An evaluation of affect and binge eating

Clarifying the pathway from anxiety sensitivity to binge eating: The mediating role of depressive symptoms in a 3-week, 3-wave longitudinal study of undergraduates

Anxiety sensitivity (AS) - characterized by a persistent fear that arousal-related bodily sensations will lead to serious cognitive, physical, and/or social consequences - is associated with various psychopathologies, including depressive symptoms and binge eating. This 3-week, 3-wave longitudinal study examined the relation between AS (including its global AS factor and lower-order AS cognitive, physical, and social concern dimensions), depressive symptoms, and binge eating among 410 undergraduates from two universities. Using generalized estimating equation models, we found that global AS, AS social concerns, and depressive symptoms predicted binge eating during any given week. Mediation analyses showed that global AS (as a latent variable with its lower-order AS dimensions as indicators), AS cognitive concerns, and AS physical concerns at Wave 1 predicted subsequent increases in depressive symptoms at Wave 2, which, in turn, led to increases in binge eating at Wave 3. Findings contribute to a better understanding of the interplay between AS, depressive symptoms, and binge eating, highlighting the role of binge eating as a potential coping mechanism for individuals with high AS, particularly in managing depressive symptoms. This study underscores the importance of AS-targeted intervention and prevention efforts in addressing depressive symptoms and binge eating.

Preferences for coaching strategies in a personalized virtual coach for emotional eaters: an explorative study

Objectives

Emotional eating is recognized as a potential contributor to weight gain. Emotional eaters often hide their problems because of feelings of shame about their behavior, making it challenging to provide them with the necessary support. The introduction of a virtual coach might offer a potential solution in assisting them. To find out whether emotional eaters are receptive to online personalized coaching, we presented emotional eaters with two essential proto-typical problem situations for emotional eaters: "experiencing cravings" and "after giving in to cravings," and asked them whether they preferred one of the three coaching strategies presented: Validating, Focus-on-Change and Dialectical.

Methods

An experimental vignette study (2 × 3 design) was carried out. The vignettes featured two distinct personas, each representing one of the two common problem scenarios experienced by emotional eaters, along with three distinct coaching strategies for each scenario. To identify potential predictors for recognition of problem situations, questionnaires on emotional eating (DEBQ), personality traits (Big-5), well-being (PANAS), and BMI were administrated.

Results

A total of 62% of the respondents identified themselves with "after giving in to cravings" and 47% with "experiencing cravings." BMI, emotional eating and emotional stability appeared to be predictors in recognizing both the problem situations. In "experiencing cravings," the participating women preferred Dialectical and the Validation coaching strategies. In the "after giving in to cravings" condition, they revealed a preference for the Dialectical and the Focus-on-Change coaching strategies.

Conclusion

Using vignettes allowed a less threatening way of bringing up sensitive topics for emotional eaters. The personas representing the problem situations were reasonably well recognized. To further enhance this recognition, it is important for the design and content of the personas to be even more closely related to the typical problem scenarios of emotional eaters, rather than focusing on physical characteristics or social backgrounds. This way, users may be less distracted by these factors. With the knowledge gained about the predictors that may influence recognition of the problem situations, design for coaching can be more customized. The participants represented individuals with high emotional eating levels, enhancing external validity.

Affective profiles of exercise episodes are associated with maladaptive and adaptive motivations for exercise

OBJECTIVE

Maladaptive exercise (i.e., driven and/or compensatory exercise) is common in binge-spectrum eating disorders (EDs; e.g., bulimia nervosa, binge ED) and associated with adverse treatment outcomes. Alternatively, individuals with EDs are often also engaging in adaptive exercise (e.g., for enjoyment or health improvement), and increasing adaptive exercise may decrease ED symptoms. The current study aimed to understand which exercise episodes are likely to be maladaptive/adaptive so that interventions can appropriately decrease/increase maladaptive and adaptive exercise.

METHOD

We used latent profile analysis (LPA) to identify pre-exercise affective profiles of 661 exercise episodes among 84 individuals with binge-spectrum EDs and examined associations between LPA-identified profiles and subsequent exercise motivations using ecological momentary assessment.

RESULTS

A two-profile solution best fit our data: Profile 1 (n = 174), 'positive affectivity,' and Profile 2 (n = 487), 'negative affectivity.' Episodes in the 'negative affectivity' profile were more likely to be endorsed as both driven and intended to influence body shape/weight. Episodes in the 'positive affectivity' profile were more likely to be endorsed as exercising for enjoyment.

CONCLUSIONS

Results support two phenotypes of exercise episodes, and differential associations of these phenotypes with adaptive and maladaptive motivations for exercise.

Ecological momentary assessment of state affect prior to and following loss of control eating in young men

OBJECTIVE

Loss of control (LOC) eating is prevalent but understudied among young men. Affect regulation models propose that LOC eating functions as a maladaptive effort to escape from distressing affective states. As such, negative affect is thought to increase before and decrease after LOC eating. However, examinations with young men are lacking and it remains unclear whether specific emotional experiences are differentially implicated in their LOC eating.

METHODS

The current study examined the temporal roles of affect in LOC eating in 31 young men (18-35 years; Mage = 25.74 ± 5.61y; 46.7 % White; 30 % Black/African American; 10 % Hispanic/Latino, 10 % South Asian) who reported engaging in recurrent LOC eating. Participants completed a 14-day ecological momentary assessment protocol and recorded all eating episodes each day and their state affect five times per day. Generalized linear mixed models were conducted to examine the trajectories of global and item-level negative and positive affect pre- and post-LOC eating episodes.

RESULTS

Negative affect did not change significantly before or after LOC eating (ps > .05). Positive affect did not change significantly before LOC eating (ps > .05). Global positive affect, excitement, and happiness decreased significantly after LOC eating (ps ≤ .001).

DISCUSSION

Study findings contradict extant theory and empirical data largely from female samples. Negative affect did not increase risk for LOC eating, nor did LOC eating function to improve participants' mood; rather, positive mood slightly decreased after LOC eating. Further investigation around the observed decline in positive affect after LOC eating will clarify if this is a relevant intervention point in this population.

Examining the components and stability of negative affect in disordered eating frequency

OBJECTIVE

There is a limited understanding of the unique components of negative affect that are most important to disordered eating. Our study tested the contributions and stabilities of unique components of negative affect in the frequency of both binge eating and restricted eating. We examined if: (1) symptoms of depression, anxiety and stress share unique, concurrent associations with binge eating and restricted eating, respectively, and if (2) instability of depression, anxiety, and stress predict binge eating and restricted eating, respectively.

