Q: How are emotions and eating disorders
like anorexia nervosa (AN) connected?
A: Eating
disorders occur when food and weight become a central focus of one’s life,
leading to unhealthy behaviors like extreme dietary restraint, binge eating,
and purging (i.e., self-induced vomiting or the misuse or laxatives or water
pills). A focus on food and weight is especially challenging in a culture where
there is an excess of food and a focus on thinness.
Eating
disorders are psychiatric conditions that are closely tied to emotions, and
include anorexia nervosa, bulimia nervosa, and binge eating disorder. The cause of eating disorders is unknown.
Genetic factors, family issues, psychological factors, or traumatic events all
may play a role. In anorexia
nervosa (AN), individuals have an intense fear of gaining weight and an inability
to maintain a normal body weight. AN often
is associated with perfectionism, social anxiety, emotional inhibition,
reluctance to take risks, and conflict avoidance.
In bulimia
nervosa, individuals attempt to restrict dietary intake, and engage in binge
eating and purging episodes. Individuals
who binge eat or purge, as a part of AN or bulimia nervosa, are more likely to
engage in secretive behavior, experience unstable moods and thought patterns,
and be hypersensitive to criticism.
A common pattern
in all eating disorders is an inability to regulate emotions, which was the
focus of our study.
Q: Previous research has shown that those
with anorexia nervosa (AN) struggle with emotion regulation. What is different about your new study?
A: Yes, there is a lot of research
connecting problems with emotion regulation to anorexia nervosa (AN). Those with AN often have difficulty recognizing
and understanding emotional experiences both in themselves and in other people,
pay less attention to and are less aware of emotions in general, and struggle
to cope with negative emotions. Individuals with AN also may have problems with
behavior control; for example, binge eating is an impulsive behavior. Some
experts think that eating disorder behaviors actually develop as a method of emotion
regulation in individuals who have pre-existing problems controlling their
emotions.
Our study
provides new information about the relation between specific aspects of emotion regulation and particular AN
symptoms such as low body weight and purging episodes. We used previous research and an emotion
regulation assessment tool to understand the function of specific eating
disorder symptoms among nearly 200 patients with AN.
Q:
What did your study find?
A: Recurrent binge eating and
recurrent purging were associated with impulse control difficulties when upset,
whereas frequent thoughts about eating, weight and shape (i.e., eating disorder
cognitions) were associated with numerous emotion regulation difficulties. When
we looked at multiple predictors of these symptoms at the same time, impulse
control difficulties when upset continued to be associated with binge eating
and purging, while poor emotional awareness was related to eating disorder
cognitions. There was no significant relationship between emotion regulation
and low body weight.
Q:
What does this mean for treatment?
A: The more we
understand about emotion regulation and eating disorders, the better able we
will be to promote recovery from AN. Specifically,
this work could help to advance treatments designed to reduce
AN symptoms through enhancement of emotion regulation skills.
You can learn more about eating disorders treatment options, too, by checking out the Center for Overcoming Problem Eating (COPE) here in Pittsburgh.