Eating disorders in the shadow of conflict: Risk factors in civilians exposed to war

Eating disorders (EDs) have been linked to emotional distress, yet underlying mechanisms during war remain unclear. This study examined associations between past and current stressful life events, differentiation of self, coping strategies, emotional distress, and EDs risk among 690 Israeli adults (75% female, mean age = 40) assessed two months after the outbreak of the Iron Swords War. Emotional distress mediated the associations between past/current stressful events, differentiation of self, and EDs risk; however, only current stressful life events showed additional indirect effects through coping, particularly emotion-focused coping/avoidance (χ 2 [18] = 28.35, p = .057; CFI = 0.993; NNFI = 0.970; RMSEA = 0.029). Participants scoring above the EAT-26 cutoff reported higher past stressful life events (F = 1.58, p = .023), emotion-focused coping/avoidance (F = 1.36, p = .002), anxiety (F = 1.19, p = .006), PTSD (F = 1.02, p = .001), and lower differentiation of self than those below the cutoff. Evacuees reported greater current stressful events (F = 6.83, p = .009, η 2 = 0.010), lower task-oriented coping (F = 5.33, p = .020, η 2 = 0.008), and higher PTSD (F = 4.58, p = .033, η 2 = 0.007). These findings enhance understanding of EDs risk factors during prolonged wartime. • Civilian wartime data: EDs risk mapped across 690 Israeli adults. • DoS and stressful life events increased EDs risk through coping and distress. • Task-oriented coping showed an unexpected positive association with EDs risk. • EDs vulnerability profile: low DoS, emotion-focused coping, and emotional distress.