METHOD

627 first year undergraduate students completed 7 assessments of these constructs across their first academic year. Generalised multilevel modelling was employed.

RESULTS

Higher than average anxiety, but not depression or stress, was concurrently associated with restricted eating. No concurrent associations between negative affect and binge eating were found. Instability of depression, but not anxiety or stress, predicted both binge and restricted eating.

CONCLUSION

Anxiety may be a more salient predictor of restricted eating than depression or stress. However, larger monthly changes in depression may confer risk for more frequent binge eating and restricted eating.

Divergent trajectories of positive affect following maladaptive and non-maladaptive exercise among individuals with binge-spectrum eating disorders

OBJECTIVE

Individuals with eating disorders (EDs) often engage in maladaptive exercise (e.g., feeling driven, or to "compensate" for eating) which maintains eating pathology. Maladaptive exercise has been theorized to help individuals with EDs regulate emotions by enhancing positive affect (PA) and reducing negative affect (NA) associated with binge episodes and poor body image. However, no research has considered the presence of non-maladaptive exercise or evaluated this theory in binge-spectrum EDs.

METHODS

This study evaluated affective trajectories pre- and post-exercise and examined exercise type (maladaptive or non-maladaptive) as a moderator. We recruited adults with binge-spectrum EDs (N = 107; n = 84 endorsed exercise) to complete a 7- to 14-day ecological momentary assessment protocol assessing NA (anxiety, guilt, and sadness), PA (excitement and cheerfulness), and exercise.

RESULTS

There was a significant quadratic trajectory of PA pre-exercise, suggesting that the upward trajectory of PA leveled out as it moved closer to an exercise episode. Exercise type significantly moderated the cubic trajectory of PA post-exercise, such that the upward trajectory of PA accelerated in the hours following non-maladaptive exercise episodes while the downward trajectory of PA accelerated in the hours following maladaptive exercise episodes. No trajectories of NA demonstrated significant effects.

CONCLUSIONS

Pre-exercise trajectories of PA may reflect positive expectancies around exercise. Post-exercise trajectories of PA suggest that non-maladaptive exercise promotes increased PA. Future research should evaluate when, and for whom, exercise serves to regulate affect and examine other momentary risk factors of exercise in EDs.

PUBLIC SIGNIFICANCE

Individuals with EDs often engage in maladaptive exercise (e.g., feeling driven, or to "compensate" for eating). Maladaptive exercise has been theorized to help individuals with EDs regulate emotions. This study evaluated affective trajectories pre- and post-exercise and examined whether exercise type (maladaptive or non-maladaptive) changed these trajectories. Pre-exercise trajectories of PA may reflect positive expectancies around exercise. Post-exercise trajectories of PA suggest that non-maladaptive exercise promotes increased PA.

Greater negative affect reduction expectancies moderate the interactive relationship between emotion regulation difficulties and distress tolerance in predicting loss-of-control eating

OBJECTIVES

Loss-of-control eating (LOCE) is often conceptualized as a negative reinforcement mechanism. However, LOCE does not consistently reduce negative affect (NA). One explanation for continued LOCE, despite a lack of NA reduction, may be expectations of NA reduction. Emotion regulation difficulties and low distress tolerance often predict LOCE, but have not been examined in the context of NA reduction expectancies.

DESIGN

This study examined the main and interactive relationships between emotion regulation difficulties, distress tolerance and NA reduction expectancies on LOCE in US adults (n = 3331).

METHOD

This study consisted of a battery of surveys administered to a national sample of US adults.

RESULTS

Results indicate NA reduction expectancies are robust, eclipsing the predictive effects of other emotion regulation variables. Distress tolerance was only able to attenuate the relationship between emotion regulation difficulties and LOCE when NA reduction expectancies were low.

CONCLUSIONS

These findings identify NA reduction expectancies as having a strong relationship with LOCE, such that the protective factor of distress tolerance is only relevant when such expectancies are low. Clinical implications suggest that targeting NA reduction expectancies in eating interventions that bolster emotion regulation difficulties and distress tolerance may improve the effectiveness of said interventions. Additionally, stand-alone expectancy interventions should be assessed for the purpose of LOCE reduction. Directions for future research are discussed.

Negative emodiversity is associated with emotional eating in adolescents: An examination of emotion dynamics in daily life

INTRODUCTION

Emotional eating is a mental health concern, common in adolescents, that develops as a result of their tendency to use high-energy food to regulate their fluctuating emotions. Due to their highly fluctuating emotional life, adolescents tend to have unique within-person profiles of emotional experiences that change across moments and days, often lost in global assessments of emotions. Hence, it is imperative to examine individual differences in dynamics of emotions, as experienced in daily life, in relation to emotional eating in adolescents.

METHODS

In an Ecological Momentary Assessment study, we examined individual differences in three within-person dynamic characteristics (baseline levels, intraindividual variability, and emodiversity) of emotions in 158 dominantly Hispanic adolescents in the United States, aged 14-17 years old, predicting trait-level emotional eating.

RESULTS

Results indicated that higher negative emodiversity, baselines, and variability in stress were predictive of emotional eating in adolescents. When all considered together, negative emodiversity (i.e., variety of the types of negative emotions experienced in one's daily life) remained the only significant predictor of emotional eating.

CONCLUSIONS

This study affirms the importance of diversity in emotional experiences in relation to emotional eating, particularly in daily contexts of adolescents' lives. Additionally, the study emphasizes the importance of distinguishing between diversity (i.e., variety in types) in positive versus negative emotional experiences with regard to emotional eating. By taking into account the ecological validity of adolescents' daily lives and individual differences in dynamical changes in emotions, we are taking a step forward by shedding light on how the dynamics of negative emotions-in terms of within-person baselines, variability, and diversity-might be related to general levels of emotional eating in adolescents.

A Review of Binge-Eating Disorder in Black Women: Treatment Recommendations and Implications for Healthcare Providers

PURPOSE OF REVIEW

We review relevant factors and barriers to care for binge-eating disorder (BED) in Black women. We examine evidence for the treatment of BED and provide recommendations to improve cultural relevance for assessing and treating BED in Black women.

RECENT FINDINGS

BED is the most common eating disorder among Black women. Moreover, evidence supports alternative factors that contribute to the onset of BED in Black women, including stress, trauma, and food insecurity. Furthermore, though there are evidence-based treatments for BED, disparities persist in access to care and treatment retention. Recommendations for increasing the cultural relevance of assessments and treatments are provided. Gaps in the literature remain on the use of evidence-based treatments for BED among Black women. As such, healthcare providers should include Black women as co-collaborators in their care and seek out training and consultation to aid in providing culturally affirming treatment.

