about food
(M=11.85; SD=5.25) than middle-aged individuals
(14-15 years: M=110.47; SD=4.58). and older age
(16-17-18 years: M=10.16; SD=4.27); and finally,
younger individuals (M=17.06, SD=5.32) also had
greater oral control than middle-aged individuals
(14-15 years: M=15.72, SD=6.08). ) and older age
(16-17-
18 years: M=14.36; SD=5.23). The differences in
the school year were significant for diet [F(3,
786)=7.68, p<0.001; ÿ2 p
=0.028;
power=0.99], concern about food [F(3, 786)=8.11,
p<0.001, ÿ2 p
=0.030; power
cia=0.99], bulimia [F(3, 786)=4.08, p<0.01;
ÿ2p=0.015, power=0.85] and oral control [F(3,
786)=9.46; p<0.001; ÿ2 p
=0.035; power
cia=0.99]. Scheffé's post hoc analysis revealed
that individuals who were in 1st year of ESO
(M=16.93; SD=6.21), 2nd year of ESO (M=17.11;
SD=0.6.40) and 3rd year of ESO (M=16.53; SD =
6.73) had a greater concern about diet than those
in 4th year of ESO (M=14.41; SD=5.10); those who
were in 1st year of ESO (M=11.92; SD=4.93) and
2nd year of ESO (M=11.63; SD=5.42) showed
greater concern about food than those in 4th year
of ESO (M=9.72; SD=4.13); those in the 3rd year
of ESO (M=10.59; SD=4.47) had a higher risk of
bulimia than those in the 4th year of ESO (M=9.19;
SD=2.92); and finally, those who were in 1st year
of ESO (M=17.29, SD=5.34) and 2nd year of ESO
(M=16.69, SD=5.81) had greater oral control than
those in 4th year of ESO. ESO (M=14.44; SD=5.36).
Finally, taking into account social networks, the
differences were not significant for diet [F(1, 788)=
0.22; p>0.05, ÿ2
p
=0.002; power=0.197],
concern about food [F(1, 788)=1.68, p>0.05, ÿ2
p
=0.002, power=0.255] and buli
mia [F(1, 788)=0.38, p>0.05, ÿ2 p
=0.0001; po
tension=0.095]; However, there were statistically
significant differences in oral control [F(1, 788)=3.85;
p<0.05; ÿ2 p
=0.009;
5
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Paula Frieiro et al

Table 1
Means and Standard Deviations of the subscales of the EAT-26 questionnaire (DI, PC,
BU, CO) taking into account gender, age, academic year and social networks.

Subscales GAVE PC BU CO

Female 16.64 (6.68) 11.11 (4.96) 10.25 (4.32) 16.56 (5.87)

Gender Male 15.99 (5.76) 11.03 (4.87) 9.81 (3.66) 15.82 (5.54)

Total 16.30 (6.23) 11.07 (4.91) 10.02 (4.01) 16.17 (5.71)

12-13 years 17.05 (6.32) 11.85 (5.25) 10.01 (3.94) 17.05 (5.32)

14-15 years 15.83 (6.37) 10.47 (4.58) 10.24 (4.21) 15.72 (6.08)
Age

16-17-18 years 15.06 (4.83) 10.16 (4.27) 9.29 (3.31) 14.36 (5.23)

Total 16.30 (6.23) 11.07 (4.91) 10.02 (4.01) 16.17 (5.71)

1st ESO 16.93 (6.20) 11.92 (4.93) 10.21 (3.98) 17.29 (5.34)

2nd ESO 17.11 (6.40) 11.62 (5.42) 10.02 (4.31) 16.69 (5.81)

3rd ESO 16.53 (6.73) 10.75 (4.79) 10.59 (4.47) 15.93 (6.01)
Academic course

4th ESO 14.41 (5.10) 9.72 (4.13) 9.19 (2.92) 14.44 (5.36)

