Eating Disorder Core Symptoms and Symptom Pathways Across Developmental Stages: A Network Analysis

Eating disorders (EDs) often develop during adolescence and early adulthood but may persist, arise, or reemerge across the life span. Research and treatment efforts primarily focus on adolescent and young adult populations, leaving large knowledge gaps regarding ED symptoms across the entire developmental spectrum. The current study uses network analysis to compare central symptoms (i.e., symptoms that are highly connected to other symptoms) and symptom pathways (i.e., relations among symptoms) across five developmental stages (early adolescence, late adolescence, young adulthood, early-middle adulthood, middle-late adulthood) in a large sample of individuals with EDs (N = 29,902; N = 32,219) in two network models. Several symptoms related to overeating, food avoidance, feeling full, and overvaluation of weight and shape emerged as central in most or all developmental stages, suggesting that some core symptoms remain central across development. Despite similarities in central symptoms, significant differences in network structure (i.e., how symptom pathways are connected) emerged across age groups. These differences suggest that symptom interconnectivity (but not symptom severity) might increase across development. Future research should continue to investigate developmental symptom differences in order to inform treatment for individuals with EDs of all ages.