Gender differences in binge eating and behavioral correlates among college students

Exploring relationships among appetitive traits, negative affect, and binge eating in adults with overweight or obesity

Binge eating (BE) is a significant public health concern due to its prevalence and impact on mental and physical health. While research has suggested both negative affect and appetitive traits are associated with BE, few studies have investigated these constructs concurrently. Structural equation modeling (SEM) evaluated relationships between negative affect, reward-related appetitive traits, and BE among 293 adults with overweight or obesity (OW/OB) seeking treatment for BE, overeating, and weight management (m age = 46.6; m body mass index[BMI] = 34.5; 81.2 % female; 20.1 % Latinx, 60.8 % White non-Latinx). BE was related to negative affect (β = 0.53; p < 0.01) and appetitive traits (β = 1.53; p < 0.001). Negative affect and appetitive traits were related to one another (r = 0.42; p < 0.001), and the full model accounted for 77 % of the variance in BE. In an exploratory follow-up analysis, multigroup SEM evaluated the above relationships in models stratified by sex. Exploratory findings demonstrated both negative affect and appetitive traits were related to BE across sex, particularly when examining BE cognitions and behaviors. However, relationships in men depended upon BE assessment tool. These findings highlight that both negative affect and appetitive traits are related to BE, and jointly may represent significant risk and maintenance factors, particularly in adults with OW/OB. Our findings also highlight the importance of future investigation of sex differences in BE and the potential impact of assessment method.

Sex and ethnic/racial differences in disordered eating behaviors and intuitive eating among college student

Introduction

Eating behaviors encompass disordered eating behaviors (e.g., overeating, binge eating, and associated symptoms of binge eating) and intuitive eating. Certain disordered eating behaviors, including binge eating, are more prevalent among female and ethnic/racial-minority college students than male and/or non-Hispanic White college students. However, sex and ethnic/racial differences among college students with other disordered eating (e.g., associated symptoms of binge eating) and intuitive eating behaviors remain unclear.

Methods

In 2022, 887 college students (Mage = 20.9 ± 2.6 years) self-reported their sex, ethnicity/race, disordered eating behaviors (e.g., overeating, binge eating, associated symptoms of binge eating), and intuitive eating. To examine sex and ethnic/racial differences among these students, we used modified Poisson regressions for students who reported disordered eating and linear regressions for students who reported intuitive eating.

Results

Except for overeating, disordered eating behaviors were more prevalent among female [adjusted prevalence ratio (aPR) = 1.3-1.8] than male college students after adjusting for sociodemographic variables, whereas intuitive eating scores did not differ by sex. Across ethnic/racial groups, disordered eating was more prevalent among all ethnic/racial-minority college students (aPR = 1.2-2.3) than non-Hispanic White college students after adjusting for sociodemographic variables. Moreover, non-Hispanic Black or African American college students had higher intuitive eating scores than non-Hispanic White college students (adjusted β = 0.7, 95% CI = -0.2, 1.6).

Conclusion

In our sample, notable differences emerged in the prevalence of disordered eating behaviors and mean scores by sex and ethnicity/race, while differences in intuitive eating scores emerged based on ethnicity/race.

Reinforcement sensitivity and bulimia symptoms: the role of emotion regulation

OBJECTIVE

Reinforcement Sensitivity Theory (RST) provides a theoretical foundation associated with various approach and avoidance behaviors and individual personality differences. Sensitivity to reward and punishment, two neural systems within the RST have been significantly associated with bingeing and purging behaviors. However, inconsistent findings are observed and specific factors mediating these relationships are not well understood. Deficits in emotion regulation may account for these relationships, as both negative urgency and distress tolerance have been independently associated with bulimia behaviors. Thus, this is an area that requires further investigation.

METHOD

The current study utilized various self-report inventories, including the Eating Disorder Inventory-3rd Edition to measure bulimia symptoms, as well as measures of negative affect, sensitivity to reward and punishment, distress tolerance, and negative urgency. These measures were used to assess whether distress tolerance and negative urgency mediated associations between sensitivity to reward and punishment and bulimia symptoms in a community sample of 394 young adults ranging from the ages of 18 to 25.

