According to meta-analytic review, body dissatisfaction (BD) is recognized as the strongest risk factor of all forms of eating disorders (EDs).Yet, it has been found that BD is so prevalent among adolescent girls and young adult women that it is “normative”. The present study investigates why only a minority of adolescents girls report severe levels of ED symptomatology, when so many are body dissatisfied?

Five theoretically relevant variables are investigated as potential moderators of the BD-ED symptomatology relationship (drive for thinness and bulimic behaviours).

A sample of 401 Italian adolescent girls completed questionnaire measures of BD, drive for thinness, bulimic behaviours, as well as the proposed moderating variables of body checking, perfectionism, appearance control beliefs, internalization of socio-cultural standards of beauty, and self-esteem.

Structural equation modeling with latent factor interactions indicated that body checking, perfectionism, appearance control beliefs and internalization of socio-cultural standards of beauty intensified the primary BD-ED symptomatology, such that BD was strongly related to drive for thinness and bulimic behaviours when levels of each moderator were higher. By contrast self-esteem buffered the deleterious effects of BD, such that when levels of the moderator were higher, the relationship between BD and each criterion variable representing female's ED symptomatology was weaker.

Several risk and protective factors have been found to interact with BD to influence its relation to ED symptomatology. The findings can inform the design and delivery of tailored prevention and treatments interventions for adolescent's eating disturbances.