The efficacy of a transdiagnostic emotion regulation skills training in the treatment of binge-eating disorder-Results from a randomized controlled trial

OBJECTIVES

Deficits in emotion regulation (ER) have been shown to be associated with binge-eating disorder (BED). To further clarify the causal nature of this association, we tested whether systematically enhancing ER skills would reduce symptoms of BED.

METHODS

We randomly allocated N = 101 individuals meeting the criteria for BED to a transdiagnostic ER skills training or to a waitlist control condition (WLC). Primary outcome was the reduction in binges during the treatment-vs.-waiting period as assessed with the Eating Disorder Examination (EDE) interview.

RESULTS

Mixed-model ANOVAs indicated that the average pre-to-post decrease in binges assessed with the EDE was significantly greater in the ER skills training condition than in the WLC (d = 0.66). These effects were stable over the 6-month follow-up period (d = 0.72). Remission rates at post/follow-up were 34.4/45.0% in the skills training and 7.5/20.0% in the WLC. Additionally, we found a greater reduction in general eating disorder psychopathology, of food consumption in a bogus taste test and of depression in the ER skills training condition. Moreover, the greater reduction in binge-eating episodes in the training condition was (partially) mediated by a greater increase in ER skills.

CONCLUSIONS

The findings provide further support for the assumed importance of deficits in ER as a maintaining factor and, hence, as a target in the treatment of BED. As ER skills trainings have been shown to also reduce other kinds of psychopathology, they might be considered a promising transdiagnostic add-on component to disorder-specific interventions.

How Does Adolescents' Usage of Social Media Affect Their Dietary Satisfaction?

In order to improve the health status of adolescents, studies are needed to illuminate the essence of their general and dietary lifestyle. Thus, we conducted this study to verify meaningful relationships between adolescent usage of social media (USM), which plays an important role in their life, their food consumption behavior (FCB), and their dietary satisfaction. This study used two analysis methods: t-tests and structural equation modeling (SEM). This study verified whether there was a significant difference in adolescent FCB depending on their USM using t-tests. This study proposes that the following FCBs showed significant differences between users and non-users of social media in adolescents: a tendency to try new types of food (t = 2.134, p < 0.05), a tendency to avoid foods with harmful risks such as suspected spoilage (t = 3.513, p < 0.001), a tendency to eat bread or fruit for a simple breakfast (t = −3.893, p < 0.001), and a tendency to often use home meal replacements (HMR), eat out or have food delivered (t = −3.245, p < 0.01). Furthermore, this study used SEM to verify the causal relationship between adolescent USM and their dietary satisfaction. According to the results of SEM, adolescents’ USM mediated by the FCB of preferring convenience fully mediates the negative relationship between adolescent USM and their dietary satisfaction (p < 0.01). It is necessary to reverse the situation in which adolescent dietary satisfaction decreases as their FCB of preferring convenience increases. Government regulations for food companies and autonomous efforts for quality improvements on their part are needed.

Anxiety Sensitivity and Fast-Food Ordering Habits Among Black Adults

Background

Black adults experience high rates of overweight/obesity, which is linked to chronic diseases and is exacerbated by fast-food consumption. Anxiety sensitivity, a relative stable fear of anxiety-related sensations, has been linked to high caloric intake. Here, we examine whether anxiety sensitivity is associated with fast-food ordering habits within a convenience sample of Black adults.

Methods

Of 124 adults (79.4% women; M_age=49.3±11.6; 84.8% overweight/obese), 107 (86.3%) reported eating from a fast-food restaurant in the last month. Participants completed the Anxiety Sensitivity-Index 3, which has a total score and physical, cognitive, and social concerns subscales. Investigator-generated items queried frequency of ordering "supersized" quantities of fast-food (e.g., cheeseburgers, fries), and healthy items (e.g., salads, oatmeal, yogurt), respectively, from "never" to "always." Covariate-adjusted ordinal logistic regression models were used to assess relations between measures of interest.

Results

Anxiety sensitivity (total and physical concerns) was associated with greater odds of more frequently ordering supersized unhealthy fast-food; and anxiety sensitivity (total and cognitive concerns) was associated with lower odds of more frequently ordering healthy items from fast-food restaurants.

Conclusions

Results suggest that adults with greater anxiety sensitivity may engage in fast-food ordering habits that can contribute to the overweight/obesity epidemic. Future studies should replicate results and determine the potential for anxiety sensitivity-reduction interventions to affect dietary choices that contribute to overweight/obesity.

Feasibility, Acceptability, and Preliminary Target Engagement of a Healthy Physical Activity Promotion Intervention for Bulimia Nervosa: Development and Evaluation via Case Series Design

Bulimia nervosa (BN) is characterized by a pattern of binge eating and compensatory behaviors as well as an overemphasis on body weight and shape in self-evaluation. Although cognitive behavioral therapy (CBT) is efficacious, recent reviews suggest that only 30% of patients reach abstinence at posttreatment. One potential reason for these poor outcomes is that CBT fails to adequately reduce elevated negative affect (NA) and shape and weight concern, which have been shown to be correlated with poorer treatment outcomes in BN. Therefore, novel treatment components that focus on improving NA and shape and weight concern are needed in order to enhance outcomes. Promoting physical activity (PA) is a promising avenue through which to reduce NA and improve body image in healthy individuals, other clinical populations (e.g., individuals with depression or anxiety), and individuals with eating disorders. While prescribing PA for individuals with BN has been controversial (due to concerns that exercise maybe be used to compensate for binge episodes or become driven or compulsive), this approach may have many benefits, including promoting healthy lifetime exercise habits that reduce likelihood of relapse through the improvement of emotion regulation skills and weight regulation. Given the promise of PA for targeting key maintenance factors of BN, we developed a 12-session healthy PA promotion intervention for BN and tested initial feasibility, acceptability, and preliminary target engagement in an iterative case series design (n = 3). The treatment provided cognitive-behavioral skills designed to identify, practice, and achieve behavioral goals while asking patients to engage in up to 150 minutes of moderate-to-vigorous PA per week, which was preplanned during each session with the client's therapist. Results suggested that the healthy PA promotion intervention was both feasible and acceptable to deliver. In addition, the intervention resulted in a clinically significant decrease in BN symptom frequency in each participant. Further, participants showed clinically significant decreases in NA and shape and weight concern. The current study demonstrates that healthy PA interventions can have beneficial effects on BN symptoms, NA, and shape and weight concern. However, due to the small sample size, conclusions must be treated with caution. Future research should investigate additional approaches for promoting healthy PA and include a larger sample in order to further test initial efficacy of this treatment approach.