Total 16.31 (6.23) 11.07 (4.91) 10.02 (4.01) 16.17 (5.71)

With networks 16.37 (6.26) 11.01 (4.93) 10.04 (4.04) 16.06 (5.71)

Social networks Without networks 15.45 (5.83) 11.87 (4.72) 9.71 (3.42) 17.55 (5.64)

Total 16.30 (6.23) 11.07 (4.91) 10.02 (4.01) 16.17 (5.71)

DI=Diet; CP=Preoccupation with food; BU=Bulimia; CO=Oral control,

6 Rev Esp Public Health. 2021; 95: December 22 e202112200

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INFLUENCE OF PERSONAL AND FAMILY VARIABLES ON EATING DISORDERS

Table 2
Differences in age, school year and social networks in
diet, preoccupation with food, bulimia and oral control.
Independent 2
EAT-26 subscales F p ÿp Power
variables

GAVE 5.47 0.004 0.014 0.85

PC 8.76 0.0001 0.022 0.97

Age
BU 2.07 0.127 0.005 0.43

CO 10.23 0.0001 0.025 0.99

GAVE 7.68 0.0001 0.028 0.99

PC 8.11 0.0001 0.030 0.99

school year
BU 4.08 0.007 0.015 0.85

CO 9.46 0.0001 0.035 0.99

GAVE 1.22 0.269 0.002 0.19

PC 1.68 0.194 0.002 0.25

Social networks
BU 0.38 0.536 0.0001 0.09

CO 3.85 0.047 0.009 0.61

DI=Diet; CP=Preoccupation with food; BU=Bulimia; CO=Oral control,

power=0.615]. Thus, individuals without social
networks (M=17.55; SD=5.64) presented greater
oral control than those who used social networks
(M=16.06; SD=5.71).
Taking into account the family environment, the
means and standard deviations obtained by the different
groups (Academic level: primary, secondary,
university studies; Family relationship: fair, good,
very good) in the scores of the different subscales
that make up the Eating Attitudes Test (EAT) [Diet
(DI), Concern about food (PC), Bulimia (BU), and Oral
Control (CO)] are found in Table 3 .

Rev Esp Public Health. 2021; 95: December 22 e202112200 7

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Paula Frieiro et al

Table 3
Means and Standard Deviations of the subscales of the EAT-26
questionnaire (DI, PC, BU, CO) taking into account the studies of the family and its family relationshi

Subscales GAVE PC BU CO

Primary 17.60 (6.03) 11.79 (5.03) 10.81 (4.10) 17.37 (6.41)

Secondary 16.75 (6.05) 11.03 (4.81) 10.05 (4.07) 15.82 (5.41)

Family educational
level
University students 15.36 (6.38) 10.89 (5.01) 9.74 (3.85) 16.22 (5.79)

Total 16.30 (6.23) 11.07 (4.91) 10.02 (4.01) 16.18 (5.71)

Regular 18.77 (7.88) 12.01 (6.08) 12.09 (5.32) 17.69 (7.16)

Good 16.37 (5.85) 11.08 (4.56) 9.98 (3.55) 15.71 (5.37)

Family
relationship
Very good 15.77 (5.96) 10.88 (4.85) 9.63 (3.82) 16.15 (5.54)

Total 16.31 (6.23) 11.07 (4.91) 10.02 (4.01) 16.17 (5.71)

