TOPLINE: 

Body dissatisfaction at the age of 16 years was associated with an increase in symptoms of eating disorders and depression and a higher BMI in young adulthood, a large population-based cohort study showed.

METHODOLOGY: 

• Data on more than 2000 individuals (60% girls; 93.5% White) born between 1994 and 1996 in England and Wales were drawn from the Twins Early Development Study (62% dizygotic/fraternal twin pairs).
• Body dissatisfaction was self-reported at 16 years of age using four items from the Eating Disorder Diagnostic Scale, which measured weight and shape concerns of participants.
• Outcomes included assessment of eating disorder symptoms via a 12-item modified Eating Disorder Inventory-2 questionnaire at the age of 21 years, depressive symptoms using an 8-item version of the Short Mood and Feelings Questionnaire at age 21 years and 26 years, and BMI calculated from self-reported height and weight at age 21 years and 26 years.

TAKEAWAY: 

• Each 1-point increase in body dissatisfaction score at age 16 was linked to increased scores in early adulthood for eating disorder (1.99-point increase) and depressive symptoms (0.59-point increase), and a 0.27 increase in BMI (all P < .0001).
• Girls had a stronger association between body dissatisfaction and eating disorders than did boys (interaction coefficient, -0.7), but there were no significant between-sex differences for interactions with depressive symptoms or BMI.
• In dizygotic twins, a 1‑point increase in body dissatisfaction score was associated with a 2-point increase in eating disorder symptoms, a 0.55-point increase in depressive symptoms, and a 0.44-point increase in BMI (all P < .0001). In monozygotic/identical twins, the associations attenuated for eating disorder symptoms to a 1.08-point increase (P = .02) but not for depressive symptoms (0.46-point increase; P = .006), with weak evidence of an association with BMI for this subgroup.
• Additive genetic factors accounted for 77% of the correlation between body dissatisfaction and eating disorder symptoms (95% CI, 0.67-0.87), indicating substantial shared genetic influence. The remainder was due to nonshared environmental factors, which showed only a modest overlap.

IN PRACTICE:

“The study supports the view that body dissatisfaction represents a potentially modifiable and transdiagnostic risk factor for adverse mental health outcomes, particularly eating disorder and depressive symptoms,” experts wrote in an accompanying editorial.

In a news release, senior study author Francesca Solmi, Division of Psychiatry, University College London, United Kingdom, said the findings point to the importance of wider public health strategies. “It is vital that body dissatisfaction is tackled head-on during the teenage years across multiple settings,” Solmi said. 

SOURCE:

The study was led by Ilaria Costantini, PhD, Division of Psychiatry, University College London, London, UK. It is published online as part of the January 2026 issue of The Lancet Psychiatry.

LIMITATIONS: 

The sample size may have been underpowered to detect small associations, and the findings may not be generalized beyond the predominantly White twin population studied. Additionally, the measure of body dissatisfaction focused primarily on weight- and shape-related concerns.

DISCLOSURES:

The study was funded by the Wellcome Trust. Three investigators reported receiving royalties from Pearson Education, serving as a consultant for OrbiMed, and/or receiving honoraria from Elsevier, Wiley-Blackwell, or the BMJ Group. The other investigators reported no relevant conflicts of interest. Two of the editorialists reported having financial or other ties with various organizations. All disclosures are fully listed in the original article. 

This article was created using several editorial tools, including AI, as part of the process. Human editors reviewed this content before publication.