RESULTS

As expected, sensitivity to reward and punishment were significantly associated with decreased distress tolerance. Distress tolerance was also directly associated with greater negative urgency, which was significantly associated with increased bulimia symptoms. Consistent with hypotheses, indirect associations between sensitivity to reward and sensitivity to punishment to bulimia symptoms via distress tolerance and negative urgency were observed, controlling for gender and negative affect.

DISCUSSION

Results contribute to understanding specific contributions of risk factors within the relationship of sensitivity to reward and punishment and bulimia symptoms, measured by the EDI-3. Novel to existing literature, results indicate that reinforcement sensitivity significantly contributes to emotion regulation deficits. Thus, these findings may have important implications for understanding the development and treatment of bulimia symptoms.

LEVEL OF EVIDENCE

Level V, based on descriptive, cross-sectional data.

The interaction between affective lability and eating expectancies predicts binge eating

Both affective lability and eating expectancies have been found to predict binge eating. There is the additional possibility that the joint effect of affective lability and eating expectancies incurs further risk: perhaps expectancies for affective relief from eating operate more strongly in those experiencing frequent, rapid shifts in emotion. In the current study, we tested whether such a joint effect predicts binge eating prospectively in college students. We assessed affective lability, eating expectancies, and binge eating in 358 college students at two time points during the first year of college (e.g., December and April). The interaction of affective lability and eating expectancies in December predicted binge eating 4 months later in April. The influence of eating expectancies on binge eating was stronger at higher levels of affective lability. Findings offer support to the hypothesis that risk factors may transact to further elevate risk for eating disorder behaviors.Clinical implicationsThe interaction of affective lability and eating expectancies predicts binge eatingRisk factors may interact to further increase binge eatingIdentification of co-occurring risk factors may have vital treatment implications.

Binge Eating and Binge Drinking: A Two-Way Road? An Integrative Review

Unhealthy diet and alcohol are serious health problems, especially in adolescents and young adults. "Binge" is defined as the excessive and uncontrolled consumption of food (binge eating) and alcohol (binge drinking). Both behaviors are frequent among young people and have a highly negative impact on health and quality of life. Several studies have explored the causes and risk factors of both behaviors, and the evidence concludes that there is a relationship between the two behaviors. In addition, some research postulates that binge eating is a precipitating factor in the onset and escalation of excessive alcohol consumption, while other studies suggest that alcohol consumption leads to excessive and uncontrollable food consumption. Given that no review has yet been published regarding the directionality between the two behaviors, we have set out to provide an upto- date overview of binge eating and binge drinking problems, analyzing their commonalities and differences, and their uni- and bidirectional associations. In addition, we explore the reasons why young people tend to engage in both behaviors and consider directions for future research and clinical implications.

Associations between weight loss difficulty, disordered eating behaviors and poor weight loss outcomes in Arab female university students

Little is known about the impact of eating behaviors on weight management efforts among college students in non-Western settings. This study aimed to explore the relationship between eating behaviors, weight loss outcomes, and perceived weight loss difficulties (PWLD) among young Arab women trying to lose weight. A cross-sectional probability sample was used to recruit female university students aged 18 years and older in the state of Qatar. Participants (N = 937) completed an online survey measuring their attitudes and behaviors towards healthy eating, body image, and weight loss. More than two third (67.2%) reported facing difficulties when trying to lose weight and around one-third (31.2%) screened positive for disordered eating. Chi-squared and logistic regression analyses showed a strong and independent association between unsuccessful weight loss including lack of weight loss or maintenance after weight loss attempts, and PWLD (OR 8.6, p = .002). In addition, eating meals a few hours before sleeping (OR 1.98; p = .02) and having disordered eating (OR 2.28; p = .02) were positively associated with PWLD. BMI, weight loss goal and skipping breakfast were not associated with PWLD after adjustment for all covariates. Future studies are needed to develop better tools to comprehensively assess PWLD and validate against short- and long-term measured weight loss outcomes.

