Indirect Effects of Body Dissatisfaction in the Association Between Intolerance of Uncertainty and Disordered Eating Attitudes: A Cross-Sectional Study on Italian University Female Students

Objectives: Intolerance of uncertainty (IU) is a transdiagnostic factor implicated in emotional disorders and has recently been linked to maladaptive eating attitudes. Body dissatisfaction, a core risk factor for maladaptive eating, may represent a key pathway through which IU exerts its effects. This study examined whether body dissatisfaction has an indirect effect on the association between IU and disordered eating attitudes in female university students, controlling for body mass index (BMI) and trait anxiety. Methods: A cross-sectional study was conducted with 141 female psychology students aged 18–35 years (M = 21.23, SD = 2.31). Participants completed self-report measures of IU (Intolerance of Uncertainty Scale–Short Form), body dissatisfaction (Body Shape Questionnaire), disordered eating attitudes (Eating Attitudes Test-26), trait anxiety (State–Trait Anxiety Inventory), and reported weight and height to calculate BMI. Indirect effects were tested using bootstrapped mediation models. Results: IU was positively associated with body dissatisfaction (β = 1.139, p = 0.001), which in turn significantly predicted dieting (β = 0.126, p < 0.001) and bulimia/food preoccupation (β = 0.033, p < 0.001), but not oral control. Bootstrapped analyses showed significant indirect effects of IU on dieting (β = 0.144, 95% CI [0.047, 0.251]) and bulimia/food preoccupation (β = 0.037, 95% CI [0.010, 0.074]) via body dissatisfaction. Direct effects of IU on eating attitudes were not significant. Conclusions: IU to be associated with disordered eating attitudes primarily through body dissatisfaction, independently of BMI and anxiety. These findings extend evidence of IU as a cognitive vulnerability for eating-related psychopathology to non-clinical populations, highlighting the need for preventive interventions addressing both body image concerns and IU in female university students.