Abstract
Purpose
Individuals with anorexia (AN) or bulimia nervosa (BN) often present with fear of loss of control in the context of eating. It is unclear whether this fear of loss of control, which has been associated with fear of failure and a sense of not being in charge of one’s own life in eating disorders, can be distinguished from self-perceived maintained control over food intake in AN. Further, anxious traits are elevated across eating disorders and could contribute to this fear of loss of control.
Methods
We recruited 113 adult women: restricting type AN (n = 26), BN (n = 28), and healthy controls (CW, n = 59). Participants completed the Eating Expectancies Inventory (EEI), which assesses learned expectations on the effects of eating, including whether Eating Leads to Feeling out of Control, and the Trait Food Craving Questionnaire (FCQ-T), which measures food craving and the ability to withstand those cravings, including self-perceived Lack of Control Over Eating.
Results
Eating Leads to Feeling out of Control was elevated in AN and BN compared to CW. Lack of Control Over Eating was similar between AN and CW but elevated in BN. Intolerance of uncertainty correlated with those measures in CW only.
Conclusion
Individuals with restricting-type AN experience feeling out of control when eating while maintaining self-perceived control over eating. The EEI’s eating leads to feeling out of control is associated with negative self-improvement expectations. Targeting self-improvement through more functional strategies could be an important aspect in psychotherapy in AN and reduce the perceived need to restrict food intake.
Level of evidence
Level III, Evidence obtained from well-designed cohort or case–control analytic studies.
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Data availability
The data that support the findings of this study are available from the corresponding author upon reasonable request.
References
Hohlstein L, Smith G, Atlas J (1998) An application of expectancy theory on eating disorders: development and validation of measures of eating and dieting expectancies. Psychol Assess 10:49–58
Brownstone LM, Bardone-Cone AM, Fitzsimmons-Craft EE, Printz KS, Le Grange D, Mitchell JE, Crow SJ, Peterson CB, Crosby RD, Klein MH, Wonderlich SA, Joiner TE (2013) Subjective and objective binge eating in relation to eating disorder symptomatology, negative affect, and personality dimensions. Int J Eat Disord 46(1):66–76. https://doi.org/10.1002/eat.22066
Cepeda-Benito A, Gleaves D, Williams T, Erath S (2000) The development and validation of the state and trait food-cravings questionnaires. Behav Ther 31(1):151–173
Trindade IA, Ferreira C (2014) The impact of body image-related cognitive fusion on eating psychopathology. Eat Behav 15(1):72–75. https://doi.org/10.1016/j.eatbeh.2013.10.014
Forrest LN, Sarfan LD, Ortiz SN, Brown TA, Smith AR (2019) Bridging eating disorder symptoms and trait anxiety in patients with eating disorders: a network approach. Int J Eat Disord 52(6):701–711. https://doi.org/10.1002/eat.23070
Frank GK, Roblek T, Shott ME, Jappe LM, Rollin MD, Hagman JO, Pryor T (2012) Heightened fear of uncertainty in anorexia and bulimia nervosa. Int J Eat Disord 45(2):227–232. https://doi.org/10.1002/eat.20929
Meule A (2020) Twenty years of the food cravings questionnaires: a comprehensive review. Curr Addict Rep 7:30–43
Cloninger CR (1994) The temperament and character inventory (TCI): a guide to its development and use, 1st edn. Center for Psychobiology of Personality, Washington University, St. Louis
Spielberger CD (1983) Manual for the state-trate anxiety inventory. Consulting Psychologists Press Inc, Palo Alto
Buhr K, Dugas MJ (2002) The intolerance of uncertainty scale: psychometric properties of the English version. Behav Res Ther 40(8):931–945
Acknowledgements
This study was supported by the National Institute of Mental Health grants MH096777 and MH103436. We would like to thank all the individuals who have participated in this study.
Funding
The study was supported by the National Institute of Mental Health grants MH096777 and MH103436.
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All authors contributed to the study conception and design. Material preparation, data collection, and analysis were performed by GKWF and MES. The first draft of the manuscript was written by LA and all authors commented on previous versions of the manuscript. All authors read and approved the final manuscript.
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The authors have no relevant financial or non-financial interests to disclose.
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This study was approved by the Colorado Multiple Institutional Review Board. The procedures used in this study adhere to the tenets of the Declaration of Helsinki.
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Written informed consent was obtained from all individual participants included in the study.
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Adler, L., Brown, T.A., Shott, M.E. et al. I know I am not out of control, but I just cannot shake the feeling: exploring feeling out of control in eating disorders . Eat Weight Disord 27, 839–845 (2022). https://doi.org/10.1007/s40519-021-01211-7
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DOI: https://doi.org/10.1007/s40519-021-01211-7