Evaluating dietary restriction as a maintaining factor in binge‐eating disorder

Abstract

ObjectiveProminent theories of binge‐eating (BE) maintenance highlight dietary restriction as a key precipitant of BE episodes. Consequently, treatment approaches for eating disorders (including binge‐eating disorder; BED) seek to reduce dietary restriction in order to improve BE symptoms. The present study tested the hypothesis that dietary restriction promotes BE among 112 individuals with BED.MethodsParticipants completed a 7‐day ecological momentary assessment (EMA) protocol before and after completing 17 weeks of either Integrative Cognitive‐Affective Therapy or guided self‐help cognitive behavioral therapy. Analyses examined whether dietary restriction on 1 day of the baseline EMA protocol predicted risk for BE later that same day, and on the following day. Changes in dietary restriction over the course of treatment were also evaluated as a predictor of change in BE from pre‐treatment to post‐treatment. Baseline dietary restraint was examined as a moderator of the above associations.ResultsDietary restriction did not predict BE later the same day, and changes in restriction were not related to changes in BE across treatment, regardless of baseline dietary restraint levels. Restriction on 1 day did predict increased BE risk on the following day for individuals with higher levels of dietary restraint, but not those with lower levels.DiscussionThese findings challenge the assumption that dietary restriction maintains BE among all individuals with BED. Rather, results suggest that dietary restriction may be largely unrelated to BE maintenance in this population, and that reducing dietary restriction generally does not have the intended effect on BE frequency.

Ultra-Processed Foods and Mental Health: Where Do Eating Disorders Fit into the Puzzle?

“…It is widely accepted in the ED field that all binge eating stems from some form of dietary restraint (commonly referred to as “restriction”), often generated by body dissatisfaction [ 123 ]. The available evidence does not support this absolute assertion [ 124 ]. On the contrary, longitudinal research using an adolescent sample found that UPFA predicted dietary restraint, but dietary restraint did not predict UPFA [ 125 ].…”

“…Addiction-like eating may drive the initial dietary restraint, which may reflect an attempt to protect oneself from the overstimulating properties of UPFs, which may then, in turn, be overridden by the anticipated reinforcement from UPFs and result in binge behaviors [ 123 ]. Not all binge eating episodes are directly linked to restriction [ 124 ]; the abundance of UPFs in our food environment may result in cue-induced craving and promote binge-like consumption patterns (i.e., the blind spot).…”

A Systematic Review of Moderators of the Association between Dietary Restraint and Binge Eating

“…While some literature has demonstrated that dietary restraint is related to an increased risk of binge eating symptoms [8,9] and may not lead to lasting weight loss [10,11], other evidence suggests restraint is not universally associated with such outcomes across the literature [5,[12][13][14][15][16][17][18][19][20][21][22][23]. That is, studies have shown that many individuals who engage in dietary restraint are successful in regulating their weight without experiencing binge eating symptoms [14][15][16][17].…”