An Open Trial Examining Dialectical Behavior Therapy Skills and Behavioral Weight Loss for Adults With Emotional Eating and Overweight/Obesity.

Third-wave cognitive behavioral interventions for weight loss have shown promise. However, sparse data exists on the use of dialectical behavior therapy for weight loss. Adapted dialectical behavior therapy skills programs may be especially well suited for adults who engage in emotional eating and are seeking weight loss. Dialectical behavior therapy is skills-based, shares theoretical links to emotional eating, and is effective in treating binge eating. The current study examined the feasibility, acceptability, and preliminary efficacy of Live FREE: FReedom from Emotional Eating, a 16-session group-based intervention. A total of 87 individuals expressed interest in the program, and 39 adults with overweight/obesity (BMI ≥25) and elevated self-reported emotional eating were enrolled. Live FREE targeted emotional eating in the initial sessions 1-9, and sessions 10-16 focused primarily on behavioral weight loss skills while continuing to reinforce emotion regulation training. Assessments were administered at baseline, posttreatment, and 6-month follow up. Enrolled participants were primarily female (97.4%) and Caucasian (91.7%). Treatment retention was strong with participants attending an average of 14.3 sessions and 89.7% of participants completing the intervention. On average, participants lost 3.00 kg at posttreatment, which was maintained at follow-up. Intent-to-treat analyses showed improvements in key outcome variables (self-reported emotional eating, BMI, emotion regulation) over the course of the intervention. Combining dialectical behavior therapy skills with conventional behavioral weight loss techniques may be an effective intervention for adults with overweight/obesity who report elevated emotional eating.

Emotion regulation mediates relationships between perceived childhood invalidation, emotional reactivity, and emotional eating.

Dialectical Behavior Therapy (DBT) is informed by the biosocial model which suggests that emotional sensitivity and childhood invalidation interact to influence emotion dysregulation, leading to behavioral disorders. Although adapted DBT interventions have resulted in improved emotional eating, little research has been conducted to examine whether key aspects of the biosocial model apply to emotional eating. Adults (N = 258) were enrolled via Amazon's Mechanical Turk. Three separate mediation analyses were performed using Hayes' SPSS macro. Results showed that emotion regulation difficulties mediated the relationships between biosocial variables (i.e. perceived maternal and paternal invalidation and emotional reactivity) and emotional eating.

Resting state heart rate variability in clinical and subthreshold disordered eating: A meta-analysis.

OBJECTIVE: Research has demonstrated mixed results regarding the direction of the association between vagal activation and disordered eating. The current meta-analysis examined studies testing the link between resting-state heart rate variability indices of vagal activation (vmHRV), and both clinical and subthreshold disordered eating. METHOD: A systematic search of the literature resulted in the inclusion of studies that were correlational (associations between HRV and disordered eating symptoms) and that examined group differences (e.g., control group vs. disordered eating group), for a total of 36 samples. RESULTS: Findings indicated a small but reliable association of vmHRV with disordered eating, r = 0.12, indicating greater vagal activation in individuals with disordered eating compared to those with little or no disordered eating behavior. Moderation analyses identified predictors of the vmHRV/disordered eating association. Bulimia nervosa was found to have a large, positive effect size with vmHRV, r = 0.60, which was significantly greater than all other types of disordered eating, Q T = 10.74, p = .047. Compared to subthreshold disordered eating, clinical eating disorders demonstrated significant, persistent increased vagal activation with a medium, reliable effect size, r = 25, QT = 3.94, p = .045. CONCLUSION: These insights contribute to an improved understanding of the pathophysiology in disordered eating.

OBJETIVO: La investigación ha demostrado resultados mixtos sobre la dirección de la asociación entre la activación vagal y la conducta alimentaria anormal. El presente metaanálisis examinó los estudios que prueban la relación entre los índices de variabilidad de activación vagal de la frecuencia cardíaca en estado de reposo (vmHRV) y la conducta alimentaria anormal tanto clínica como subclínica. MÉTODO: Una búsqueda sistemática de la literatura resultó en la inclusión de estudios que eran correlacionales (asociaciones entre HRV y síntomas de conductas alimentarias anormales) y que examinaron las diferencias grupales (por ejemplo, grupo control versus grupo de conductas alimentarias anormales), para un total de 36 muestras. RESULTADOS: Los resultados indican una asociación pequeña pero confiable de vmHRV con conductas alimentarias anormales, r = 0,12, lo que indica una mayor activación vagal en individuos con conductas alimentarias anormales en comparación con aquellos con poca o ninguna conducta alimentaria anormal. Los análisis de moderación identificaron predictores de la asociación vmHRV/conducta alimentaria anormal. Se encontró que la bulimia nervosa (BN) tenía un tamaño de efecto positivo, grande con vmHRV, r = 0.60, que era significativamente mayor que todos los otros tipos de conductas alimentarias anormales, QT = 10.74, p = .047. En comparación con las conductas alimentarias anormales subclínicas, los trastornos de la conducta alimentaria clínicos demostraron una activación vagal aumentada significativa y persistente con un tamaño de efecto medio y confiable, r = 25, QT = 3.94, p = .045. CONCLUSIÓN: Estas ideas contribuyen a una mejor comprensión de la fisiopatología en las conductas alimentarias anormales.

Cardiovascular effects of brief mindfulness meditation among perfectionists experiencing failure.

