Elsevier

Appetite

Volume 151, 1 August 2020, 104688
Appetite

Negative and positive emotional eating uniquely interact with ease of activation, intensity, and duration of emotional reactivity to predict increased binge eating

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Abstract

Binge eating is present in obesity and clinical eating disorder populations and positively associated with poor health outcomes. Emotional eating may be related to binge eating, but relationships with emotional reactivity remain unexplored. The present study examined the relationships between negative and positive emotional eating and emotional reactivity in predicting binge eating. A cross-sectional study was employed using an online community sample in the United States. Participants (N = 258) completed surveys assessing negative (Emotional Eating Scale-Revised, depression subscale) and positive emotional eating (Emotional Appetite Questionnaire), negative and positive emotional reactivity (Perth Emotional Reactivity Scale), and binge eating (Binge Eating Scale). Six moderation analyses were calculated with negative and positive emotional reactivity (ease of activation, intensity, and duration) as moderators of the relationship between negative and positive emotional eating, respectively, and binge eating. Increased negative emotional eating was associated with increased binge eating when duration of negative emotional reactivity was 1 standard deviation above average (p < .001), but at 1 standard deviation below average (p < .001), increased negative emotional eating was associated with decreased binge eating. Increased positive emotional eating was associated with increased binge eating when intensity (p < .01) of positive emotional reactivity was 1 standard deviation above average and when activation (p < .05) of positive emotional reactivity was slightly above 1 standard deviation above average. Increased positive emotional eating was associated with decreased BE when intensity of positive emotional reactivity was 1 standard deviation below (p < .05) average. Emotional reactivity may uniquely impact the relationship between emotional eating and binge eating. Research and clinical implications for the contribution of negative and positive emotional eating and emotional reactivity on binge eating are discussed.

Introduction

Binge eating (BE) is characterized as the consumption of an unusually large amount of food over a short period of time coupled with feelings of loss of control during the eating episode (American Psychiatric Association [APA], 2013). Some research holds that BE is the most common eating disorder symptom (Mitchison & Mond, 2015). BE has gained research attention because of its relevance across all clinical eating disorders (APA, 2013) and significant psychological comorbidity (Bulik, Sullivan, & Kendler, 2002; Yanovski, Nelson, Dubbert, & Spitzer, 1993). In addition, BE has emerged as a significant public health concern because it is a risk factor for weight gain, obesity, and related secondary health conditions such as high blood pressure, type 2 diabetes, and heart disease (Bankier, Januzzi, & Littman, 2004; Bulik et al., 2002; Hasler et al., 2004; Telch, Agras, & Rossiter, 1988; Yanovski et al., 1993). Understanding factors related to the development and maintenance of BE is critical to improving prevention and treatment outcomes.

Emotional eating, or eating triggered by emotions in the absence of physiological hunger (Arnow, Kenardy, & Agras, 1995), is one factor that may be related to BE. Emotional eating and BE are distinct constructs. For example, emotional antecedents are not required to trigger BE (APA, 2013), nor is eating an unusually large amount of food over a short period of time required for emotional eating (Arnow et al., 1995). Even more, BE has marked feelings of loss of control during the eating episode (APA, 2013), a clinical feature unshared by emotional eating. That said, emotional eating and BE share negative health consequences (e.g., weight gain and obesity; Fairburn et al., 1998; Hudson, Hiripi, Pope Jr, & Kessler, 2007; Koenders & van Strien, 2011; Raman, Smith, & Hay, 2013; Udo & Grilo, 2018). Emotional eating is further conceptualized along negative and positive emotional dimensions (Nolan, Halperin, & Geliebter, 2010), leading some to consider how such diverse emotions relate to eating behavior including BE.