Disordered Eating Behaviors and Sexual Harassment in Italian Male and Female University Students

The aim of this study is to describe sexual harassment among Italian university students and analyze the relationship between harassment and disordered eating behaviors. An observational survey was conducted among university students at Trieste University (Italy) in spring 2014. Students answered an anonymous self-administered questionnaire about sexual harassment, including three domains-sexual harassment, unwanted comments on physical appearance, cyber-harassment-and disordered eating behaviors. The global sexual harassment index was computed with three levels: Level 0, no harassment; Level 1, harassment in at least one of the three domains; and Level 2, harassment in two or three domains. Disordered eating behaviors were classified by at least one of the following: (a) eating without being able to stop or vomiting at least once or twice a month, (b) using laxatives or diuretics at least once or twice a week, (c) monitoring weight every day, and (d) dieting at least very often. The sample included 759 students (347 men and 412 women; 18-29 years old). Experiencing sexual harassment was related to eating disorder symptoms for both genders with a regular gradient: the higher the harassment score, the more frequent the disordered eating behavior symptoms, even after adjusting for age and previous sexual violence. The association was stronger for males than females. Sexual harassment and disordered eating behaviors have long been considered mainly a female problem. Men are not exempt from these problems and in some cases may be more affected than women. The topics should be assessed in men and women.

Binge Eating and Loss of Control in College-Age Women

BACKGROUND

Loss of control (LOC) over eating is a cardinal feature of the DSM-5 definition of binge eating (BE). While this behavior is frequently reported in college-age women, there is limited research on descriptions of loss of control from first-person accounts from individuals reporting LOC associated with BE.

OBJECTIVE

The objective of this study was to investigate descriptions of LOC associated with BE episodes in college-age women who reported recent BE behavior.

STUDY DESIGN

A secondary analysis of previously collected qualitative data on BE behaviors in college students was conducted. Two hundred and twenty-one college-age women's (age = 19.77 ± 1.03) comments regarding the experiences of LOC associated with BE episodes were analyzed using conventional content analysis. Codes were inductively generated allowing categories to emerge from the data codes.

RESULTS

Three major overarching descriptive categories were identified: (1) LOC over eating, (2) feelings associated with the LOC, and (3) cognitive dispositions (thoughts) associated with LOC during a BE episode.

DISCUSSION

The findings of this study expand the current literature on LOC over eating and provide a number of potential targets for intervention with college-age women who report BE behaviors.

The moderating role of resilience on the relationship between perceived stress and binge eating symptoms among young adult women

OBJECTIVE

Adolescence and young adulthood are developmental periods during the life course that are sometimes associated with heightened stress and engagement in binge eating. Binge eating has been linked to psychiatric comorbidity, poorer physical health, and lower quality of life. However, less is known about protective factors that could buffer against binge eating behaviors. The current study examined the moderating role of resilience on the relationship between perceived stress and binge eating symptoms among emerging adult female college students.

METHOD

Participants were 297 young adult women aged 18-25 years (M_age = 19.22, SD = 1.51; 52% self-identifying as a racial/ethnic minority) with Body Mass Index ranging from 15 to 66 (M_BMI = 25.01, SD = 6.18). Women completed this cross-sectional study while they were attending universities in the Western or Southern United States. Participants provided demographic and height/weight information, and completed the following measures: Perceived Stress Scale, Binge Eating Scale, and Brief Resilience Scale.

RESULTS

Higher perceived stress was significantly associated with more severe binge eating symptoms (b = 0.31; p < .01). In addition, higher resilience was associated with lower binge eating pathology (b = -0.20; p < .01). Moderation was supported as the relationship between perceived stress and binge eating symptoms varied by resilience level (b = -0.16; p < .01).

CONCLUSIONS

Women who perceived higher stress were more likely to engage in binge eating relative to women experiencing low stress; however, resilience attenuated this association. Resilience could be targeted to reduce the negative effects of perceived stress on eating behaviors in young women.

Psychosocial and metabolic function by smoking status in individuals with binge eating disorder and obesity

Individuals with binge eating disorder (BED) report smoking to control appetite and weight. Smoking in BED is associated with increased risk for comorbid psychiatric disorders, but its impact on psychosocial functioning and metabolic function has not been evaluated. Participants were 429 treatment-seeking adults (72.4% women; mean age 46.2±11.0years old) with BED comorbid with obesity. Participants were categorized into current smokers (n=66), former smokers (n=145), and never smokers (n=218). Smoking status was unrelated to most historical eating/weight variables and to current eating disorder psychopathology. Smoking status was associated with psychiatric, psychosocial, and metabolic functioning. Compared with never smokers, current smokers were more likely to meet lifetime diagnostic criteria for alcohol (OR=5.51 [95% CI=2.46-12.33]) and substance use disorders (OR=7.05 [95% CI=3.37-14.72]), poorer current physical quality of life, and increased risk for metabolic syndrome (OR=1.80 [95% CI=0.97-3.35]) and related metabolic risks (reduced HDL, elevated total cholesterol). On the other hand, the odds of meeting criteria for lifetime psychiatric comorbidity or metabolic abnormalities were not significantly greater in former smokers, relative to never smokers. Our findings suggest the importance of promoting smoking cessation in treatment-seeking patients with BED and obesity for its potential long-term implications for psychiatric and metabolic functioning.

