Do momentary changes in body dissatisfaction predict binge eating episodes? An ecological momentary assessment study
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BRIEF REPORT
Do momentary changes in body dissatisfaction predict binge eating episodes? An ecological momentary assessment study Paakhi Srivastava1 · Megan L. Michael1 · Stephanie M. Manasse2 · Adrienne S. Juarascio2 Received: 24 August 2019 / Accepted: 11 January 2020 © Springer Nature Switzerland AG 2020
Keywords Feeding and eating disorders · Body dissatisfaction · Ecological momentary assessment · Variability in body dissatisfaction
Introduction Extant theoretical models and empirical evidence indicate that body dissatisfaction (BD), the negative subjective evaluation of one’s shape [1], plays a key role in the onset and maintenance of binge eating (BE) pathology. BD has historically been conceptualized and treated as relatively stable, dispositional tendency of individuals with BE pathology to negatively evaluate their body shape. This typical approach to characterizing BD can be defined as trait BD (defined as a stable and unchanging characteristic that is transferable across a wide range of contexts [2]). Consequently, associations between BD and BE have mostly been tested using trait-like measures of BD and longer term assessments of BE (e.g., the Eating Disorder Examination [3]). Emerging data from ecological momentary assessment (EMA) studies have shown that BD may be better conceptualized as a fluid construct that varies across time and contexts (i.e., state BD) [3, 4]. Studies have found that individuals often experience variability in state BD characterized by changing levels of BD within a single day in response to different contexts [3–5]. For instance, a recent study that assessed state BD over 2 weeks of EMA in a non-clinical sample using a 11-point Likert scale found a notable average within-person variation of 4 points between any two consecutive time points [6]. Variability in BD has been shown to * Paakhi Srivastava [email protected] 1
Center for Weight, Eating, and Lifestyle Sciences (WELL Center), Drexel University, Stratton Hall, 3141 Chestnut Street, Philadelphia, PA 19104, USA
Department of Psychology and WELL Center, Drexel University, Stratton Hall, 3141 Chestnut Street, Philadelphia, PA 19104, USA
2
arise due to a variety of internal (e.g., stress levels) and contextual factors (e.g., social settings) [7]. Although evidence suggests that state BD is variable in non-clinical samples, it is currently unknown whether individuals with eating disorders (EDs), who have elevated trait BD compared to the general population, also experience variability in BD. If BD is variable within an ED population, this could change how we conceptualize the role of BD in the etiology and maintenance of BE pathology. While trait BD is commonly viewed as a distal risk factor for BE pathology broadly, state variations in BD may be a proximal risk factor for BE episodes. Day-to-day experiences of individuals with ED (such as seeing oneself in mirrors, exposure to thin-body glorifying media, company of a romantic partner) may cause variability in BD. For instance, in an experimental study, when hea
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