Loneliness in Eating Disorders: Is It Related to Specific Eating Behaviors? A Transdiagnostic Analysis From a Bicentric Italian Study

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BACKGROUND: Loneliness is the emotional experience arising from the discrepancy between an individual's desired and actual social relationships. Despite a solid rationale for expecting high levels of loneliness in eating disorders (EDs), this construct has been relatively underexplored. AIMS: The present study aimed to compare levels of loneliness between people with EDs and healthy controls (HCs), assess the possible differences according to predominant pathological eating behaviors, and explore the variables associated with loneliness. METHODS: A total of 124 individuals with EDs and 134 HCs completed the UCLA Loneliness Scale-3 (LS-3) and measures of ED psychopathology (EDI-3), general psychopathology (SCL-90-R), functional impairment (WSAS), quality of life (EQ-5D), wisdom (SD-WISE), hopelessness (BHS-20), and temperament (TEMPS-A). Within the ED sample, participants were compared according to their predominant pathological eating behaviors. Associations with loneliness were examined using stepwise multiple linear regression analyses. RESULTS: Individuals with EDs reported higher levels of loneliness compared to HCs. No differences emerged based on the specific eating behaviors, and loneliness was not associated with BMI, illness duration, or frequency of pathological eating behaviors. In the clinical sample, loneliness was most strongly associated with ED-related interpersonal problems, global psychological distress, and lower wisdom. In the control group, the associations of loneliness replicated those identified in the clinical sample. DISCUSSION: Higher levels of loneliness were observed among individuals with EDs irrespective of behavioral subtype and clinical severity. These findings support the conceptualization of loneliness as a transdiagnostic dimension rather than a feature linked to specific eating behaviors.

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