Fear of fatness and desire for thinness as distinct experiences: A qualitative exploration

Abstract

Objective: The pursuit of thinness and fear of gaining weight have been found to play an important role in eating disorder symptomatology. While these dimensions have typically been considered conjointly, emerging evidence suggests they may be distinct dimensions. The aim of this study was to explore the subjective experiences of fear of fatness and drive for thinness in young women with body image concerns.Method: Young women endorsing weight concerns (N = 29, mean age = 20.86, SD = 2.70 years) were interviewed and asked to describe an experience of fear of fat and drive for thinness, respectively.Results: Qualitative analysis was conducted and identified four themes: (1) precipitating events; (2) physiological, emotional, cognitive, and proprioceptive experiences;(3) coping strategies; and (4) sociocultural influences. While similarities emerged, the experiences of fear of fatness, and of drive for thinness also evidenced clear differences situating the former in the context of fear-based avoidance patterns, and the latter in approach-based reward models.Discussion: These findings provide additional support for the usefulness of considering fear of fat and drive for thinness as distinct constructs. Further research examining the contributions of each of these constructs to eating pathology is warranted.disordered eating, drive for thinness, fear, fear of fatness, qualitative, reward, weight and shape concerns | INTRODUCTIONBody image concerns have been shown to be important drivers of eating pathology (Stice, Marti, & Durant, 2011). Specifically, the pursuit of thinness, that is efforts to obtain and maintain a very slender body, and fear of fatness, that is fear of gaining weight, body fat, or becoming larger bodied, have been found to play an important role in eating disorder symptomatology, and indeed overvaluation of weight and shape is an important clinical criterion for eating disorders (Fairburn, Cooper, & Shafran, 2003). Typically, both of these dimensions have been considered conjointly, for example in assessment tools (Fairburn & Beglin, 1994). However, there is emerging evidence that these may be distinct dimensions (Levitt, 2003;Rodgers, DuBois, Frumkin, & Robinaugh, 2018), which would have important theoretical and intervention implications. Specifically, findings from a study among nonclinical college students using a network approach revealed that drive for thinness was a central symptom in the eating disorder network and highly interconnected with other core symptoms such as body dissatisfaction (Rodgers et al., 2018). In contrast, fear of fatness was a more peripheral symptom and was less strongly related to other core elements of the network. Given the centrality of these dimensions to the development and maintenance of eating disorder pathology, as well as the importance of increasing our understanding of the potential independence of these dimensions, this study sought to

Unattractive, corrupted, and culpable feared self-themes: Expanding our understanding of self-concept in relation to eating pathology

“…This is one of a few studies to consider the effect of perceived proximity to a feared self (rather than to an ideal or ought self) on eating pathology and is, to our knowledge, the first study to assess different feared self-themes as they relate to disordered eating attitudes and behaviours. More broadly, our results are in line with an emerging body of research highlighting the importance of fear and avoidance in relation to eating pathology (Levinson et al, 2019;Rodgers et al, 2022) and extend a focus on fear/avoidance to the domain of self-concept.…”

Weighing in: qualitative explorations of weight restoration as recovery in anorexia nervosa

“…Requiring a certain weight for treatment may cause iatrogenic harm if people set that weight as a goal, refuse to gain weight above it, or more simply never weigh so little that they qualify for treatment. A fear of fatness or weight gain does not necessarily indicate a desire to be thinner as a component of mental illness, but may, as with our respondents, indicate a fear of losing support [ 67 ]. Time-delays matter: There is evidence that outcomes are better when intervention occurs in the first three years of illness [ 68 ], deceasing time between onset, detection, and treatment [ 69 , 70 ].…”