Eating Disorder Symptoms in Multiple Sclerosis: Relationships Between Neuroticism, Body Dissatisfaction and Self-Esteem

Background/Objectives: Research on eating disorders (EDs) in individuals with multiple sclerosis (MS) is limited. In ED populations, neuroticism has been linked to ED symptoms through lower self-esteem and greater body dissatisfaction, but these relationships remain unexplored in MS. This study aimed to examine whether self-esteem and body dissatisfaction mediate the link between neuroticism and ED symptoms in individuals with MS. Methods: The current sample consisted of 275 participants who reported a neurologist-confirmed diagnosis of MS (M age = 43.0, SD = 12.9). Participants completed an online questionnaire measuring neuroticism (Big Five Inventory), self-esteem (Rosenberg Self-esteem Scale), body dissatisfaction (Body Shape Questionnaire), and ED symptoms (Eating Attitudes Test-26). Results: A serial mediation analysis controlling for age, sex, and ambulation level revealed that the association between neuroticism and ED symptoms is respectively and serially explained by self-esteem and body dissatisfaction in individuals with MS. The total model accounted for 43% of the variance in ED symptoms. Conclusions: Findings suggest that self-esteem and body dissatisfaction are important in understanding the relationship between neuroticism and ED symptoms and should be considered in the assessment and treatment of ED symptoms in individuals with MS.