DI=Diet; CP=Preoccupation with food; BU=Bulimia; CO=Oral control,

In general, the degree of family relationships was
perceived as “very good” in 55.6% of the cases, “good”
by 33.3% of the students and defined as “regular” in a
percentage of the students. 11.1%. At the multivariate
level (MANOVA), the results showed that there were
significant differences between the risk of eating disorders
and the family's level of education [Wilks' Lambda=0.97,
F(4, 785)=3.29, p <0.01, ÿ2
p
=0.014, power=0.944] and
the family relationship [Wilks Lambda=0.96, F(4,
785)=4.49, p<0.001, ÿ2 p
=0.022, power=0.997].
From a univariate perspective (Table 4), the existence
of significant differences was shown according to the
studies and the family relationship with the different
subscales of the EAT-26 questionnaire (DI, PC, BU, CO).
Considering the level of education of the family, the
differences were not significant for concern about food
[F(2, 787)=1.28, p>0.05, ÿ2
=0.003,
p
power=0.280] and bulimia [F(2, 787)=2.74, p>0.05, ÿ2
p
=0.007, power=0.543]; without em
However, there were statistically significant differences
in the diet [F(2, 787)=6.83,

8 Rev Esp Public Health. 2021; 95: December 22 e202112200

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INFLUENCE OF PERSONAL AND FAMILY VARIABLES ON EATING DISORDERS

p<0.01, ÿ2 p =0.017, power=0.921] and with to the family relationship, the differences were not
oral troll [F(2, 787)=2.98, p<0.05, ÿ2 p
=0.009, significant in concern about food [F(2, 787)=1.94,
power=0.670]. Thus, individuals from families with p>0.05, ÿ2 p
=0.005,
primary (M=17.60; SD=6.03) and secondary education power=0.404]; but they did show statistically significant
(M=16.75; SD=6.05) presented greater concern about differences for diet [F(2, 787)=8.70, p<0.001, ÿ2
diet than those from families with university studies p =0.022,po
(M=15.36; SD=6.38). Similarly, individuals from tension=0.969], bulimia [F(2, 787)=14.29, p<0.001, ÿ2
families with primary education (M=17.37; SD=6.41) p =0.035, power=0.999] and the with
showed greater oral control than those from families oral troll [F(2, 787)=3.99, p<0.05, ÿ2 p
=0.010,
with secondary education (M=15.82; SD=5.41). ). In power=0.715]. Regarding diet, families with a regular
reference relationship (M=18.77; SD=7.88) had greater concern
about

Table 4
Differences in family academic level and type of family relationship in diet, preoccupation with
food, bulimia, and oral control.

