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Identifying Mechanisms that Predict Loss of Control (LOC) Eating Using Ecological Momentary Assessment: A pilot study
Uniformed Services University Of The Health Sciences Bethesda United States
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Binge eating disorder BED is the most prevalent eating disorder in the U.S., with estimates ranging from 2.5 in the community to 30 in overweight, treatment seeking individuals. In youth, full-syndrome BED is rare, however rates of binge eatingBE and loss of control LOC eating in absence of the full syndrome range from 6 - 40, with the highest rates observed in overweight adolescent girls. Given ambiguity surrounding what amount of food constitutes a binge among growing youth of varying ages and energy requirements, the experience of LOC is considered the most salient feature of pathological eating, rather than the amount of food consumed. In youth, LOC eating is associated with elevated eating pathology and general psychological symptoms and is predictive of excess weight gain and worsening eating pathology. Despite its adverse correlates, little is known about the etiology of LOC eating, specifically, the moment-to-moment processes promoting LOC episodes. One model used to explain LOC eating is the interpersonal model, positing that interpersonal problems precede and predict negative affect, which in tum precedes and predicts episodes of LOC eating. Despite support for links between model components, no study has directly tested the interpersonal model in a temporally sensitive and ecologically-valid manner. The present study examined the feasibility of using ecological momentary assessment to examine the interpersonal model of LOC among overweight adolescent girls who experience LOC eating. Additionally, because youth and individuals with eating pathology are thought to have difficulty identifying and describing their emotional states, negative affect was also assessed using a physiologic proxy, heart rate variability, as an index of emotional stress. Thirty participants who experienced LOC completed ecological momentary assessments multiple times per day for a period of two weeks. Heart rate variability was assessed on a subset of two days of ...
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