Depressive symptoms, psychological flexibility, and binge eating in individuals seeking behavioral weight loss treatment

Kathryn M. Godfrey, Meghan L. Butryn, Evan M. Forman, Monica Martinez, Savannah R. Roberts, Nancy E. Sherwood

Research output: Contribution to journalArticlepeer-review

5 Scopus citations


Depressive symptoms and binge eating are both prevalent in weight management populations and may be associated with reduced benefit from behavioral weight loss, including higher attrition, more perceived barriers, lower weight loss, and increased weight regain. These two potential risk factors for poor behavioral weight loss outcomes may also be associated with each other as depressive symptoms may trigger binge eating, and binge eating-related distress could increase depressive symptoms. The depressive symptom-binge eating link has not been well studied in weight management samples, and psychological processes involved in this relationship have not yet been elucidated. Psychological flexibility, an individual's ability to be connected with and conscious of the present moment and to engage in values-consistent behavior even in the presence of difficult internal experiences, may be one psychological process that changes the depressive symptom-binge eating relationship. High psychological flexibility may be a protective factor in the association of depressive symptoms with binge eating. This study examined the relationship between depressive symptom and binge eating and a potential interactive role of psychological flexibility. Participants (N = 468, 76% female) completed self-report questionnaires of binge eating, depressive symptoms, and psychological flexibility at baseline prior to initiating behavioral weight loss. Depressive symptoms were positively associated with binge eating (B = 1.00, p < 0.001). Psychological flexibility had an interactive role (B = −0.03, p = 0.005). Among participants with minimal to mild depressive symptoms, those with higher psychological flexibility had less severe binge eating. Findings suggest that psychological flexibility may be a protective factor in the association between depressive symptoms and binge eating in the majority of individuals initiating behavioral weight loss. Psychological flexibility is a psychological process to consider targeting for enhancing efficacy of weight loss treatment, especially among individuals with minimal to mild depressive symptoms and binge eating behavior.

Original languageEnglish (US)
Pages (from-to)50-54
Number of pages5
JournalJournal of Contextual Behavioral Science
StatePublished - Oct 2019

Bibliographical note

Funding Information:
Drs. Butryn, Forman, and Sherwood receive grants from the National Institutes of Health for the current study and related research. Dr. Forman and Dr. Butryn receive royalties from editing and authoring books on acceptance-based treatment for weight management. We certify that all authors otherwise have no affiliation with or financial involvement in any organization or entity with a direct financial interest in the subject matter or materials discussed in the manuscript (e.g., employment, consultancies, stock ownership, honoraria).

Funding Information:
This project was funded by an R01 grant ( R01CA188892 ; PI: Nancy Sherwood) from the National Cancer Institute .

Publisher Copyright:
© 2019


  • Behavioral weight loss
  • Binge eating
  • Depression
  • Psychological flexibility


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