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 (Mage = 43.0, SD = 12.9) with the majority being female (218/275; 79.3%). 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 level of ambulation 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. Neuroticism, self-esteem, and body dissatisfaction may be important targets for assessing and treating EDs in individuals with MS. Future longitudinal research is needed to examine causal relationships.