**5. Discussion**

This study has reflected how different factors, such as the level of self-esteem (Table 1), might play a significant rolein disordered eating behaviours. Among these factors the bodyimage that women perceived over themselves stood out as a significant element. In this sense, according to previous researchers, body image is multidimensional, being made of perceptual, behavioural and cognitive-affective domains created by the individual [46]. This perception is dependent on a variety of elements, including social media and beauty ideals. In the case of social media, the results from this study showed a relationship between the body image, body ideals and the use of social media (Tables 2 and 3). Furthermore, previous publications explained that the desire to achieve the beauty ideal emerges as the internalization of the portrayed image exposed by the media [59,60]. Homan (2010) discussed how, among female college students, two principal beauty ideals coexist: the athletic-ideal and thin-ideal [61]. The internalization of the athletic-ideal predicts compulsive exercise [61–63]. Meanwhile, the thin-ideal internalization predicts food restriction and body dissatisfaction, both leading to disordered eating attitudes and possible origins for eating disorders [64–66]. These results confirm the association obtained between the desire of having a thinner body image and the use of the media since this media is the primary source to promote such ideals (Table 3).

The issue resides on the fact that the thin-ideal produces a worse body image with a tendency toward frustration based on a fatter body image than desired. This concern among young women results in making different choices to obtain the desired image, such as surgery [67,68]. In this sense, the results from this paper also showed a high frequency of women determined to undergo plastic surgery to improve their image, being focused on breast surgery.

Notwithstanding, internalization of the fit-ideal has been studied as a predictor of the use of social media content related to health and fitness [69,70]. In this case, the fit ideal or athletic ideal may become a replacement for the other ideals, leading to healthier behaviour [71].

The results (Table 2) have established that body dissatisfaction might be a potential agen<sup>t</sup> in body image and desire to change this body image. These publications also accord with our earlier observations, which showed that levels of body dissatisfaction were associated with the desire of changing the body image in order to achieve a thinner body, especially using dieting [72]. Based on this, the results appear to match with previous works about how body dissatisfaction and body concerns in young women and teenagers may be related to disordered eating attitudes [27,73].

Another significant outcome was the link between body concerns, body dissatisfaction and levels of self-esteem (Table 2). These data are in accord with recent investigations which connected body dissatisfaction and self-esteem to mental illness and the role of emotional distress in behavioural disorders [48].

Another study found that body dissatisfaction and disordered eating attitudes could be related to a high level of intrauterine testosterone, measured by the 2D:4D ratio. The prenatal masculinization has been established as a potential intermediate phenotype for the development of these disorders in their o ffspring [74]. Following these studies, the results obtained in this paper seem to initially match such conclusions (Table 3) [75]. These results are partially consistent with the existing literature relating to dieting, alimentary products, such as supplements, negative a ffect, body dissatisfaction and the tendency to thinness [71]. Nevertheless, the results obtained regarding the hormonal levels may be related to the environmental conditions during the pregnancy more than the individual level of hormones [76].

The results of the study (Table 4) have shown how social network sites might play an important role in disordered eating attitudes. In the study carried out by Cohen et al. (2018), the influence of the social networks was determined by the content and the selfies that the users upload to them more than by the assiduity of the connections [20]. This is partially contradictory to the present results in which the addiction to SNS and the duration of the connections were linked to weight loss and unhealthy dieting. These results match with previous studies in the sociocultural factors, not included among biological measures [77,78]. Withstanding, it is important to note that the regression model obtained in this study have shown the probable role of factors, such as the degree of body satisfaction, self-esteem, use of SNS and other measures, such as the 2D:4D ratio, related to disordered eating behaviours.

Additionally, SNS addiction, which has been related to other mental disorders [79], has shown correlation with stereotypes, self-esteem, method of change, thinner body image and the desired part of the body to change. In this sense, prior investigations proved the addiction to social media as cause–e ffect of disordered behaviours [80,81].

The present study raises the possibility that disordered eating attitudes in women might be conditioned by the influence of the ideals of beauty imposed by the social environment and to a lesser extent by the exposure to intrauterine levels of testosterone extracted from the 2D:4D ratio of the phalanges. It is possible, therefore, that disordered eating attitudes are multidimensional disorders produced by the media, hormones, and factors related to body concerns. Although this study has focused on Spanish college students, the results (Table 2 and Figure 2) seem to match with previous works conducted in Caucasian women [82,83]. These studies seem to distant themselves from publications focused on Latina or African American young women or adolescents [84,85]. Nevertheless, it is possible, therefore, that because the study was carried out in Spanish college students, the results might not match university women from other countries.

Nevertheless, as with all research, the current findings need to be considered in light of possible limitations of the study. Therefore, biases and possibly incorrect data may have been included, and causal inferences cannot be drawn. Additionally, as with the majority of the body image literature, the current participants were university students, based on the sample and size of the sample caution is recommended in not generalizing these results to other samples or di fferent samples. Nevertheless, these results seem to provide essential data regarding social media, disordered eating and the perception of the young people about themselves. Another limitation present in this study is the lack of inclusion of further cultural factors, such as the mother–child relationship, and anthropometric data, such as BMI.

All being said, the results from this manuscript and the comparison with previous works sugges<sup>t</sup> how the initial hypothesis has been entirely or partially confirmed, showing how disordered eating behaviours are complex eating attitudes.
