Momentary Mediational Associations Among Affect, Emotion Dysregulation, and Different Types of Loss of Control Eating Among Adults With Binge Eating Disorder

Objective: Few studies have directly assessed the mechanistic role of transdiagnostic self-regulatory factors that are theorized to promote core disinhibited disordered eating behaviors that characterize binge eating disorder (BED) in the natural environment, such as emotion dysregulation. The present study used ecological momentary assessment (EMA) to address this research gap by examining whether: (1) emotion dysregulation mediated associations between negative and positive affect and loss of control (LOC) eating at the within-person level; (2) these associations varied across distinct LOC eating dimensions. Method: Adults with BED (N = 107; M_age = 39.87, SD = 13.35) responded to six surveys per day for a 7-day EMA period. Multilevel structural equation models examined whether momentary emotion dysregulation mediated momentary associations between negative and positive affect, and different LOC eating outcomes (“general” [subjective experience of] LOC while eating; difficulties resisting eating; difficulties stopping eating after starting; feeling driven/compelled to eat; not paying attention to one's eating; feeling disconnected while eating [e.g., numb, zoned out]). Results: Experiencing a sequential worsening of negative affect and, in turn, emotion dysregulation over a day mapped onto higher levels of certain LOC eating outcomes (“general” LOC eating, difficulties resisting eating, driven/compelled to eat, disconnected while eating) but not others (difficulties stopping eating, not paying attention to one's eating). All momentary mediational pathways involving positive affect as a predictor were not significant. Discussion: These findings support emotion dysregulation as a mechanistic process that can precipitate certain types of LOC eating in daily life and may be leveraged to improve BED theory, research, and real-time interventions.