Independent 2
EAT-26 subscales F p Power
variables ÿp

GAVE 6.83 0.001 0.017 0.92

PC 1.28 0.277 0.003 0.28

Family academic
level
BU 2.74 0.065 0.007 0.54

CO 2.98 0.048 0.010 0.65

GAVE 8.70 0.0001 0.022 0.96

PC 1.94 0.143 0.005 0.40

Type of family
relationship
BU 14.29 0.0001 0.035 0.99

CO 3.99 0.019 0.010 0.71

DI=Diet; CP=Preoccupation with food; BU=Bulimia; CO=Oral control,

Rev Esp Public Health. 2021; 95: December 22 e202112200 9

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Paula Frieiro et al

diet than those with good relationships (M=16.37; statistically significant with respect to the DI,
SD=5.85) and very good relationships (M=15.77; SD=5.96).PC
and CO subscales. Thus, younger
Similarly, individuals from families with a individuals (12-13 years old) have greater
regular relationship (M=12.09; SD=5.32) concern about diet, food and oral control
presented a greater risk of bulimia than those than older or intermediate-aged individuals.
from good relationships (M=9.98; SD=3.55) It is evident that it is at the beginning of
and very good (M=9.63; SD=3.82). Finally, adolescence when greater concerns about
families with a regular relationship (M=17.69; eating disorders appear. In this sense, in
SD=7.16) showed greater oral control than different studies it has been observed that
those with good relationships (M=15.71; SD=5.37). eating disorders occur earlier than in other
mental health pathologies, with puberty being
DISCUSSION a critical moment for this problem(4,16) . The
age differences are not statistically significant
As previously stated, the present study for the bulimia dimension, agreeing with
sought to identify whether certain personal studies that identify the appearance of
and family variables of ESO students bulimic behaviors before adolescence as
significantly influence risk attitudes and very rare(33).
behaviors for suffering from EDs. Regarding
the personal variables, included in the first
hypothesis, the results show that it is partially Linked to age, it is observed that in the
confirmed, given that there are statistically school year variable there are also significant
significant differences between risk attitudes results in all the subscales (DI, PC, BU and
towards EDs and the variables of age, school CO). The youngest students, who are in 1st
year and social networks. , but not with and 2nd year of ESO, show greater concern
respect to gender. about food and oral control than 4th year
students. Similarly, students in the first three
years are more concerned about diet than
Consequently, taking gender into account, students in the last year. Finally, regarding
although in this study no statistically the bulimia dimension, 3rd grade students
significant differences were obtained in eating present higher values than 4th grade
disorders, slightly higher results were students. Thus, the first ESO courses are
achieved for the female gender. Different decisive for prevention-intervention in eating
studies agree that young women constitute disorders.
the majority of people who present anus rexia
and bulimia nervosa(8,26). It must be
considered that, historically, the study of EDs Regarding the use of social networks,
has focused on women, so the nosology of among the students who had networks,
eating disorders has evolved from studies attitudes of concern were seen, without being
that lack high representativeness with statistically significant, in the DI, PC and BU
respect to research that consider the subscales. However, students without social
masculine gender. networks show statistically significant
differences regarding oral control compared
to those who did have social networks. In this
The results, regarding the age variable, regard, we must keep in mind that the use of
indicate that this variable represents differences social networks can generate concern for

10 Rev Esp Public Health. 2021; 95: December 22 e202112200

Machine Translated by Google
INFLUENCE OF PERSONAL AND FAMILY VARIABLES ON EATING DISORDERS
body image, while contributing to the risk of
developing and maintaining eating pathologies(20,21).
If we look at the second hypothesis, which analyzed
family-related variables, it can be said that it is
confirmed in its entirety.
Thus, the results show that there are significant
differences between risk attitudes towards eating
disorders with respect to the “family's level of
education” and the “degree of family relationship.”
Regarding the educational level of the family,
there are statistically significant differences in diet
and oral control. Thus, the sample of students from
families with primary and secondary education show
greater concern about diet than those from families
with university education. Similarly, individuals from
families with primary education show greater oral
control than families with secondary education. In
this regard, some studies have revealed that families
with a higher level of education have a greater ability
to cope with the development of ED(15).
In reference to the family relationship, the
differences are not statistically significant in concern
about food; but they do show significant differences
for diet, bulimia and oral control. Regarding diet,
families with a regular relationship have greater
concern about diet than those with good and very
good relationships. Similarly, individuals from families
with a regular relationship have a greater risk of
bulimia and oral control than those from good
relationships. This result is consistent with studies
that show the influence of family functioning on eating
disorders. Thus, when family relationships and
dynamics are complex and rigid and very strict
relationships occur, these influence by predicting
possible psychopathological symptoms which, in turn,
can be one
Rev Esp Public Health. 2021; 95: December 22 e202112200
of the triggers of eating disorders (16,22,23,24).
In view of the results, it can be concluded that risk
attitudes and behaviors associated with eating
disorders are influenced by personal variables (age,
school year and use of social networks) and family
variables (family educational level and degree). of
family relationship). Knowing and identifying the
statistically significant relationship of these variables
is of special relevance in these health problems that
debut at such an early age. Without a doubt, having
good instruments for identifying risk attitudes and
behaviors is important, but it is also important to know
the degree of interference of individual and family
variables in this type of behavior(10,19). All of this
enables improvement in intervention and also in the
design of preventive strategies, which help avoid the
development of eating disorders, as well as the
physical, psychological, and social morbidity and high
mortality associated with these problems(7). For all of
the above, we emphasize the need to keep in mind
that the growing prevalence of eating disorders
requires a periodic and updated study that continues
to delve into the different personal and family variables
that interfere with the appearance and persistence of
these disorders.
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