Association of shared family meals with adolescent disordered eating risk: a multicenter cross-sectional study across three Turkish cities

Background Disordered eating is a growing public health concern among adolescents worldwide, across countries at all levels of economic development. This study aimed to estimate the prevalence of high-risk disordered eating in a multicenter clinical adolescent sample and to examine its associations with family mealtime habits and parent–adolescent relationship characteristics. Methods A multicenter cross-sectional study was conducted in accordance with the Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) guidelines in outpatient clinics across three major cities in Türkiye (Istanbul, Izmir, and Ankara). After exclusion of 17 questionnaires with ≥ 20% missing data, the final analytic sample comprised 522 adolescents aged 11–18 years (53.6% female; mean age 14.55 ± 2.14 years). Disordered eating risk was assessed using the Eating Attitudes Test-26 (EAT-26), with a score ≥ 20 defining high-risk status. Parent–adolescent relationship quality was evaluated with the Turkish-validated Adolescent–Parent Relationship Questionnaire. Multivariable logistic regression was performed to identify factors independently associated with high-risk disordered eating. Results The prevalence of EAT-26 high-risk disordered eating was 9.6%. Four variables were independently associated with high-risk disordered eating. Female sex (OR = 2.44, 95% CI: 1.15–5.20, p = 0.020) and older age per year (OR = 1.22, 95% CI: 1.02–1.46, p = 0.027) were associated with increased risk. Lower positive mother–adolescent relationship score was also independently associated with higher risk (OR = 0.93, 95% CI: 0.88–0.99, p = 0.013). Compared with adolescents reporting shared family meals only on weekends, those in the non-daily ≥ 3-times-per-week category had substantially lower odds of high-risk disordered eating (OR = 0.05, 95% CI: 0.01–0.20, p < 0.001). Conclusions In this multicenter clinical sample, more frequent shared family meals were independently associated with lower odds of disordered eating risk. Family mealtime practices therefore represent a modifiable factor that merits further study in adolescent nutrition and preventive health.