Research links perfectionism, the tendency to hold and pursue unrealistically high standards, to negative mental health outcomes such as eating disorders, anxiety, and depression. Previous research used high frequency heart rate variability (HF-HRV) to measure recovery from stress during a mindfulness meditation in perfectionistic university students and found that only nonperfectionists demonstrated HF-HRV recovery from stress, suggesting that mindfulness was not effective for perfectionists. However, the mindfulness meditation did not incorporate a nonjudgment element, which may be a key component for perfectionists. In the current study, we examined whether mindfulness with a focus on nonjudgment helps university student perfectionists (n = 120) recover from failure (measured by heart rate (HR), HF-HRV, pNN50). Students were randomly assigned to one of four meditation groups: nonjudgment mindfulness, general mindfulness (i.e., attentional awareness without a nonjudgment component), progressive muscle relaxation, and nothing. Cardiac data were recorded during a 5-min baseline, failure task, and 10-min meditation session. HR results suggest that both mindfulness conditions and "nothing" encouraged cardiovascular recovery, but that the mindfulness conditions showed even further recovery during the last five minutes of the meditations. HF-HRV results indicated that participants in the nonjudgment mindfulness condition had marginally higher HF-HRV during the last five minutes of the meditation than at baseline, while participants in the other conditions did not. Therefore, mindfulness with a focus on nonjudgment of emotions may be especially important to help perfectionists improve HF-HRV after failure.

Self-reported emotional eating is not related to greater food intake: results from two laboratory studies.

Objective: Despite widespread use of emotional eating self-report measures, the validity of these measures has been questioned. Most of this research has focused on the validity of the Dutch Eating Behavior Questionnaire (DEBQ) as opposed to the Emotional Eating Scale (EES). The current paper describes two experimental studies that examined associations between self-reported emotional eating and emotional eating measured in the laboratory. To address previous design limitations, the current studies used highly palatable foods, effective mood induction methods, and the EES, in addition to the DEBQ. Design: In two samples of college students, participants were randomised to a neutral or negative mood induction. Main Outcome Measures: The traditional DEBQ and the original and revised versions of the EES were used to measure self-reported emotional eating. Emotional eating was assessed in the laboratory using a bogus taste test. Subjects were asked to taste various foods, and food intake was measured. Results: In both samples, self-reported emotional eating using the DEBQ and EES was unrelated to laboratory measured emotional eating (i.e. food consumed during the bogus taste test). Conclusion: Future research in this area would benefit from using diverse samples and development of novel methods of assessing emotional eating.

The mindful attention and awareness scale is associated with lower levels of high-frequency heart rate variability in a laboratory context.

Trait mindfulness has been associated with well-being. A key component of trait mindfulness is intentional attention and awareness which is most commonly measured by the Mindful Attention and Awareness Scale (MAAS). This study investigated the relationship between the MAAS and cardiovascular (HF-HRV, heart rate) reactivity to two laboratory stressors that evoked different patterns of change in heart rate (HR). One stressor (viewing a video of a surgery) evoked HR deceleration while the other stressor (mental arithmetic) evoked HR acceleration. Undergraduate students completed the MAAS and were then exposed to the two stressors while ECG (electrocardiography) was recorded. Findings support the reliability of the stressors to induce expected differential cardiovascular responses and explicate the role of parasympathetic activation. Further, a main effect for MAAS was observed indicating that across laboratory conditions, persons scoring higher on the MAAS had lower HF-HRV relative to persons scoring lower on the MAAS. These findings suggest that higher levels of intentional attention and awareness in a laboratory context might promote parasympathetic withdrawal because these participants were more vigilant, experienced higher cognitive load, and detected more threat cues. Implications for the MAAS and cardiovascular responses to stress are discussed.

Emotion regulation difficulties and impaired working memory interact to predict boredom emotional eating.

Emotional eating (EE), or eating in response to emotions, is related to depression, binge eating, and weight gain. Emotion regulation difficulties are a risk factor for EE. Working memory deficits may also be a risk factor for EE, as working memory is an important cognitive factor in emotion regulation. The current study is a secondary analysis that examined whether working memory moderated the relationship between emotion regulation and emotional eating. A college student sample completed measures of EE in response to depression, boredom, and anxiety/anger (Emotional Eating Scale), emotion regulation (Difficulties in Emotion Regulation Scale) and a working memory task (AOSPAN). Moderated regression analyses were conducted. Conditional moderation was observed, such that greater emotion regulation difficulties were associated with boredom EE, when working memory was one standard deviation (SD) below average. Moderation analyses were not significant when examining associations between working memory, emotion regulation difficulties, and depression and anxiety EE. Findings suggest that the correlates of boredom EE may be different than depression and anxiety/anger EE. Although the current study was cross-sectional, it is possible that individuals with poorer working memory and emotion regulation difficulties, especially in tandem, may be at increased risk for boredom EE.

Eating when depressed, anxious, bored, or happy: Are emotional eating types associated with unique psychological and physical health correlates?

The majority of research on emotional eating has examined general emotional eating, to the exclusion of more distinct emotions such as boredom and positive emotions. The current study aimed to examine whether specific types of emotional eating (i.e., eating in response to depression (EE-D), anxiety/anger (EE-A), boredom (EE-B), and positive emotions (EE-P)) were related to a range of psychological (i.e., global psychological well-being, eating disorder symptoms, emotion regulation) and physical health variables. A sample of adults (n = 189) with overweight/obesity were recruited via Amazon Mechanical Turk. Participants self-reported height and weight and completed a battery of questionnaires. Correlational analyses showed that more frequent EE-D, EE-A, and EE-B were related to poorer psychological well-being, greater eating disorder symptoms, and more difficulties with emotion regulation. EE-P was not significantly related to outcome variables. In regression analyses, eating in response to depression (EE-D) was the type of emotional eating most closely related to psychological well-being, eating disorder symptoms, and emotion regulation difficulties. Exploratory analyses revealed associations between EE-D, EE-A, and EE-B and facets of emotion regulation and specific disordered eating symptoms. Findings suggest that unique patterns exist between specific types of emotional eating and psychological outcomes.