The Neurobiology of Binge-eating Disorder Compared with Obesity: Implications for Differential Therapeutics

PURPOSE

Emerging work indicates divergence in the neurobiologies of binge-eating disorder (BED) and obesity despite their frequent co-occurrence. This review highlights specific distinguishing aspects of BED, including elevated impulsivity and compulsivity possibly involving the mesocorticolimbic dopamine system, and discusses implications for differential therapeutics for BED.

METHODS

This narrative review describes epidemiologic, clinical, genetic, and preclinical differences between BED and obesity. Subsequently, this review discusses human neuroimaging work reporting differences in executive functioning, reward processing, and emotion reactivity in BED compared with obesity. Finally, on the basis of the neurobiology of BED, this review identifies existing and new therapeutic agents that may be most promising given their specific targets based on putative mechanisms of action relevant specifically to BED.

FINDINGS

BED is characterized by elevated impulsivity and compulsivity compared with obesity, which is reflected in divergent neurobiological characteristics and effective pharmacotherapies. Therapeutic agents that influence both reward and executive function systems may be especially effective for BED.

IMPLICATIONS

Greater attention to impulsivity/compulsivity-related, reward-related, and emotion reactivity-related processes may enhance conceptualization and treatment approaches for patients with BED. Consideration of these distinguishing characteristics and processes could have implications for more targeted pharmacologic treatment research and interventions.

Affect Dysregulation in Context: Implications and Future Directions of Experience Sampling Research on Affect Regulation Models of Loss of Control Eating

Loss of control eating is a core, transdiagnostic eating disorder symptom associated with psychological distress, functional impairment, and reduced quality of life. However, the factors that contribute to persistent loss of control eating despite negative consequences are not fully understood. Understanding the mechanisms that maintain loss of control eating is crucial to advance treatments that interrupt these processes. Affect regulation models of loss of control eating hypothesize that negative emotions trigger loss of control eating, and that loss of control eating is negatively reinforced because it temporarily decreases negative affect. Several variations on this basic affect regulation model have been proposed, including theories suggesting that negative affect decreases during loss of control eating rather than afterwards (escape theory), and that loss of control eating replaces one negative emotion with another that is less aversive (trade-off theory). Experience sampling designs that measure negative affect and eating behavior multiple times per day are optimally suited to examining the nuanced predictions of these affect regulation models in people's everyday lives. This paper critically reviews experience sampling studies examining associations between negative affect and loss of control eating, and discusses the implications for different affect regulation models of loss of control eating. The review concludes by proposing an expanded affect-focused model of loss of control eating that incorporates trait-level individual differences and momentary biological and environmental variables to guide future research. Clinical implications and recommendations are discussed.

Is comfort food actually comforting for emotional eaters? A (moderated) mediation analysis

An important but unreplicated earlier finding on comfort eating was that the association between food intake and immediate mood improvement appeared to be mediated by the palatability of the food, and that this effect was more pronounced for high than for low emotional eaters [26]. This has not yet been formally tested using mediation and moderated mediation analysis. We conducted these analyses using data from two experiments on non-obese female students (n = 29 and n = 74). Mood and eating satisfaction in Study 1, and mood, tastiness and emotional eating in Study 2 were all self-reported. In Study 1, using a sad mood induction procedure, emotional eaters ate more food, and when mood was assessed immediately after food intake, 'eating satisfaction' acted as mediator between food intake and mood improvement (decrease in sadness or increase in happiness). In Study 2, where we measured the difference in actual food intake after a control or a stress task (modified Trier Social Stress Test), and assessed mood during the food intake after stress, we found significant moderated mediation. As expected, there was a significant positive mediation effect of tastiness between food intake and mood improvement in the high emotional eaters, but also a significant negative mediation effect of tastiness between food intake and mood improvement in the low emotional eaters. This suggests that tastiness promotes 'comfort' from food in female emotional eaters, but conflicts in non-emotional eaters with a tendency to eat less when stressed. In conclusion, palatable food may indeed provide comfort specifically for high emotional eaters during eating.

Prospective associations of negative mood and emotion regulation in the occurrence of binge eating in binge eating disorder

Retrospective and experimental data demonstrate the importance of emotion regulation (ER) in the maintenance of binge episodes in binge eating disorder (BED). The current study tested whether mood and ER prospectively influence binge episodes in individuals with BED via ecological momentary assessment (EMA). Individuals with BED (n = 79) completed two weeks of EMA. Each sampling point consisted of a series of questions pertaining to participants' mood, ER, and eating behaviour. Successful application of adaptive ER strategies predicted subsequent abstinence, while rumination predicted subsequent binge episodes. However, neither successful application of adaptive ER, nor maladaptive ER, moderated the association between negative mood and probability of binge episodes. This naturalistic study emphasizes the importance of promoting the successful application of adaptive ER skills and cessation of rumination in treatment interventions designed to decrease the occurrence of binge episodes in BED.

Family mealtime negativity and adolescent binge-eating: A replication and extension study in a community sample

OBJECTIVE

To explore differences in family mealtime characteristics and family mealtime emotions among adolescents who report engaging in binge-eating in comparison to those who do not.

METHOD

Adolescents (N = 495) recruited from UK schools/colleges reported on their family mealtime frequency and atmosphere, family mealtime emotions, anxiety, depression and eating psychopathology.

RESULTS

No significant differences were found between adolescents who reported binge-eating (n = 32 boys; n = 82 girls) and those who did not (n = 196 boys; n = 185 girls) on family mealtime frequency or mealtime atmosphere scores. However, boys and girls who binge-eat reported significantly lower levels of positive family mealtime emotions and significantly higher levels of family mealtime anxiety and anger (girls only), compared with their peers who did not report binge-eating.

DISCUSSION

Adolescents who binge-eat experience significantly greater negative emotional responses to family mealtimes than their peers. Further research should explore why these experiences are more negative, including broader familial factors and interactions.

