Alexithymia, body image, self-esteem and eating disorders in adolescents

Adolescence is a sensitive period for the emergence of body-image concerns and disordered eating. Yet evidence from Albania is scarce. This study examined how alexithymia (difficulty identifying/expressing emotions), self-esteem, and body image dissatisfaction relate to eating disorder symptoms among Albanian adolescents. A cross-sectional survey was administered to N = 302 secondary-school students (approximately ages 14–15). Participants completed the Toronto Alexithymia Scale (TAS-20), Rosenberg Self-Esteem Scale (RSE), Multidimensional Body-Self Relations Questionnaire (MBSRQ) indices of body dissatisfaction, and the Eating Disorder Examination–Questionnaire (EDE-Q 6.0). After data cleaning, we reported descriptives and internal consistencies, then ran bivariate correlations and multiple linear regression predicting EDE-Q global severity from alexithymia, self-esteem, body dissatisfaction, and demographics. Measures showed acceptable internal consistency. Bivariate analyses indicated that higher alexithymia and greater body dissatisfaction were associated with higher EDE-Q scores, while higher self-esteem correlated with lower EDE-Q scores. In the multivariable model, body dissatisfaction emerged as the strongest unique predictor of eating-disorder symptoms, with alexithymia contributing small additional variance and self-esteem inversely associated with outcomes. The mediation model tested (alexithymia as mediator between self-esteem and eating- disorder symptoms) was not supported; indirect effects were nonsignificant. Exploratory moderation (e.g., by sex/BMI) yielded limited and inconsistent evidence, and effects should be interpreted cautiously. Among Albanian adolescents, body dissatisfaction is the most robust correlate of eating-disorder symptomatology, with alexithymia and self-esteem providing additional, smaller contributions. Findings emphasize the value of school-based prevention that integrates body-image literacy, emotion-identification skills, and self-esteem enhancement, tailored to cultural norms and the rapidly changing media environment in Albania.