Eat Weight Disord DOI 10.1007/s40519-015-0203-2
LETTER TO THE EDITOR
The relationship between internet addiction and eating disorders Fatih Canan1
Received: 16 June 2015 / Accepted: 17 June 2015 Springer International Publishing Switzerland 2015
Dear Editor, I have read with interest the recent article by Alpaslan et al. [1] on the relationship between internet addiction and disordered eating attitudes. The authors have found that abnormal eating attitude was independently associated with internet addiction. They state that no studies have been published on the relationship between internet addiction and eating attitudes among Turkish participants [1]. However, there are at least two published papers from Turkey about this topic [2, 3]. Studies investigating the association of internet addiction and disordered eating have been accumulating recently. With the present communication, I would like to add a few considerations—focusing on the relationship of internet addiction and disordered eating—based on most
recent experience. The main findings of the relevant studies are presented in Table 1. According to the results of this mini-review: •
• •
Internet addiction and abnormal eating attitudes are closely related (Canan et al. [3] have found no association). This association may be more manifest in females than in males. Depression may be a mediator in the relationship between internet addiction and bulimia.
Although most of the previous studies indicate an association of internet addiction with abnormal eating behaviors; the cross-sectional design of these studies hinders definite conclusions. Future prospective studies using
& Fatih Canan [email protected] 1
Department of Psychiatry, Akdeniz University School of Medicine, 07059 Kampu¨s, Antalya, Turkey
123
Eat Weight Disord Table 1 Studies evaluating the relationship of eating attitudes and internet addiction Study
Sample
Assessment tools
Findings
Comments
Tao and Lui (2009) [4]
Secondary school and college students (n = 1119)
Young’s screening instrument for addictive internet use.
Controlling for BMI did not change the results
Female/male: 767/432
EAT
Mean age 18.9 years
EDI
The female internet dependents scored higher on diet behavior, bulimia, oral control subscales of the EAT and ineffectiveness, and interoceptive awareness subscales of the EDI than their non-dependent counterparts
Rodgers et al. (2013) [5]
Adults (n = 431)
IAT
Female/male: 292/139
EAT
The survey was conducted online
Mean age 25.2 years
The Body Image Avoidance Questionnaire
Internet addiction and body image avoidance were independently associated with disordered eating among women
Tao (2013) [6]
College students (n = 2036)
IAT
Female/male: 767/432
DSM-IV criteria for bulimia
The proportion of DSM-IV bulimia was comparable between students with internet addiction and those without internet addiction No correlation was found between IAT and EDI subscales
Depression was a partial mediator in the relationship between internet addiction and bulimia
IAT
EAT was not correlated with IAT
EAT (a cutoff score determined individuals with a possible eating disorder)
IAT and EAT were independently associated with BMI
Internet addiction and duration of internet use were not associated with the presence of a possible eating disorder
PIUS
Significant positive correlation between PIUS and EAT.
Mean age 18.9 years
EDI
Beck depression inventory Canan et al. (2015) [2]
High school students (n = 1938) Female/male: 1007/931 Mean age 16 years
C¸elik et al. (2015) [3]
University students (n = 315)
EAT
Female/male: 167/148
PIUS score was independently associated with EAT
Mean age 20.6 years
Alpaslan et al. (2015) [1]
High school students (n = 584) Female/male: 381/203 Mean age 16.1 years
Only gender and computer ownership was included in the multiple linear regression analysis. Body mass index (BMI) was not evaluated
IAT EAT (a cutoff score determined individuals with DEAs)
Significant positive correlation between IAT and EAT. Male gender, presence of DEAs and being overweight or obese were independently associated with IAT
Several confounding factors (DEAs, gender, educational status of parents, family income, alcohol use, smoking, and BMI categories) were included in the logistic regression analysis
BMI body mass index, DEAs disordered eating attitudes, EAT eating attitude test, EDI eating disorder inventory, IAT internet addiction test, PIUS problematic internet use scale
structured or semi-structured interviews should investigate the temporal relationship of internet addiction and specific eating disorders, particularly binge eating disorder. Conflict of interest conflict of interest.
The corresponding author states that there is no
Ethical approval This article does not contain any studies with human participants performed by any of the authors. Informed consent subjects.
This study does not involve human or animal
References 1. Alpaslan AH, Kocak U, Avci K, Uzel Tas H (2015) The association between internet addiction and disordered eating attitudes among Turkish high school students. Eat Weight Disord. doi:10.1007/s40519-015-0197-9
123
2. Canan F, Yildirim O, Ustunel TY, Sinani G, Kaleli AH, Gunes C, Ataoglu A (2014) The relationship between internet addiction and body mass index in Turkish adolescents. Cyberpsychol Behav Soc Netw 17:40–45. doi:10.1089/cyber.2012.0733 3. C¸elik C¸B, Odacı H, Bayraktar N (2015) Is problematic internet use an indicator of eating disorders among Turkish university students? Eat Weight Disord 20:167–172. doi:10.1007/s40519014-0150-3 4. Tao ZL, Liu Y (2009) Is there a relationship between internet dependence and eating disorders? a comparison study of internet dependents and non-internet dependents. Eat Weight Disord 14:e77–e83. doi:10.1007/BF03327803 5. Rodgers RF, Melioli T, Laconi S, Bui E, Chabrol H (2013) Internet addiction symptoms, disordered eating, and body image avoidance. Cyberpsychol Behav Soc Netw 16:56–60. doi:10.1089/cyber. 2012.1570 6. Tao Z (2013) The relationship between internet addiction and bulimia in a sample of Chinese college students: depression as partial mediator between internet addiction and bulimia. Eat Weight Disord 18:233–243. doi:10.1007/s40519-013-0025-z
LETTER TO THE EDITOR
The relationship between internet addiction and eating disorders Fatih Canan1
Received: 16 June 2015 / Accepted: 17 June 2015 Springer International Publishing Switzerland 2015
Dear Editor, I have read with interest the recent article by Alpaslan et al. [1] on the relationship between internet addiction and disordered eating attitudes. The authors have found that abnormal eating attitude was independently associated with internet addiction. They state that no studies have been published on the relationship between internet addiction and eating attitudes among Turkish participants [1]. However, there are at least two published papers from Turkey about this topic [2, 3]. Studies investigating the association of internet addiction and disordered eating have been accumulating recently. With the present communication, I would like to add a few considerations—focusing on the relationship of internet addiction and disordered eating—based on most
recent experience. The main findings of the relevant studies are presented in Table 1. According to the results of this mini-review: •
• •
Internet addiction and abnormal eating attitudes are closely related (Canan et al. [3] have found no association). This association may be more manifest in females than in males. Depression may be a mediator in the relationship between internet addiction and bulimia.
