Do emotion regulation difficulties when upset influence the association between dietary restraint and weight gain among college students?

Obesity is a significant public health concern that affects more than one-fifth of adolescents aged 12-19 in the United States. Theoretical models suggest that prolonged dietary restraint leads to binge-eating behaviors, which in turn increases individuals' risk for weight gain or obesity. Results from the literature indicate a potential role for negative urgency (the tendency to act rashly when distressed) as a mediating variable that explains the link between dietary restraint and binge-eating episodes. The current study tested short-term, prospective longitudinal associations among dietary restraint, binge eating, negative urgency, and weight gain among college students - a population at increased risk for the development of overweight and obesity. We hypothesized that dietary restraint and weight gain would be mediated by negative urgency and binge eating, but only among participants with overweight and obesity. College students (N = 227) completed the Eating Pathology Symptoms Inventory, UPPS-P Impulsivity Scale, and self-reported weight and height to calculate body mass index. Results showed that the association between dietary restraint and weight gain was mediated by negative urgency and binge eating, but only among participants with overweight and obesity. Our findings indicated that negative urgency might represent a mechanism that explains why dietary restraint leads to future binge-eating episodes and weight gain among college students with overweight and obesity. Results suggest that future treatment and prevention programs for overweight and obesity may benefit from incorporating strategies to improve emotion regulation as a way to reduce binge eating and to prevent additional weight gain among 'at-risk' populations.

Is "drunkorexia" an eating disorder, substance use disorder, or both?

Researchers have identified a specific behavior pattern labeled "drunkorexia" to describe recurrent inappropriate compensatory behaviors (e.g., fasting and self-induced vomiting) to avoid weight gain from consuming alcohol (referred to as ICB-WGA). Several studies have investigated the prevalence of these behaviors among college students, but few have tested whether this behavior pattern is more strongly related to substance use or disordered eating, which may have future implications for eating disorder and substance abuse research fields. The aim of this project was to test: (1) whether disordered eating or alcohol use adds incremental validity to the prediction of ICB-WGA when controlling for the other variable and (2) the effect of sex on ICB-WGA. College participants (N=579; 53% female) completed the Eating Pathology Symptoms Inventory (EPSI), the Alcohol Use Disorders Identification Test (AUDIT), and several questions designed to measure ICB-WGA. Results indicated that EPSI Restricting and Body Dissatisfaction scales were not significant predictors of ICB-WGA, whereas the AUDIT and EPSI Cognitive Restraint, Excessive Exercise, Purging, and Binge Eating scales significantly predicted ICB-WGAs. Results indicated that disordered eating and alcohol use both added incremental validity to the prediction of ICB-WGA; however, ICB-WGA was more strongly related to disordered eating, and this was particularly true for women. Our findings suggest that individuals engaging in ICB-WGA may be at-risk for future development of both eating and substance disorders. Notably, our findings highlight the need for future research to focus on trans-diagnostic prevention programs that target mechanisms that underlie both disordered eating and substance misuse.

Are common measures of dietary restraint and disinhibited eating reliable and valid in obese persons?

Disordered eating measures were developed and validated in primarily normal weight samples; thus, it is unclear if the psychometric properties are equivalent across weight groups. This study evaluated the reliability and validity of self-reported disinhibited eating and dietary restraint measures in a community-recruited sample of overweight individuals (N = 201) and obese individuals (N = 101) and normal weight matched controls. Coefficient alpha and average inter-item correlations were used to test internal consistency reliability. Correlations between lifetime disordered eating behaviors and measures of dietary restraint and disinhibited eating were used to test convergent validity. Disordered eating measures included: Eating Disorders Examination Questionnaire (EDE-Q), Three Factor Eating Questionnaire (TFEQ), Dutch Eating Behavior Questionnaire (DEBQ), Eating Disorders Inventory-3 (EDI-3), and Restraint Scale. Correlations between lifetime disordered eating behaviors and measures of non-disordered-eating-related psychopathology were used to test discriminant validity. Results indicated that most measures demonstrated acceptable internal consistency reliability across groups, with the exception of the Restraint Scale. Significantly higher convergent correlations between lifetime history of fasting and TFEQ Cognitive Restraint emerged for the overweight vs. obese group, and the magnitude of discriminant correlations between lifetime history of binge eating and the Inventory of Depression and Anxiety Symptoms (IDAS) Well Being scale was stronger in the normal weight vs. overweight group. Findings suggest the majority restrained and disinhibited eating measures are reliable and valid among weight groups, and are suitable to use in overweight and obese populations.

Characterization of eating patterns among individuals with eating disorders: what is the state of the plate?

Eating disorders will affect approximately 18 million individuals in the United States at some point in their lives, and are associated with significant psychological distress, psychosocial and quality-of-life impairment, medical morbidity, and mortality. Although aberrant eating behaviors play a central role in diagnostic definitions for eating disorders, much remains to be learned about eating patterns, diet quality, and energy balance among individuals with eating pathology. The goal of the current paper was to systematically review and integrate findings from published research studies characterizing the eating behaviors of individuals with eating disorders, including findings from both descriptive and laboratory-based research. We also describe results from studies using ecological momentary assessment - a methodology that assesses individuals' behaviors in their natural environment as they occur, which may reduce retrospective recall bias, and provide improved ability to prospectively assess the temporal occur of changes in multiple eating behaviors over time. We conclude with suggestions for future research, including the need for additional studies to test for differences in eating patterns among different demographic groups of individuals with eating disorders, and the need for new, more objective, assessment tools.

Gender norms, psychometric properties, and validity for the Eating Pathology Symptoms Inventory.

OBJECTIVE: The Eating Pathology Symptoms Inventory [EPSI; Forbush KT, Wildes JE, Pollack LO, Dunbar D, Luo J, Patterson K, et al. Development and validation of the EPSI. Psychological Assessment, in press] is an empirically derived self-report measure of eating disorder (ED) symptoms. The EPSI is able to capture the majority of variance associated with established ED measures, yet possesses additional content that is not currently represented in any existing multidimensional ED measure. The purpose of this study was to present normative and psychometric data for the EPSI in a large sample of college men (N = 502) and women (N = 625). METHOD: Participants completed the EPSI and a battery of self-report measures to evaluate convergent and discriminant validity. To provide context as to how normative scores compare to ED psychopathology, undergraduate student scores were compared to scores from individuals with EDs (N = 150). RESULTS: Confirmatory factor analyses indicated that the EPSI had a robust eight-factor structure that was replicated in both men and women. Mean scores for most scales were significantly higher in women, except for Excessive Exercise, Muscle Building, and Negative Attitudes toward Obesity, which were significantly higher in men. Most scale scores were significantly lower in college students than in patients with EDs. Results indicated excellent convergent and discriminant validity in both genders. DISCUSSION: These data provide the first large-scale normative data for the EPSI in young adults, as well as additional evidence supporting the psychometric properties and construct validity of the EPSI.