Predictors for being at risk for EDs in regards to visiting diet, fitness and

As seen previously, media use is associated with many different aspects of body image, eating habits, and EDs. The emerging tendencies best fit in a complex model where multiple mediators take place and media use (especially when individuals use it with

certain motivations such as dieting) can predict the use of unhealthy weight loss methods.

Therefore, it was important to examine that after all these possible contributors to EDs, whether media use, especially the exposure to diet, fitness and ProED content (which showed strong associations previously) would be able to predict if there is a risk for EDs or not based on exposure to these media contents.

The fifth part of the current study aimed to investigate whether reading magazines, watching TV shows, visiting websites in the topic of fitness, diet and/or browsing web pages that support eating disorders predicts the elevated risk for EDs and/or risk for developing unspecified feeding or eating disorders (UFED) among the 18-35 years old young population. Results showed that most often the preferred way to seek media content in regards to dieting, sport and lifestyle was online. It was found that one-sixth of the sample was browsing such online content at least once a week. The occasional browsing of eating disorders promoting pages appeared to be alarmingly high, close to 10% of the respondents reported such activity. Compared to Internet use, magazine reading and television watching with regards to bodily appearance were considerably less often preferred. Women compared to men reported a more frequent media use in case of all types of media content.

The assessment of ED risk was carried out by using the EDI, SEED, and SCOFF questionnaires. These measures are widely used in the literature. The study aimed to assess the risk regarding developing traditional EDs such as AN and BN and also the risk for developing binge eating disorders and unspecified feeding or eating disorders. It is important to emphasize that since the study did not use any diagnostic clinical interview the categories reflecting the risk for developing EDs, BED and UFED is solely based on the already mentioned questionnaires and screening tools. According to the results, the vast majority of this sample (men and women) showed no risk at all for developing EDs.

Nevertheless, 25.4% of the participants appeared to be at risk for some sort of EDs or UFED.

Similar to previous findings (Hudson, Hiripi, Pope, & Kessler, 2007) among women the risk for developing EDs was higher than it is among men. It was found in this study that

browsing diet, fitness/health related websites at least once a week was associated with 2.5 times higher risk for UFED and a threefold risk of being at risk for EDs. The exposure to ProED pages elevated the risk for ED and UFED as well, again with having even (almost four times) higher risk for EDs. After adjusting for potential background variables (gender, age, education and self-esteem), as well as involving other psychological variables, in addition, it was found that browsing diet, fitness/health related websites at least once a week and browsing ProED pages occasionally still predicted a significant the risk for developing UFED and EDs. These results could be especially important given that based on previous research of all adults that seek treatment for eating disorders about half are diagnosed with EDNOS (eating disorders otherwise not specified) and research also has shown that 60% of most eating disorder cases are EDNOS (Fairburn, Cooper, Bohn, O‘Connor, Doll, & Palmer, 2007).

Results also indicate that the pressure from media was associated with a higher risk for developing UFED and EDs. The tendency to compare one‘s physical appearance to others predicted a higher risk for EDs and when compared to UFED, the model showed that this risk is in favour for EDs rather than UFED. Finally, the model revealed, similar to previous findings that higher BMI, lower self-esteem, and the female gender all predicted a higher risk for EDs and UFED (Haines & Neumark-Sztainer, 2006). Rouleau and colleagues (2011) argued that ProED websites could exacerbate or maintain users' eating disorder symptoms, especially since they not only disguise promoting EDs as support but also reinforce EDs related behaviours and prevent help-seeking and recovery. Furthermore, in Jett, LaPorte, and Wanchisn‘s (2010) study the authors explained that after participants were exposed to ProED websites only for 1.5 hrs., they reported using techniques they learnt from the websites to help them with food reduction and reported strong emotional reactions to the websites. These changes persisted for three weeks after the study finished.

It is not only important to consider the possible risks from such websites but also to take into account their clinical relevance. As Harshbarger and colleagues (2009) explained, it is meaningful to be clear with the content of such web pages and to support those who suffer from EDs in this aspect as well. The content of these pages not only contains harmful and encouraging messages regarding unhealthy or extremely unhealthy weight loss methods but

also can also deepen the maladaptive habits and beliefs in those who already suffer from EDs and with a seemingly supportive attitude actually prevent them from getting the appropriate help they need.

Previous research also supports our findings regarding diet and fitness content in media and the elevated risk for EDs. Utter, Neumark-Sztainer, Wall, and Story (2003) found that being exposed to diet-related content in magazines indicated psychosocial distress and unhealthy dieting among adolescents. Thomsen and colleagues (2001, 2002) and Hyla (2003) reported that reading women's health and fitness magazines was associated with the use of unhealthy weight-control practices such as low calorie diet, excessive exercise, self-induced vomiting, and the use of laxatives among high-school girls, adolescent females, and college women as well. The results showed that the appearance-focused media;

especially diet, fitness-themed Internet pages, and ProED websites carry a considerable risk for developing EDs among young adults as well. We suggest putting a great emphasis on online diet and fitness content and ProED sites when designing future prevention and media education programs. Results of this study highlight the importance of such programmes and the need to educate children and young people of all aspects of the media that could influence their relationship with their bodies. We suggest the implementation of the current results not only in prevention and education programs that are targeting EDs but also in individual, group, and family therapies. Clinical care and public education should demystify the taboo surrounding these sites. Legislators and lawmakers should tighten the rules around ProED web pages and limit the availability of such websites.