Self-regulatory predictors of eating disorder symptoms: Understanding the contributions of action control and willpower beliefs

Action orientation, or the ability to regulate both positive and negative affect to perform goal-directed action, has been associated with eating behavior in previous research. Additionally, differences in beliefs about self-control have been shown to influence behavior, but it is unclear how these beliefs impact disordered eating behavior or how they may interact with other self-regulatory mechanisms to predict eating outcomes. In this study, 1128 participants were recruited online via Amazon Mechanical Turk to answer questions about self-regulation constructs and eating behavior. A three-way moderated regression analysis was used to assess relationships between two subtypes of action orientation (failure-related action orientation, or AOF, which describes an ability to up-regulate positive affect, and decision-related action orientation, or AOD, which describes an ability to down-regulate negative affect), willpower beliefs, and binge eating. Results revealed a significant three-way interaction between AOD, AOF, and willpower beliefs such that the interaction between AOF and willpower beliefs was only significant for those with low AOD. These findings suggest an ability to down-regulate negative affect (high AOF) is a protective factor against increased disordered eating, though this may not be the case for individuals with an inability to up-regulate positive affect (low AOD) and simultaneously ascribe to beliefs that willpower is a limited resource.

Effectiveness of lifestyle interventions to reduce binge eating symptoms in African American and Hispanic women

OBJECTIVE

Lifestyle interventions that promote physical activity and healthy dietary habits may reduce binge eating symptoms and be more feasible and sustainable among ethnic minority women, who are less likely to seek clinical treatment for eating disorders. The purpose of this study was to investigate (1) whether participating in a lifestyle intervention is a feasible way to decrease binge eating symptoms (BES) and (2) whether changes in BES differed by intervention (physical activity vs. dietary habits) and binge eating status at baseline (binger eater vs. non-binge eater) in African American and Hispanic women.

METHOD

Health Is Power (HIP) was a longitudinal randomized controlled trial to promote physical activity and improve dietary habits. Women (N = 180) who completed anthropometric measures and questionnaires assessing fruit and vegetable and dietary fat intake, BES and demographics at baseline and post-intervention six months later were included in the current study.

RESULTS

Over one-fourth (27.8%) of participants were categorized as binge-eaters. Repeated measures ANOVA demonstrated significant two- and three-way interactions. Decreases in BES over time were greater in binge eaters than in non-binge eaters (F(1,164) = 33.253, p < .001), and women classified as binge eaters who participated in the physical activity intervention reported greater decreases in BES than non-binge eaters in the dietary habits intervention (F(1,157) = 5.170, p = .024).

DISCUSSION

Findings suggest behavioral interventions to increase physical activity may lead to reductions in BES among ethnic minority women and ultimately reduce the prevalence of binge eating disorder and health disparities in this population.

Binge eating and weight loss behaviors of overweight and obese college students

PURPOSE

To investigate binge eating (BE) and weight-related behaviors in overweight and obese college students.

DATA SOURCES

This was a secondary analysis of data from 487 overweight and obese college-age students from a private university in the northeastern United States.

CONCLUSIONS

BE was reported by 34.9% of students. Only 6.2% of participants reported the use of compensatory behaviors (i.e., self-induced vomiting, laxative, or diuretic use) to prevent weight gain. BE was associated with smoking and exercising to lose weight. Gender differences emerged from the data as women were more likely to report being obese, the use of compensatory behaviors, and to perceive themselves as moderately or extremely overweight.

IMPLICATIONS FOR PRACTICE

BE is a significant problem on college campuses and is associated with the development of obesity and eating disorders. Nurse practitioners (NPs) are in an excellent position to effect change in this population through their frequent contact with young adults in community and school-based venues. NPs are well-prepared to identify at-risk college students and provide them with individualized care, education, and support.