Negative and positive emotional eating may be associated with overeating and BE. In the context of negative emotional eating, several theories have been put forth to explain the relationship with BE. According to affect regulation theories of BE, BE is elicited to reduce the internal experience of negative emotions (Heartherton & Baumeister, 1991; Pine, 1985; Polivy & Herman, 1993). While research into the mechanisms of positive emotional eating is limited, some research holds that positive emotional eating may be driven by hedonic (Macht, 1999) or external influences (van Strien, Konttinen, Homberg, Engels, & Wikens, 2016). Research has demonstrated that consumption of highly palatable foods (e.g., both savory and sweet foods) was greater after positive mood inductions than negative mood inductions (Cardi, Leppanen, & Treasure, 2015) and that positive emotions, compared to negative emotions, are related to increased pleasantness and motivation to eat food (Macht, 1999; Macht, Roth, & Ellgring, 2002). Because some estimates hold that positive emotional eating occurs just as frequently as negative emotional eating (Macht, Haupt, & Salewsky, 2004), more research is needed to understand how the full range of emotions influence eating behavior, specifically BE.

Research has revealed negative correlations between negative and positive emotional eating across various emotional eating instruments (e.g., Emotional Appetite Questionnaire and Dutch Eating Behavior Questionnaire; Geliebter & Aversa, 2003; Nolan et al., 2010; van Strien, Frijters, Bergers, & Defares, 1986; van Strien, Rookus, Bergers, Frijters, & Defares, 1986). For example, Nolan et al. (2010) found significant negative correlations between negative and positive emotional eating dimensions on the Emotional Appetite Questionnaire, consistent with other research using the Emotional Eating Scale (Braden, Musher-Eizenman, Watford, & Emley, 2018). In experimental settings, individuals who are more likely to endorse negative rather than positive emotional eating consumed more snacks after a negative mood induction (van Strien et al., 2013). Interestingly, a recent meta-analysis of experimental paradigms demonstrated that the link between negative emotions and food consumption was not present while a small, significant effect for increased eating was found for positive emotions (Evers, Dingemans, Junghans, & Boevé, 2018). It should be noted, however, this review did not consider the effects of negative and positive emotions on maladaptive eating behaviors such as BE.

Negative emotional eating has been found to be positively associated with BE. For example, research has identified that individuals with binge eating disorder were more likely to engage in negative emotional eating than both individuals with eating disorder not otherwise specified and control participants (Eldredge & Agras, 1996). These early data set the stage for continued research on negative emotional eating and BE, which has been replicated in the literature (Agras & Telch, 1998; Fischer et al., 2007; Tanofsky, Wilfley, Spurrell, Welch, & Brownell, 1997; Telch & Agras, 1996a, 1996b). What is less clear is the relationship between positive emotional eating and BE.

Recent research has shown that increased positive emotional eating may be related to overeating and BE (Bongers, de Graaff, & Jansen, 2016; Bongers, Jansen, Havermans, Roefs, & Nederkoorn, 2013; Bongers, Jansen, Houben, & Roefs, 2013; Evers, de Ridder, & Adriaanse, 2009; Sultson, Kukk, & Akkermann, 2017). A majority of this research has examined if positive emotional eating leads to overeating (Bongers, Jansen, Havermans et al., 2013; Bongers, Jansen, Houben et al., 2013; Bongers et al., 2016; Evers et al., 2009) not BE, leaving only one study that has directly explored the relationship between positive emotional eating and BE (Sultson et al., 2017). Sultson and colleagues identified a moderate, positive correlation between positive emotional eating and BE, with positive emotional eating continuing to predict BE after controlling for negative emotional eating in healthy adults (Sultson et al., 2017). Although previous research cites evidence for associations between negative and positive emotional eating and BE, no research has examined factors that may strengthen the relationship between emotional eating and BE.

Emotional reactivity is one factor that may interact with emotional eating to influence BE. Emotional reactivity is characterized as an emotional response to a stimulus that varies by individual and by ease of activation, intensity, and duration (Davidson, 1998; Rothbart & Derryberry, 1981). These levels of variability in the time-course progression of emotional responses are supported by a body of research (Becerra, Preece, Campitelli, & Scott-Pillow, 2017; Davidson, 1998; Gruber, Harvey, & Purcell, 2011; Mauss, Cook, Cheng, & Gross, 2007) and significant variance in emotional reactivity underscores many models of psychopathology (Gross & Jazaieri, 2014; Linehan, 1993; Rottenberg & Johnson, 2007). This research also holds that returning emotional reactivity to baseline is a central tenant across diverse psychotherapeutic treatment programs (Barlow et al., 2010; Linehan, 1993). Thus, exaggerated emotional reactivity across both negative and positive emotions could have additive effects on emotional eating in which eating is engaged in response to these very emotions.