Psychological Meanings of Eating Disorders and Their Association With Symptoms, Motivation Toward Treatment, and Clinical Evolution Among Outpatients

Unlike patients suffering from egodystonic disorders, people with eating disorders sometimes attribute positive meanings to their symptoms, and this attribution process contributes to the maintenance of the disorder. This study aims at exploring psychological meanings of eating disorders and their associations with symptoms, motivation toward treatment, and clinical evolution. Eighty-one adults with an eating disorder (anorexia nervosa, n = 46 and bulimia nervosa, n = 35) treated in a day-hospital program were asked, each week over an 8-week period, to identify the psychological meanings they ascribed to their eating disorder. Avoidance was the most frequently identified meaning, followed by mental strength, security, death, confidence, identity, care, and communication. Avoidance was more frequently mentioned by participants with bulimia than in cases of anorexia. Security and mental strength were associated with less motivation toward treatment. Death was associated with more depressive and anxious symptoms. An exploratory factor analysis showed that these meanings formed three main dimensions: Avoidance, Intrapsychic, and Relational. Findings suggest that psychological meanings associated with eating disorders can be assessed and used as a clinical tool to increase treatment acceptability and effectiveness.

Emotion Regulation in Binge Eating Disorder: A Review

The purpose of the present review is to provide a summary of the research findings on emotion regulation in Binge Eating Disorder (BED). Negative emotions and maladaptive emotion regulation strategies play a role in the onset and maintenance of binge eating in BED. Anger and sadness, along with negative emotions related to interpersonal experiences (i.e., disappointment, being hurt or loneliness), seem to be particularly relevant. Individuals with BED have a tendency to suppress and ruminate on their unwanted emotions, which leads to increased psychopathological thoughts and symptoms. Compared to healthy controls, they use adaptive strategies, such as reappraisal, less frequently. Evidence concerning the causal relation between negative affect and binge eating is inconclusive and still very limited. While experimental studies in a laboratory setting lack ecological validity, ecological momentary assessment studies offer more promise at unraveling the causal relationship between emotions and binge eating. Increases in negative affect are found to be antecedents of binge eating in BED. However, there seems to be less support for the possibility that binge eating serves as a means to alleviate negative affect. Finally, BED seems to be related to other forms of maladaptive emotion regulation strategies, such as substance abuse and self-harm.

The importance of thinking styles in predicting binge eating

Impulsivity, Body Mass Index, negative emotions and irrational food beliefs are often reported as predictors of binge eating. In the current study we explored the role played by two thinking styles, namely food thought suppression and desire thinking, in predicting binge eating among young adults controlling for established predictors of this condition. A total of 338 university students (268 females) participated in this study by completing a battery of questionnaires measuring the study variables. Path analysis revealed that impulsivity was not associated with binge eating, that Body Mass Index and negative emotions predicted binge eating, and that irrational food beliefs only influenced binge eating via food thought suppression and desire thinking. In conclusion, thinking styles appear an important predictor of binge eating and they should be taken into consideration when developing clinical interventions for binge eating.

A Pilot Study of an Acceptance-based Behavioral Treatment for Binge Eating Disorder

While existing treatments produce remission in a relatively large percentage of individuals with binge eating disorder (BED), room for improvement remains. Interventions designed to increase emotion regulation skills and clarify one's chosen values may be well-suited to address factors known to maintain BED. The current study examined the preliminary efficacy of a group-based treatment, Acceptance-based Behavioral Therapy (ABBT), in a small open trial (n=19), as well as the relationship between changes in hypothesized mechanisms of action and outcomes. ABBT includes the behavioral components of cognitive behavioral treatment for BED and emotion-focused strategies from acceptance and commitment therapy and dialectical behavioral therapy. Results from generalized linear multilevel modeling revealed significant fixed linear effects of time on depression, quality of life, global eating pathology, and binge frequency (all ps < .05). Global eating disorder symptoms appeared to improve rapidly from pre- to mid-treatment, and continued to improve toward post-treatment and follow-up, but at a slower rate. Binge frequency decreased rapidly from pre- to mid-treatment, followed by a slight increase at post-treatment and a reduction again by follow-up. Improvements in experiential acceptance were strongly and consistently related to decreases in overall eating pathology across several measures (rs = .35-.54). Additionally, greater access to emotion regulation strategies was strongly related to decreases in overall eating pathology (r= .67). Preliminary results support the efficacy of this novel treatment approach and indicate that additional research on ABBT for BED is warranted.

Behavioral evidence of emotion dysregulation in binge eaters

Binge eating is the most common disordered eating symptom and can lead to the development of obesity. Previous self-report research has supported the hypothesis that individuals who binge eat report greater levels of general emotion dysregulation, which may facilitate binge-eating behavior. However, to date, no study has experimentally tested the relation between binge eating history and in-vivo emotion dysregulation. To do this, a sample of female college students who either endorsed binge eating (n = 40) or denied the presence of any eating pathology (n = 47) completed the Difficulties with Emotion Regulation Scale (DERS) and a behavioral distress tolerance task (the Paced Auditory Serial Addition Task-Computer: PASAT-C) known to induce negative affect and distress. The binge eating group was 2.96 times more likely to quit the PASAT-C early (χ² = 5.04, p = 0.025) and reported greater irritability (F(1,84) = 7.09 p = 0.009) and frustration (F(1,84) = 5.00, p = 0.028) after completing the PASAT-C than controls, controlling for initial levels of these emotions. Furthermore, across the entire sample, quitting early was associated with greater emotion dysregulation on the DERS (r_pb = 0.342, p < 0.01). This study is the first to demonstrate that individuals who binge eat show in-vivo emotional dysregulation on a laboratory task. Future studies should examine the PASAT-C to determine its potential clinical utility for individuals with or at risk of developing binge eating.

Does cognitive avoidance mediate the relation of anxiety and binge eating?

PURPOSE

Theory suggests that binge eating symptoms may develop in an attempt to avoid distressing states that arise in the context of negative affect. In light of its theoretical significance, including the "escape from awareness" model of binge eating, surprisingly few empirical evaluations have examined the empirical evidence for this variable in relation to anxiety and binge eating symptoms. In addition, although it is understood that anxiety is more prevalent among women than men, empirical investigations of gender differences in cognitive avoidance in binge eating are thus far absent from the published literature.

METHODS

Participants (N = 436) were recruited from diverse geographic regions across the United States to take part in an online study. Cognitive avoidance, anxiety, and binge eating measures were collected.

RESULTS

Cognitive avoidance partially mediated the relation between anxiety and binge eating in the full sample; however, results differed across genders. Specifically, cognitive avoidance was a mediator for women, but not for men.

CONCLUSIONS

Findings support the "escape from awareness" model of binge eating among women, and suggest that targeting cognitive avoidance in binge eating treatment may be a promising clinical avenue. Future research may benefit from exploring the broader construct of experiential avoidance to determine if the gender differences in cognitive avoidance observed in this study are indicative of a larger pattern of avoidance behavior, and if factors other than cognitive avoidance may have greater relevance for men.

