Ecological momentary assessment of eating episodes in obese adults

Objective: The context of eating episodes in obesity is poorly understood. This study examined emotional, physiological, and environmental correlates of pathological and nonpathological eating episodes in a heterogeneous sample of obese adults.Methods: Communitybased participants (n = 50; 84% female [n = 42]; mean [standard deviation] body mass index = 40.3 [8.5]; mean [standard deviation] age = 43.0 [11.9]) recorded all eating episodes and their emotional, physiological, and environmental correlates via ecological momentary assessment for 2 weeks. Generalized estimating equations examined relations between these variables and eating episodes characterized by both self-identified loss of control (LOC) while eating and overeating (binge eating; BE), LOC only, overeating only (OE), and neither LOC nor OE (nonpathological eating). Results: Episodes involving loss of control (BE and LOC) were associated with heightened preepisode and postepisode negative effects (Wald Χ2 range, 15.67-24.39; p values < .001), whereas those involving overeating (BE and OE) were associated with the lowest preepisode and postepisode hunger (Wald Χ2 range, 18.14-39.75; p values <.001). LOC episodes were followed by heightened postepisode cravings (Wald Χ2 = 25.87; p < .001) and were most likely to occur when participants were alone (Wald Χ2=13.20; p = .004). Conclusion: BE and LOC eating were more consistently associated with emotional and physiological cues than OE and nonpathological eating, whereas most environmental variables did not differ among eating episode types. Results support distinctions among the different constructs characterizing aberrant eating and may be used to inform interventions for obesity and related eating pathology.