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

Abstract

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.Keywords social anxiety; binge eating; social appearance anxiety; perfectionism; dietary restraint; disordered eating Binge eating, the uncontrollable consumption of an unusually large amount of food for a particular situation within a two-hour time period, is a prevalent eating disorder symptom associated with significant detrimental effects on physical and mental health, such as an Correspondence regarding this article should be addressed to Cheri Levinson, Department of Psychological and Brain Sciences, University of Louisville, Life Sciences Rm 309, Louisville, KY 40208. Phone: 502-852-7710, cheri.levinson@louisville.edu. We have no conflicts of interests to report.Publisher's Disclaimer: This is a PDF file of an unedited manuscript that has been accepted for publication. As a service to our customers we are providing this early version of the manuscript. The manuscript will undergo copyediting, typesetting, and review of the resulting proof before it is published in its final citable form. Please note that during the production process errors may be discovered which could affect the content, and all legal disclaimers that apply to the journal pertain. HHS Public Access Author ManuscriptAuthor Manuscript Author ManuscriptAuthor Manuscript increased risk for obesity and psychiatric co-morbidity (American Psychiatric Association, 2013;Hovrud & De Young, 2015;Hudson, Hiripi, Pope Jr, & Kessler, 2007;Wilfley, Wilson, & Agras, 2003). Binge eating is a primary characteristic of both binge eating dis...

Psychological Predictors of Unhealthy Eating Attitudes in Young Adults

“…The configuration of intensity for all measures confirms results often obtained by individuals in a healthy population (people who do not manifest various types of eating disorders), which also is reflected in research conducted by Boyd (2006) , who showed that compared to individuals suffering from eating disorders, healthy people show less disordered emotional functioning, higher ability to cope with negative emotions in stressful situations, better ability to cope with stress and lower level of psychopathological traits. Other studies have also indicated that psychopathological traits of excessive anxiety, depression, impulsivity, emotional dysregulation, and negative coping are important criteria that differentiate healthy people from those with eating disorders ( Grant et al, 2002 ; Jacobi et al, 2004 ; Boyd, 2006 ; Tchanturia et al, 2012 ; Torres et al, 2015 ; Gorwoord et al, 2016 ; Levinson and Rodebaugh, 2016 ; Brosof and Levinson, 2017 ; Wang and Li, 2017 ; Westwood et al, 2017 ; Brown et al, 2018 ).…”

“…There are studies that indicate that alexithymia may trigger unhealthy eating attitudes and be related to symptoms of eating disorders, thus strengthening anxiety, depression, and stress( Tchanturia et al, 2012 ; Torres et al, 2015 ; Westwood et al, 2017 ; Brown et al, 2018 ). There are also studies indicating a lack of evidence to support a significant role for affective disorders in the formation of unhealthy eating attitudes, thus suggesting possible multi-level correlations between improper eating and body attitudes in eating disorders and various affective disorders ( Wallis and Hetherington, 2009 ; Gorwoord et al, 2016 ; Levinson and Rodebaugh, 2016 ; Brosof and Levinson, 2017 ; Wang and Li, 2017 ). From psychological and medical perspectives, particularly in preventive healthcare and the prevention of eating disorders, seeking the unexplored multi-level influences of various psychosocial conditions on the formation of unhealthy eating attitudes is important for medical and psychological treatment.…”

“…There is a need for research to verify the multi-level relationships and correlations between different personal factors and unhealthy eating attitudes in a population of young adults, both women and men. The source material collected over the last years regarding eating disorders (particularly among young women) shows that restrained and compulsive eating, apart from eating disorders, have a significant disorganizing effect on an individual’s psychosocial functioning ( Józefik, 2014 ; Levinson and Rodebaugh, 2016 ; Brosof and Levinson, 2017 ; Izydorczyk and Sitnik-Warchulska, 2018 ). In choosing independent and dependent variables for the original study model, the current authors referred to other researchers’ findings that compulsive and restrained eating can be related to increased levels of depression, anxiety, and low self-esteem ( Iniewicz, 2005 ; Sassaroli et al, 2008 ; Józefik et al, 2010 ; Brechan and Kvalem, 2015 ).…”

Linking body esteem to eating disorders among adolescents: A moderated mediation model

“…More recently, social appearance anxiety has been found to be more strongly linked to EDs, such as anorexia and bulimia nervosa, relative to other facets of social anxiety (Dakanalis et al, 2016; Levinson and Rodebaugh, 2012; Levinson et al, 2013). Brosof and Levinson (2017) investigated 300 women, and found that social appearance anxiety not only predicted binge eating at baseline but also mediated the relationship between concern over mistakes and binge eating across 6 months.…”

Sağlıklı Yaşam Biçimi Davranışları ile Sosyal Görünüş Kaygısı Arasındaki İlişkinin İncelenmesi

“…Yapılan iki çalışmada da SYBDÖ'nin beslenme alt boyutu ile SGK arasında ilişki olmadığı saptanmıştır (16,19). Bununla birlikte literatür incelemesinde beslenme davranışı, obezite, aşırı yeme, bulimia nevroza gibi beslenme sorunları ile SGK arasındaki ilişkiye yönelik çalışmaların sıklıkla yapıldığı görülmektedir (26)(27)(28). Kılıç ve Karakuş (2016) üniversite öğrencileri ile yapmış olduğu çalışmada da kilosundan hiç memnun olmayanlarda SGKÖ puan ortalamasının daha yüksek olduğunu belirtmiştir (17).…”