Frances Allyn: Restraint, emotions and health in relation to binge eating.

Aims: This sub-study of the ALSWH project examined attitudes of women hypothesised to be at risk of Binge Eating Disorder (BED). BED is a newly defined psychiatric disorder affecting up to 2% of the general population and 30% of individuals presenting to weight loss clinics. Designed to increase our understanding of the risk factors leading to the development of this disorder, the study tested an integrated dual pathway model of binge eating. The model examines the extent to which certain attitudes and experiences predict binge eating. The two paths tested were a restraint path and an interpersonal pathway. Variables included in the restraint path were sociocultural pressure, ideal-body internalisation, body dissatisfaction, and dietary restraint. Factors tested in the interpersonal path were the presence of interpersonal problems, depression, and emotional eating.
Method: Participants were from the mid-age cohort of the ALSWH project. Our sample of 600 women was randomly selected from a pool of 903 women who responded positively to screening questions on disordered eating in the baseline ALSWH survey (N = 14,011). Participants had a mean age of 49 years. Data were collected from questionnaires returned by 68% of the sample.
Main Findings: The integrative dual pathway model of binge eating was tested by estimation of a structural equation model. The model provided an adequate fir to the data, supporting the majority of hypothesised relationships between binge eating and restraint and interpersonal variables. On the restraint pathway, perceptions of sociocultural pressure were associated with body dissatisfaction, ideal-body internalisation and dietary restraint. Body dissatisfaction predicted dietary restraint and negative affect. Dietary restraint was associated with emotional eating. Emotional eating was a predictor of binge eating. A further funding, not included among the original hypotheses, was that dietary restraint predicts emotional eating.
Conclusions: The findings suggest that sociocultural, interpersonal and emotional factors are all important determinants of binge eating pathology. Restraint theory appears applicable to BED. In addition, the newly tested interpersonal pathway suggests that those individuals with higher levels of interpersonal problems experience negative affect, increasing the likelihood of binge eating by using emotional eating as a coping mechanism. High levels of dietary restraint also appear to increase an individual's susceptibility to emotional eating.
Implications: This study contributes to the identification of risk factors for BED which, when targeted in treatment may be predictive of successful outcomes. In particular, targeting emotional eating amy be an important adjunct to future therapeutic interventions