In the context of negative emotional reactivity, experience sampling methods show that negative emotional reactivity played an important role in the experience of negative emotions in overweight adults with BE (Lingswiler, Crowther, & Stephens, 1987). This research also identified that duration of negative emotions, as opposed to intensity of negative emotions, was related to BE severity (Lingswiler et al., 1987). More recent research has demonstrated that negative reactivity plays an important role in the development of disordered eating attitudes in adolescents, important antecedents to disordered eating behaviors including BE (Evans et al., 2019). To the understanding of the authors, no research to date has directly examined the moderating influence of negative emotional reactivity on the relationship between negative emotional eating and BE. Similarly, limited research has endeavored to understand the relationships between positive emotional reactivity and BE.

One recent laboratory-based study showed that positive, but not negative, emotional reactivity to food images was positively associated with BE among college students (Racine, Hebert, & Benning, 2018). Thus, positive emotional reactivity and reward valuation of food and eating cues may be related to BE (Racine et al., 2018; Schag, Schönleber, Teufel, Zipfel, & Giel, 2013; Simon et al., 2016). Like research on negative emotional reactivity, positive emotional reactivity maps onto the experience of these emotions in everyday life (Becerra et al., 2017; Davidson, 1998; Rothbart & Derryberry, 1981); thus, this general index of emotional reactivity could be useful in assessing emotional eating in which general emotions, not food-specific emotions, are purported antecedents to eating behavior. Indeed, despite evidence that positive emotional reactivity may be related to increased BE, this study (Racine et al., 2018) primarily focused on food-specific positive emotions as opposed to positive emotionality more broadly. Therefore, the present study builds on this work by examining negative and positive emotional reactivity (i.e., ease of activation, intensity, and duration of emotions) as potential moderators of the relationships between negative and positive emotional eating and BE.

The present study used theories of negative and positive emotional eating and emotional reactivity (Arnow et al., 1995; Becerra et al., 2017; Davidson, 1998; Macht, 1999; Macht et al., 2002; Rothbart & Derryberry, 1981) to examine these variables as potential correlates of BE. Because no research to date has examined negative and positive emotional eating and emotional reactivity together in the prediction of BE, the present study was exploratory in nature. While research on the positive association between negative emotional eating and BE is more clear (Agras & Telch, 1998; Fischer et al., 2007; Tanofsky, Wilfley, Spurrell, Welch, & Brownell, 1997; Telch & Agras, 1996a, 1996b), the present study added to this understanding by exploring how negative emotional reactivity moderated this relationship. The present study also added to limited work identifying that increased positive emotional eating was associated with BE (Sultson et al., 2017), as well as limited work identifying a positive association between positive emotional reactivity and BE (Racine et al., 2018). To this end, we aimed to understand if negative and positive emotional reactivity (i.e., ease of activation, intensity, and duration of emotional reactivity) strengthened the relationship between emotional eating and BE.

Section snippets

Participants

Participants (N = 258) were recruited through Amazon Mechanical Turk (MTurk; a paid participant database run through Amazon.com) to participate in a cross-sectional study on eating behaviors, childhood experiences, and health. The current study is a secondary analysis of a primary study that examined correlates of emotional eating (Braden et al., under review). Inclusion criteria were that participants were adults (≥18 years), residents of the U.S., and fluent in English. Initially, 638

Preliminary results

Of the sample of 258 participants, 2 participants (0.78%) reported implausible age values and 20 participants (7.75%) reported height and weight values that yielded unlikely BMI values or BMI values which may indicate moderate to severe thinness (i.e., BMI < 17; World Health Organization, 1995). Unlikely BMI values were determined by identifying subjects who reported impossible height or weight data (e.g., weight of 3 pounds). BMI values which may indicate moderate to severe thinness were