Although most of the previous studies indicate an association of internet addiction with abnormal eating behaviors; the cross-sectional design of these studies hinders definite conclusions. Future prospective studies using
& Fatih Canan [email protected] 1
Department of Psychiatry, Akdeniz University School of Medicine, 07059 Kampu¨s, Antalya, Turkey
123
Eat Weight Disord Table 1 Studies evaluating the relationship of eating attitudes and internet addiction Study
Sample
Assessment tools
Findings
Comments
Tao and Lui (2009) [4]
Secondary school and college students (n = 1119)
Young’s screening instrument for addictive internet use.
Controlling for BMI did not change the results
Female/male: 767/432
EAT
Mean age 18.9 years
EDI
The female internet dependents scored higher on diet behavior, bulimia, oral control subscales of the EAT and ineffectiveness, and interoceptive awareness subscales of the EDI than their non-dependent counterparts
Rodgers et al. (2013) [5]
Adults (n = 431)
IAT
Female/male: 292/139
EAT
The survey was conducted online
Mean age 25.2 years
The Body Image Avoidance Questionnaire
Internet addiction and body image avoidance were independently associated with disordered eating among women
Tao (2013) [6]
College students (n = 2036)
IAT
Female/male: 767/432
DSM-IV criteria for bulimia
The proportion of DSM-IV bulimia was comparable between students with internet addiction and those without internet addiction No correlation was found between IAT and EDI subscales
Depression was a partial mediator in the relationship between internet addiction and bulimia
IAT
EAT was not correlated with IAT
EAT (a cutoff score determined individuals with a possible eating disorder)
IAT and EAT were independently associated with BMI
Internet addiction and duration of internet use were not associated with the presence of a possible eating disorder
PIUS
Significant positive correlation between PIUS and EAT.
Mean age 18.9 years
EDI
Beck depression inventory Canan et al. (2015) [2]
High school students (n = 1938) Female/male: 1007/931 Mean age 16 years
C¸elik et al. (2015) [3]
University students (n = 315)
EAT
Female/male: 167/148
PIUS score was independently associated with EAT
Mean age 20.6 years
Alpaslan et al. (2015) [1]
High school students (n = 584) Female/male: 381/203 Mean age 16.1 years
Only gender and computer ownership was included in the multiple linear regression analysis. Body mass index (BMI) was not evaluated
IAT EAT (a cutoff score determined individuals with DEAs)
Significant positive correlation between IAT and EAT. Male gender, presence of DEAs and being overweight or obese were independently associated with IAT
Several confounding factors (DEAs, gender, educational status of parents, family income, alcohol use, smoking, and BMI categories) were included in the logistic regression analysis
BMI body mass index, DEAs disordered eating attitudes, EAT eating attitude test, EDI eating disorder inventory, IAT internet addiction test, PIUS problematic internet use scale
structured or semi-structured interviews should investigate the temporal relationship of internet addiction and specific eating disorders, particularly binge eating disorder. Conflict of interest conflict of interest.
The corresponding author states that there is no
Ethical approval This article does not contain any studies with human participants performed by any of the authors. Informed consent subjects.
This study does not involve human or animal
References 1. Alpaslan AH, Kocak U, Avci K, Uzel Tas H (2015) The association between internet addiction and disordered eating attitudes among Turkish high school students. Eat Weight Disord. doi:10.1007/s40519-015-0197-9
123
2. Canan F, Yildirim O, Ustunel TY, Sinani G, Kaleli AH, Gunes C, Ataoglu A (2014) The relationship between internet addiction and body mass index in Turkish adolescents. Cyberpsychol Behav Soc Netw 17:40–45. doi:10.1089/cyber.2012.0733 3. C¸elik C¸B, Odacı H, Bayraktar N (2015) Is problematic internet use an indicator of eating disorders among Turkish university students? Eat Weight Disord 20:167–172. doi:10.1007/s40519014-0150-3 4. Tao ZL, Liu Y (2009) Is there a relationship between internet dependence and eating disorders? a comparison study of internet dependents and non-internet dependents. Eat Weight Disord 14:e77–e83. doi:10.1007/BF03327803 5. Rodgers RF, Melioli T, Laconi S, Bui E, Chabrol H (2013) Internet addiction symptoms, disordered eating, and body image avoidance. Cyberpsychol Behav Soc Netw 16:56–60. doi:10.1089/cyber. 2012.1570 6. Tao Z (2013) The relationship between internet addiction and bulimia in a sample of Chinese college students: depression as partial mediator between internet addiction and bulimia. Eat Weight Disord 18:233–243. doi:10.1007/s40519-013-0025-z
