Eating behaviors and depression in adolescents: An approach based on network analysis

Background: Adolescence is a critical period for emotional and behavioral health. This study investigated the network relationships between risky eating behaviors and depressive symptoms in Peruvian adolescents.Method: We designed a cross-sectional study. A network analysis was conducted on 612 adolescents aged 12–17. Depressive symptoms were measured by the abbreviated Reynolds Adolescent Depression Scale, and eating behaviors were assessed with the Spanish short version of the Eating Attitudes Test (EAT-12), covering dieting, bulimia, food concern, and oral control. Bayesian network modeling quantified symptom associations with rigorous statistical criteria.Results: Sadness, loneliness, and unhappiness emerged as central depressive symptoms, with anger bridging depression and oral control behaviors. Irritability and dieting showed strong associations (M = 12.87, SD = 6.19 for dieting), and self-harm was directly connected to dieting behaviors. Bayesian factors >10 indicated robust symptom links, emphasizing the role of emotional dysregulation in eating pathology. Cultural factors, including academic pressure and internalized Western beauty ideals, influence these symptom networks.Conclusion: The study revealed that sadness, unhappiness, and loneliness were the most central depressive symptoms in the network, while anger acted as a bridge symptom linking emotional distress with oral control behaviors. Additionally, dieting showed robust associations with bulimic behaviors and self-harm, highlighting critical pathways through which depression and risky eating behaviors reinforce each other. These findings emphasize the need for culturally sensitive preventive strategies for Peruvian adolescents.