Discussion

Binge eating cuts across all clinical eating disorders (APA, 2013) and is positively associated with a range of negative health outcomes including weight gain and obesity (Fairburn et al., 1998; Hudson, Hiripi, Pope, & Kessler, 2007; Raman et al., 2013; Udo & Grilo, 2018). Research has endeavored to understand risk and maintenance factors associated with BE, including the complex role of emotional eating. Adding to this research, the present study investigated the interaction between negative

Conclusions

Taken together, the results of the present study provide initial evidence for the interaction between negative and positive emotional eating and aspects of emotional reactivity to predict BE. Here, we show that people who engage in increased positive emotional eating, and who also feel increased ease of activation and intensity of positive emotions, were predicted to have increased BE. We also show that people who engage in increased negative emotional eating, coupled with increased duration of

Declaration of competing interest

None.

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    • ‘Quarantine 15’: Pre-registered findings on stress and concern about weight gain before/during COVID-19 in relation to caregivers' eating pathology

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      Another eating phenotype potentially impacted by stress and concern about weight gain is emotional eating (EE). EE, or the urge to eat in response to negative emotions in the absence of hunger (Arnow, Kenardy, & Agras, 1995), is positively associated with DE attitudes, cognitions, and behaviors across diverse symptom presentations (Barnhart, Braden, & Jordan, 2020; Barnhart, Braden, & Price, 2021; Braden, Musher-Eizenman, Watford, & Emley, 2018; Duarte & Pinto-Gouveia, 2015; Fischer et al., 2007; Ricca et al., 2012). Furthermore, EE is positively related to stress (Oliver, Wardle, & Gibson, 2000), concern about weight gain (Belcher et al., 2011), and appears to be elevated during COVID-19 (Elmacioğlu, Emiroğ; Al-Musharaf, 2020); however, no research to date has explored relationships among these constructs with specific EE types like EE-depression, EE-anger/anxiety, and EE-boredom as outcomes (Arnow et al., 1995; Koball, Meers, Storfer-Isser, Domoff, & Musher-Eizenman, 2012).

    • Relationships among perceived stress, emotional eating, and dietary intake in college students: Eating self-regulation as a mediator

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      One systematic review indicated that internal cues such as stress and anxiety might elicit a greater urge to eat than external cues such as the presence of palatable, but unhealthy food (Frayn & Knäuper, 2018). Emotional eating can result in binge eating disorder (Barnhart, Braden, & Jordan, 2020; Ricca et al., 2009) and excessive weight gain (Diggins, Woods-Giscombe, & Waters, 2015; Lazarevich, Irigoyen Camacho, Velázquez-Alva, & Zepeda Zepeda, 2016), contributing to the phenomenon of U.S. students gaining the Freshman 15 (Vadeboncoeur, Townsend, & Foster, 2015). One study with 967 college students reported that students on average had moderate emotional eating behavior and about 10% had food addiction (Yu & Tan, 2016).

    • Emotion regulation difficulties interact with negative, not positive, emotional eating to strengthen relationships with disordered eating: An exploratory study

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      Third, the present study explored research questions with non-clinical presentations of DE to hone in on research questions specific to emotional eating (see parent study, Braden et al., 2020). However, it is known that emotional eating and DE occur in non-clinical populations (Barnhart et al., 2020; Braden et al., 2018; Cooley & Toray, 2001; Krahn et al., 2005) and data from the present study provide a springboard for future research to examine potential constraints on generality with diverse, clinical samples (Henrich et al., 2010; Simonds et al., 2017). Fourth, the present study conceptualized emotion regulation broadly and did not parse out specific facets of emotion regulation such as impulsiveness, non-acceptance of emotions, difficulty engaging in goal-directed behavior, limited use of emotion regulation strategies, awareness of emotions, and lack of emotional clarity that could further explain findings.

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