Understanding the Association of Impulsivity, Obsessions, and Compulsions with Binge Eating and Purging Behaviours in Anorexia Nervosa

Abstract

Objective To further refine our understanding of impulsivity, obsessions, and compulsions in anorexia nervosa (AN) by isolating which behaviors—binge eating, purging, or both—are associated with these features. Methods We conducted regression analyses with binge eating, purging, and the interaction of binge eating with purging as individual predictors of scores for impulsivity, obsessions, and compulsions in two samples of women with AN (n = 1373). Results Purging, but not binge eating, was associated with higher scores of impulsivity, obsessions and compulsions. Purging was also associated with worst eating rituals and with worst eating preoccupations. Conclusion Our results suggest that purging, compared with binge eating, may be a stronger correlate of impulsivity, obsessions, and compulsions in AN.

Temperament and emotional eating: A crucial relationship in eating disorders

“…This suggests that temperament specifically modulates emotional eating in patients with binge eating, independent of purging. This result may seem partly at variance with that of a previous study in AN, in which correlations with TCI scales were reported for purging, but not bingeing (Hoffman et al, 2012); however, it should be observed that, in the previous study, only patients with AN were included, whereas the present study enrolled a broader range of patients with EDs, with a majority of individuals in whom binge eating was the principal pathological behavior.…”

“…Previous studies have shown that temperamental features can moderate purging in patients with AN (e.g., Hoffman et al, 2012). It is possible that some of the relationships between binge eating and temperament are moderated by concomitant purging.…”

The relationship between perfectionism and discounting measures

“…In addition, future research should examine perfectionism and delay discounting in populations of people with clinical diagnoses, such as different AN subtypes (Slof-Op't Landt et al, 2016). People with AN binge eating/purging type score higher on measures of impulsivity compared to people with AN restricting type (Claes, Nederkoorn, Vandereycken, Guerrieri, & Vertommen, 2006); although purging, but not binging, in people with AN has been associated with elevated levels of impulsivity (Hoffman et al, 2012). This research could help determine if low levels of delay discounting combined with high levels of perfectionism are predictive of AN onset, similar to the predictive ability of high levels of impulsivity with the onset of BED (Fischer, Peterson, & McCarthy, 2013).…”

Decision-making impulsivity in disordered eating: outcomes from a discounting task

“…Previous research has shown that impulsivity is related to other problems and disorders associated with eating behavior, including obesity (Rasmussen, Lawyer, & Reilly, 2010;Weller, Cook, Avsar, & Cox, 2008), binge-eating disorder (Manwaring et al, 2011), bulimia nervosa (Kemps & Wilsdon, 2010), and anorexia nervosa (Hoffman et al, 2012;Waxman, 2009). For example, Hoffman et al (2012) showed that purging behavior, common in the binge-eating/purging subtype of anorexia nervosa, was predictive of multiple measures of impulsivity. Purging seems to reflect an impulsive decision, intended to control weight and reduce anxiety at the expense of long-term consequences to health and psychological well-being.…”

“…Purging seems to reflect an impulsive decision, intended to control weight and reduce anxiety at the expense of long-term consequences to health and psychological well-being. Individuals with anorexia nervosa are also likely to engage in other behaviors typically considered impulsive, such as substance abuse/dependence, self-injury, and suicide attempts (Hoffman et al, 2012).…”