Emotion regulation difficulties in binge eating disorder with and without the overvaluation of weight and shape

The objective of this study was to examine the relationship between overvaluation of weight/shape ('overvaluation') and emotion regulation (ER) difficulties among women with binge eating disorder (BED) symptoms. Four groups of women were recruited from a community-based sample and compared on ER difficulties: individuals with probable BED with (n=102) and without (n=72) overvaluation, and non-binge eating obese (n=40) and healthy-weight (n=40) control participants. Data for patients with a formal diagnosis of BED receiving treatment from a previous study were included for numerical comparative purposes. Women with probable BED and overvaluation reported significantly greater ER difficulties than all other groups and had similar levels of ER difficulties to BED patients. Women with probable BED in the absence of overvaluation were comparable to the obese control group on total ER difficulties and the majority of the ER difficulties subscales. The findings provide further evidence for the clinical significance of overvaluation among individuals with BED symptomatology. BED in the absence of overvaluation does not appear to align with current models of the disorder in which ER difficulties are viewed as a core etiological mechanism. Further research is needed to elucidate the status of this presentation.

Social appearance anxiety and dietary restraint as mediators between perfectionism and binge eating: A six month three wave longitudinal study

Binge eating is related to perfectionism and restrained eating. However, the mechanisms underlying these relationships are not well understood. It is possible that social anxiety, specifically social appearance anxiety (i.e., the fear of overall appearance evaluation), influences the relationship between binge eating, perfectionism, and dietary restraint. In the current study (N = 300 women), we tested the relationship between dietary restraint, social appearance anxiety, concern over mistakes (a component of perfectionism), and binge eating in prospective data (three time points: at baseline, at two month, and at six month follow up). We found that social appearance anxiety, dietary restraint, and concern over mistakes each predicted binge eating at baseline. Only social appearance anxiety prospectively predicted binge eating when accounting for all variables. Further, in the tested model, social appearance anxiety mediated the relationship between concern over mistakes and binge eating across six months. On the contrary, dietary restraint did not mediate the relationship between concern over mistakes and binge eating in the tested model. The finding that social appearance anxiety served as a mediator between concern over mistakes and binge eating, but that dietary restraint did not, implies that social appearance anxiety may be a more salient prospective predictor of binge eating than dietary restraint. Intervening on social appearance anxiety may be important in the treatment and prevention of binge eating.

Binge-type eating disrupts dopaminergic and GABAergic signaling in the prefrontal cortex and ventral tegmental area

OBJECTIVE

Binge eating is characterized by repeated intermittent bouts of compulsive overconsumption of food. Treatment is challenging given limited understanding of the mechanisms underlying this type of disordered eating. The hypothesis that dysregulation of mesocortical dopaminergic and GABAergic systems underlie binge eating was tested.

METHODS

Analysis of gene expression within the ventral tegmental area and its terminal mesocortical regions was examined in bingeing rats before and after bingeing occurred. In addition, alterations in binge-type behavior induced by pharmacological inactivation of subnuclei of the prefrontal cortex (PFC) and by pharmacological activation and inhibition of cortical D1 and D2 receptors were examined.

RESULTS

Correlative and functional evidence demonstrates dysregulated neurotransmitter processing by the PFC and ventral tegmental area, but not the amygdala or nucleus accumbens, in bingeing rats. Either GABAergic inactivation or D2-like receptor activation within the PFC increased consumption in bingeing rats, but not controls, suggesting that the PFC, and D2 receptors in particular, functions as a behavioral brake to limit bingeing.

CONCLUSIONS

The act of bingeing resolved some gene expression differences that preceded binge onset, further suggesting that bingeing may partially serve to self-medicate a system driving this maladaptive behavior. However, the failure of bingeing to resolve other dopaminergic/GABAergic differences may render individuals vulnerable to future binge episodes.

Differential Effects of Estrogen and Progesterone on Genetic and Environmental Risk for Emotional Eating in Women

Recent data show shifts in genetic and environmental influences on emotional eating across the menstrual cycle, with significant shared environmental influences during pre-ovulation, and primarily genetic effects during post-ovulation. Factors driving differential effects are unknown, although increased estradiol during pre-ovulation and increased progesterone during post-ovulation are thought to play a role. We indirectly investigated this possibility by examining whether overall levels of estradiol and progesterone differentially impact genetic and environmental risk for emotional eating in adult female twins (N = 571) drawn from the MSU Twin Registry. Emotional eating, estradiol levels, and progesterone levels were assessed daily and then averaged to create aggregate measures for analysis. As predicted, shared environmental influences were significantly greater in twins with high estradiol levels, whereas additive genetic effects increased substantially across low versus high progesterone groups. Results highlight significant and differential effects of ovarian hormones on etiologic risk for emotional eating in adulthood.

Implications of an Emerging Integration of Universal and Culturally Specific Psychologies

Psychological researchers increasingly recognize that human behavior reflects a complex interplay of universal human capacities, cultural responses to unique histories and circumstances, and individual differences. Many psychological processes appear to reflect culturally specific instantiations of universal capacities. Current integrative research focuses on further clarifying definitions of universality and on refining methods for identifying universal and cultural components of psychological processes. In this article, we consider implications of this emerging integration. To illustrate possible implications for psychology, we apply it to the study of psychopathology. We report on formal models that explain why some cultures embrace dysfunction among members. We then use the integrative framework to describe methods for determining whether putative disorders bring universal or contextual life dysfunction and to clarify etiological models of three disorders. Models of psychopathology can be more informed and precise if they include careful consideration of both universal and cultural influences on behavior.

Metacognitions about desire thinking predict the severity of binge eating in a sample of Italian women

In this study, our principal aim was to investigate whether metacognitions about desire thinking predict the severity of binge eating in women and, if so, whether this relationship is independent of age, self-reported body mass index (BMI), negative affect, irrational food beliefs and craving. One hundred and four women, consisting of 32 consecutive patients with binge eating disorder undergoing initial assessment for cognitive therapy for eating disorders, 39 moderate binge eaters, and 33 non-binge eaters (both from the general population), completed the following measures: Self-reported BMI, Hospital Anxiety and Depression Scale, Irrational Food Beliefs Scale, General Craving Scale, Metacognitions about Desire Thinking Questionnaire, and Binge Eating Scale. A series of Spearman's rho correlation analyses revealed that self-reported BMI, anxiety, depression, irrational food beliefs, craving, and all three factors of the metacognitions about desire thinking questionnaire were significantly associated with the severity of binge eating. A stepwise regression analysis identified self-reported BMI, craving, and negative metacognitions about desire thinking as significant predictors of the severity of binge eating. These results, taken together, highlight the possible role of metacognitions about desire thinking in predicting the severity of binge eating. The clinical implications of these findings are discussed.

