Associations of adolescent emotional and loss of control eating with 1‐year changes in disordered eating, weight, and adiposity

Abstract

Objective Adolescent emotional-eating, referring to eating in response to negative affective states, is frequently reported by those with loss of control (LOC) eating. Although LOC eating has been shown to predict exacerbated disordered eating and excess weight/adiposity gain, the extent to which emotional-eating, either alone or in combination with LOC, predicts adverse outcomes has not been determined. Thus, we examined associations of baseline emotional-eating with changes in disordered eating, BMI, and adiposity over 1-year, and to what degree the presence or absence of baseline LOC moderated these associations. Methods 189 non-treatment-seeking youth (15.4±1.4y; 66% female; 67% non-Hispanic White, 38% overweight [BMI ≥85th %ile]) completed the emotional-eating Scale for Children/Adolescents and the Eating Disorder Examination interview at baseline and again at 1-year. Air displacement plethysmography assessed adiposity at both time points. Results Baseline emotional-eating alone was not significantly associated with the development of objective binge eating or changes in disordered eating attitudes, BMI or adiposity 1-year later. However, baseline emotional-eating interacted with the presence of baseline LOC in the prediction of 1-year outcomes. Among adolescents with LOC eating, greater baseline emotional-eating was related to increased disordered eating attitudes (p=.03), BMI (p=.04), and adiposity (p=.04) at 1-year, after correcting for false discovery rate. Discussion Emotional-eating among youth also reporting LOC was associated with adverse outcomes over 1-year. Adolescents who report both behaviors may represent a subset of individuals at especially high risk for exacerbated disordered eating and excess weight gain.

Mindfulness and laboratory eating behavior in adolescent girls at risk for type 2 diabetes

“…Given previous research supporting LOC-eating as an individual vulnerability factor in exacerbating the effects of emotional eating on excess weight gain in adolescents (Stojek et al, 2017), we explored the interaction of reported LOC-eating with mindfulness in the prediction of eating behavior. Contrary to our hypothesis, LOC-eating and mindfulness did not show a significant interaction in the prediction of meal intake when hungry or EAH.…”

“…As a secondary objective, we explored the interaction of mindfulness and LOC in the prediction of laboratory eating behavior. Based on previous findings of other variables associated with eating and weight (Kelly et al, 2016; Shank et al, 2015; Stojek et al, 2017), we expected that reported LOC-eating status would exacerbate the inverse association of mindfulness with energy intake, such that being prone to uncontrolled eating in combination with less present-moment awareness would have the strongest effect on EAH. Finally, because attention (or lack of attention) to hunger cues is a key aspect of the conceptual model through which mindfulness regulates eating behavior (Brown et al, 2007; Schachter & Rodin, 1974), we adjusted for hunger state in all models and tested its interactions with mindfulness and LOC-eating.…”

Eating in case of emotion dys‐regulation, depression and anxiety: Different pathways to emotional eating in moderate and severe obesity

“…The Difficulties in Emotion Regulation Scale 17,66 is a 36‐item self‐report measure with a 5‐point Likert format. It evaluates difficulties in six domains of emotion regulation 1 : acceptance of emotional response (non‐acceptance), 2 adoption of goal‐directed behaviours (goal‐directed), 3 control of impulsive behaviours (impulses), 4 emotional awareness (awareness), 5 access to emotion regulation strategies (limited access) 6 and emotional clarity (clarity). Higher total scores indicate greater emotion regulation difficulties.…”

“…People with EE tend to eat larger amounts of food than needed and more “comforting,” energy‐dense food 2,3 . EE has been identified as a major risk factor for weight gain, weight maintenance and obesity 4,5 . Accordingly, most patients seeking treatment for their obesity present EE 6,7 .…”

Cue reactivity, habituation, and eating in the absence of hunger in children with loss of control eating and attention‐deficit/hyperactivity disorder

“…LOC eating is cross‐sectionally characterized by pronounced eating disorder and general psychopathology, marked distress, obesity, and related metabolic symptoms (e.g., Hilbert & Czaja, ; Matherne et al, ; Radin et al, ; Shomaker et al, ). Longitudinally, childhood LOC eating predicts full‐syndrome BED and, at least in vulnerable youth, excess weight gain (Hilbert, Hartmann, Czaja, & Schoebi, ; Hilbert & Brauhardt, ; Stojek et al, ; Tanofsky‐Kraff et al, , ).…”