Subjective binge eating: a marker of disordered eating and broader psychological distress

Abstract

Purpose

There is building, but limited evidence to suggest that subjective binge eating (SBE) is clinically concerning. The current study examined associated features of SBEs including disordered eating, body shame, negative affect, and interpersonal problems, as well as how SBE occurrence relates to other daily eating experiences.

Methods

Participants were 400 individuals recruited via internet snowball or Amazon Mechanical Turk, including 132 with at least one SBE [with or without objective binge eating episodes (OBEs)] in the prior 3 months, 135 with at least one OBE (and no SBEs) in the prior 3 months, and 133 with no loss of control eating in the prior 3 months nor a likely lifetime history of anorexia nervosa. Participants responded to questionnaires assessing eating disorder behaviors (i.e., frequency of compensatory behaviors, dietary restriction), body shame, negative affect (depressive/anxiety symptoms), interpersonal difficulties, and perception of daily eating experiences.

Results

Individuals with SBEs had higher numbers of vomiting, laxative misuse and hard exercise episodes, dietary restriction, body shame, depressive and anxiety symptoms, and negative perceptions of daily eating experiences as compared to those with only OBEs and no loss of control eating.

Conclusion

These results suggest that SBEs (whether on their own or combined with OBEs) are more related to disordered eating symptoms, body image concerns, depressive/anxiety symptoms, and general eating distress than OBEs on their own, suggesting that clinicians may view SBEs as markers of concern across domains.

Level of evidence

III, well-designed group-comparison regression analysis.

Appendix

Selected items used in online survey

UCLA Loneliness Scale Version 3: Participants indicate frequency of experiencing this from “Often”, “Sometimes”, “Rarely”, “Never” [25]. Items included were: “There is no one I can turn to (item 7)”, “No one really knows me well (item 15)”, “I feel isolated from others (item 16)”.

Depression Anxiety Stress Scales (DASS-21): Participants indicate the extent to which the statement “applies to them” on a scale from 0 to 4: “Did not apply to me” (0) to “Applied to me very much or most of the time” (3) [23]. Items included were: “I couldn’t seem to experience any positive feeling at all (item 3)”, “I experienced breathing difficulty (e.g. excessively rapid breathing, breathlessness in the absence of physical exertion) (item 4)”, “I felt that I had nothing to look forward to (item 10)”, “I was aware of the action of my heart in the absence of physical exertion (e.g. sense of heart rate increase, heart missing a beat) (item 19)”, “I felt scared without any good reason (item 20)”, “I felt that life was meaningless (item 21)”.

Multidimensional Scale of Perceived Social Support (MSPSS): Participants indicate on a scale from 1 to 7 the extent to which the agree with the statement (“1” if you Very Strongly Disagree Circle to “7” if you Very Strongly Agree) [26]. Items included were: “I get the emotional help and support I need from my family (item 4)”, “I can talk about my problems with my friends (item 12)”.

Objectified Body Consciousness Scale-Body Shame subscale (OBCS-BS): Participants indicate the extent to which they agree with the statement (“1” if they “Strongly Disagree” to “5” if they “Strongly Agree”) [22]. Items included were: “When I can’t control my weight, I feel like something must be wrong with me (item 9)”, “I feel like I must be a bad person when I don’t look as good as I could (item 11)”.