The relation of anxiety, depression, and stress to binge eating behavior

This study aimed to extend the literature by examining several psychological factors (i.e. depression, anxiety, and stress) in relation to binge eating. Data were collected via online surveys from a community sample of men and women of diverse backgrounds. The main study hypotheses were supported, indicating a unique relation between anxiety and binge eating, and between stress and binge eating, independent of the impact of depression. Gender differences are discussed. The results of this study suggest a need for a more detailed examination of negative affect in binge eating. Furthermore, the role of anxiety may be important for future research.

Developing an Acceptance-Based Behavioral Treatment for Binge Eating Disorder: Rationale and Challenges

Binge eating disorder (BED), characterized by recurrent eating episodes in which individuals eat an objectively large amount of food within a short time period accompanied by a sense of loss of control, is the most common eating disorder. While existing treatments, such as cognitive behavioral therapy (CBT), produce remission in a large percentage of individuals with BED, room for improvement in outcomes remains. Two reasons some patients may continue to experience binge eating after a course of treatment are: (a) Difficulty complying with the prescribed behavioral components of CBT due to the discomfort of implementing such strategies; and (b) a lack of focus in current treatments on strategies for coping with high levels of negative affect that often drive binge eating. To optimize treatment outcomes, it is therefore crucial to provide patients with strategies to overcome these issues. A small but growing body of research suggests that acceptance-based treatment approaches may be effective for the treatment of binge eating. The goal of the current paper is to describe the development of an acceptance-based group treatment for BED, discuss the structure of the manual and the rationale and challenges associated with integrating acceptance-based strategies into a CBT protocol, and to discuss clinical strategies for successfully implementing the intervention.

A daily diary study of perceived social isolation, dietary restraint, and negative affect in binge eating

Negative affect and dietary restraint are key predictors of binge eating, yet less is known about the impact of social factors on binge eating. The study sought to replicate and extend research on the relationships between negative affect, dietary restraint, perceived social isolation and binge eating using a daily diary methodology. College women (N = 54) completed measures of dietary restraint, negative affect, perceived social isolation, and binge eating daily for 14 days. Participants completed the measures nightly each day. A series of generalized estimating equations showed that dietary restraint was associated with less binge eating while controlling for negative affect and for perceived social isolation separately. Negative affect and perceived social isolation were associated with greater binge eating while controlling for restraint in separate analyses, but only perceived social isolation was significant when modeled simultaneously. All two-way interactions between negative affect, dietary restraint, and perceived social isolation predicting binge eating were nonsignificant. This study furthers our understanding of predictors of binge eating in a nonclinical sample. Specifically, these data suggest perceived social isolation, negative affect, and dietary restraint are important variables associated with binge eating in daily life and warrant further research.

Changes in genetic risk for emotional eating across the menstrual cycle: a longitudinal study

BACKGROUND

Previous studies have shown significant within-person changes in binge eating and emotional eating across the menstrual cycle, with substantial increases in both phenotypes during post-ovulation. Increases in both estradiol and progesterone levels appear to account for these changes in phenotypic risk, possibly via increases in genetic effects. However, to date, no study has examined changes in genetic risk for binge phenotypes (or any other phenotype) across the menstrual cycle. The goal of the present study was to examine within-person changes in genetic risk for emotional eating scores across the menstrual cycle.

METHOD

Participants were 230 female twin pairs (460 twins) from the Michigan State University Twin Registry who completed daily measures of emotional eating for 45 consecutive days. Menstrual cycle phase was coded based on dates of menstrual bleeding and daily ovarian hormone levels.

RESULTS

Findings revealed important shifts in genetic and environmental influences, where estimates of genetic influences were two times higher in post- as compared with pre-ovulation. Surprisingly, pre-ovulation was marked by a predominance of environmental influences, including shared environmental effects which have not been previously detected for binge eating phenotypes in adulthood.

CONCLUSIONS

Our study was the first to examine within-person shifts in genetic and environmental influences on a behavioral phenotype across the menstrual cycle. Results highlight a potentially critical role for these shifts in risk for emotional eating across the menstrual cycle and underscore the need for additional, large-scale studies to identify the genetic and environmental factors contributing to menstrual cycle effects.

Desire thinking: A risk factor for binge eating?

In the current study we explored the role of desire thinking in predicting binge eating independently of Body Mass Index, negative affect and irrational food beliefs. A sample of binge eaters (n=77) and a sample of non-binge eaters (n=185) completed the following self-report instruments: Hospital Anxiety and Depression Scale, Irrational Food Beliefs Scale, Desire Thinking Questionnaire, and Binge Eating Scale. Mann-Whitney U tests revealed that all variable scores were significantly higher for binge eaters than non-binge eaters. A logistic regression analysis indicated that verbal perseveration was a predictor of classification as a binge eater over and above Body Mass Index, negative affect and irrational food beliefs. A hierarchical regression analysis, on the combined sample, indicated that verbal perseveration predicted levels of binge eating independently of Body Mass Index, negative affect and irrational food beliefs. These results highlight the possible role of desire thinking as a risk factor for binge eating.

The difficulty in defining binge eating in obese women: how it affects prevalence levels in presurgical bariatric patients

OBJECTIVE

We aim to determine how increasing the specificity of binge eating criteria affects the prevalence of self-reported binge eating among presurgical bariatric patients.

METHOD

197 women ages 20 to 65 being assessed for bariatric surgery with a BMI greater than 30kg/m(2) were interviewed and completed the Eating and Exercise Examination.

RESULTS

The prevalence of self-reported binge eating was 55% (n=109). The addition of the criterion 'more than a little loss of control/distress' reduced the rate to 23% (n=45), a minimum of six servings of food reduced the rate to 34% (n=67). The addition of a minimum frequency of twice per week for six months (DSM-VI) reduced the rate to 22% (n=43), or once per week for three months (DSM-5) reduced the rate to 53% (n=104).

DISCUSSION

More precise definitions and diagnostic criteria for binge eating may result in more consistent reports of prevalence levels of BED.

Emotion dysregulation, self-image and eating disorder symptoms in University Women

BACKGROUND

We studied associations between emotion dysregulation, self-image and eating disorder (ED) symptoms in university women, and contrasted two indirect effect models to examine possible intervening mechanisms to produce ED symptoms.

