Prospective Associations of Gastrointestinal Symptoms With Eating Disorder Psychopathology in Chinese Men and Women

Objective: Previous literature has primarily employed cross-sectional designs to investigate associations between gastrointestinal (GI) symptoms and eating disorder (ED) psychopathology, a closely correlated, potentially bidirectional phenomenon; yet few studies have examined the longitudinal directionality of these relationships. This study examined the bidirectional associations between GI symptoms and ED psychopathology in cisgender Chinese adults. Method: Using a two-wave, 6-month longitudinal design, data were collected from 400 men (M_age = 31.86 years at baseline) and 400 women (M_age = 29.71 years at baseline) via online self-reported questionnaires. GI symptoms and three types of ED psychopathology were measured at baseline (T1) and 6 months later (T2). Data analyses were conducted separately for men and women. Pearson correlation analyses were used to examine bivariate correlations among the variables. Cross-lagged models examined the bidirectional associations of GI symptoms with three types of ED psychopathology, after adjusting for demographic covariates and baseline levels of ED psychopathology. Results: Thinness-oriented disordered eating (βs = 0.12–0.16) and avoidant/restrictive food intake disorder (ARFID) symptoms (βs = 0.12–0.13) were found to have positive bidirectional associations with GI symptoms in men. No significant bidirectional associations were identified in women. However, in women, thinness- and muscularity-oriented ED psychopathology significantly predicted more GI symptoms, and GI symptoms significantly predicted more ARFID symptoms. Conclusions: Findings provide valuable insights for potential intervention strategies that target GI symptoms to reduce thinness-oriented ED psychopathology and ARFID symptoms in men. For women, the non-significant bidirectional results also underscore the need for future research to further clarify associations between GI symptoms and ED psychopathology.