METHODS

252 female Swedish university students completed the Difficulties in Emotion Regulation Scale (DERS), the Structural Analysis of Social Behavior (SASB) self-image measure, and the Eating Disorder Examination Questionnaire (EDE-Q). Correlations between scales were followed by five simple mediation analysis pairs with two possible pathways using five ED symptom variables as outcome. The models posited either self-image or emotion dysregulation as mediator or independent variable, respectively. ED symptoms were EDE-Q Global score, objective binge eating episodes (OBE), subjective binge eating episodes (SBE), and two variants of EDE-Q excessive exercise.

RESULTS

Emotion dysregulation and self-image were strongly correlated, and both correlated moderately with EDE-Q Global score. There were distinct indirect effects through self-image on the relationship between emotion dysregulation and ED symptoms, but not vice versa. These indirect effects were evident in relation to cognitive ED symptoms and both OBE and SBE, but not in relation to excessive exercise.

CONCLUSIONS

Results suggest that even if closely related, emotion dysregulation and self-image both contribute unique knowledge in relation to ED symptoms. Self-image as an intervening mechanism between emotion dysregulation and ED symptoms is relevant for models of the development, maintenance and treatment of ED, as well as treatment focus.

Eating behaviors and negative affect in college women's everyday lives

OBJECTIVE

A growing body of research seeks to understand the relationship between mood and eating behaviors. Ecological Momentary Assessment (EMA) methods provide a method for assessing these processes in natural settings. We used EMA to examine the relationship between mood and eating behaviors in everyday life among women with subclinical disordered eating behaviors.

METHOD

Participants (N = 127, age M = 19.6 years, BMI M = 25.5) completed five daily EMA reports on palmtop computers for 1 week. Assessments included measures of negative affect (NA) and eating-related behavior during eating (eating large amounts of food, loss of control over eating, and restricting food intake) and noneating episodes (skip eating to control weight/shape). Time-lagged multilevel models tested mood-eating behavior relationships.

RESULTS

Higher NA did not precede any unhealthy eating and weight control behaviors. However, NA was higher when women reported eating large quantities of food, losing control over eating, and restricting food intake during their most recent eating episode, but not after skipping eating to control weight/shape.

DISCUSSION

These findings elucidate the processes in daily life that may influence the development and maintenance of unhealthy eating and weight control behaviors that, in turn, can inform interventions.

The role of high-quality friendships in female adolescents' eating pathology and body dissatisfaction

PURPOSE

Peers may serve as risk factors for body dissatisfaction and eating pathology through two possible routes: (1) promoting body dissatisfaction through appearance-related interactions (e.g. weight-teasing); (2) a non-specific social support route whereby poor quality peer relations result in depression and consequently eating pathology. The second route has received little attention and, therefore, was the focus of this study.

METHODS

A cross-sectional study in which 216 adolescent girls (aged 13-16 years) completed self-report measures of positive and negative friendship qualities, friendship functions, eating pathology, body dissatisfaction and depression.

RESULTS

Those reporting poorer quality friendships tended to show greater eating pathology and greater body dissatisfaction. These associations were reduced to non-significance when covarying depression. There was no evidence that the role of friendships was moderated by the extent to which participants valued close relations.

CONCLUSIONS

Low-quality friendships are associated with disordered eating and may be suitable targets for prevention.

Pilotstudie zur Effektivität eines Emotionsregulationstrainings bei Frauen mit Binge-Eating-Störung

Negative Emotionen sind ein häufiger Auslöser von Essanfällen bei Personen mit Binge-Eating-Störung (BES). Erste Untersuchungen haben gezeigt, dass Defizite in der Emotionsregulation (ER) den Zusammenhang von negativen Emotionen und Essanfällen mediieren. Vor diesem Hintergrund erhielten im Rahmen einer Pilotstudie 14 Frauen mit BES ein ER-Training in der Gruppe. Indikatoren für die Effektivität des Trainings waren Anzahl der Episoden und Tage mit objektiven Essanfällen, Körperunzufriedenheit, sowie Depressivität vor Studienbeginn (T0), nach 8 Wochen Wartezeit (T1) und nach dem 8-wöchigen ER-Training (T2). Während es keine Veränderungen von T0 zu T1 gab, zeigte sich eine signifikante Reduktion der Symptomatik in allen erhobenen Variablen von T1 zu T2. Die Ergebnisse der Pilotstudie unterstützen die Relevanz der ER bezüglich der Reduktion von Essanfällen und damit die Notwendigkeit gut implementierter Therapiestudien, die die Effektivität von ER-Trainings in der Veränderung der Psychopathologie der BES untersuchen. Zudem sind weitere Studien, die die Rolle der ER bei der Aufrechterhaltung der BES klären, notwendig.

Pre-meal affective state and laboratory test meal intake in adolescent girls with loss of control eating

Loss of control eating confers risk for excess weight gain and exacerbated disordered eating. Affect theory proposes that loss of control eating is used to cope with negative mood states. Self-report data suggest that negative affect may contribute to the etiology of loss of control eating, but this theory has not been well-tested using laboratory paradigms. We examined associations between pre-meal affective states and intake during a laboratory test meal. One-hundred and ten adolescent girls with reported loss of control eating whose body mass index fell between the 75th and 97th percentile for age and sex completed state mood ratings prior to a test-meal. Results indicated that pre-meal state negative affect was associated with greater carbohydrate and less protein consumption, as well as greater snack and dessert and less fruit and dairy intake. All girls experienced significant decreases in negative affect from pre- to post-meal, but intake during the meal was unassociated with post-meal affect. In support of affect theory, negative affective states reported among girls with loss of control may be a driving factor for increased energy-dense food intake, which may play a role in excess weight gain.

Influence of negative affect on choice behavior in individuals with binge eating pathology

Research suggests that individuals with binge eating pathology (e.g., bulimia nervosa (BN) and binge eating disorders (BED)) have decision making impairments and particularly act impulsively in response to negative affect. The aim of this study was to examine the influence of negative affect on choice behavior in women with BN and BED. Ninety women (59 with BN or BED and 31 healthy controls) watched a sad or control film fragment and were subsequently asked to complete a choice behavior task (as measured by a variation of the Bechara Gambling Task (BGT)). Results showed that negative affect influenced choice behavior differently in healthy controls and in women with BN and BED after punishment (but not after reward). In the context of increased negative affect, punishment was associated with more disadvantageous choice behavior in both BN and BED women but not in healthy controls, while the effect was the exact opposite in both groups after a decrease in negative affect. Levels of sadness were not found to influence choice behavior after reward in either groups. These findings suggest that emotional states may have a direct impact on choice behavior of individuals with binge eating pathology and are not only related to pathological behavior itself.