Film-induced sadness as a trigger for disinhibited eating

Eye-tracking study on the effects of happiness and sadness on body dissatisfaction and selective visual attention during mirror exposure in bulimia nervosa

OBJECTIVE

Abundant research points to the central role of body image disturbances in the occurrence of eating disorders (ED). While emotional arousal has been identified as a trigger for binge eating in bulimia nervosa (BN), empirical knowledge on the influence of emotions on body image in individuals with BN is scarce. The present study sought to experimentally examine effects of a positive and negative emotion induction on body dissatisfaction and selective attention towards negatively valenced body parts among people with BN.

METHOD

In a randomized-controlled cross-over design, happiness and sadness were induced by film clips one-week apart in women with BN (n = 23) and non-ED controls (n = 26). After the emotion induction, participants looked at their body in a full-length mirror, while their attentional allocation was recorded with the help of a mobile eye tracker. Participants repeatedly rated their momentary body dissatisfaction.

RESULTS

Induction of happiness led to a significant decrease in self-reported body dissatisfaction. Furthermore, attentional bias (higher gaze duration and frequency) towards the most disliked body part relative to the most liked body part was significantly greater in the sadness than happiness condition in BN. No significant effects of emotion induction on gaze duration and gaze frequency during mirror exposure were found for controls.

DISCUSSION

In line with assumptions of current models on ED, findings support the notion that emotional state influences the body image of patients with BN.

Non-response to sad mood induction: implications for emotion research

Experimental induction of sad mood states is a mainstay of laboratory research on affect and cognition, mood regulation, and mood disorders. Typically, the success of such mood manipulations is reported as a statistically significant pre- to post-induction change in the self-rated intensity of the target affect. The present commentary was motivated by an unexpected finding in one of our studies concerning the response rate to a well-validated sad mood induction. Using the customary statistical approach, we found a significant mean increase in self-rated sadness intensity with a moderate effect size, verifying the "success" of the mood induction. However, that "success" masked that, between one-fifth and about one-third of our samples (adolescents who had histories of childhood-onset major depressive disorder and healthy controls) reported absolutely no sadness in response to the mood induction procedure. We consider implications of our experience for emotion research by (1) commenting upon the typically overlooked phenomenon of nonresponse, (2) suggesting changes in reporting practices regarding mood induction success, and (3) outlining future directions to help scientists determine why some subjects do not respond to experimental mood induction.

Contextual factors associated with eating in the absence of hunger among adults with obesity

Eating in the absence of hunger (EAH) is under-explored in adults with obesity. In this study, 50 adults with obesity recorded eating episodes and theoretically-relevant environmental, perceptual, and emotional correlates in the natural environment for 2weeks via ecological momentary assessment (EMA). Generalized linear models and mixed models were used to characterize correlates and consequences of EAH vs. non-EAH episodes/tendencies (within-subjects and between-subjects effects, respectively), time of day, and time of day×EAH interactions. Approximately 21% of EMA-recorded eating episodes involved EAH, and 70% of participants reported at least 1 EAH episode. At the within-person level, participants' EAH episodes were associated with greater self-labeled overeating than their non-EAH episodes. At the between-person level, participants who tended to engage in more EAH reported less self-labeled overeating than those who engaged in less EAH. Across EAH and non-EAH episodes, eating in the evening was associated with overeating, expecting eating to be more rewarding, greater alcoholic beverage consumption, eating alone, eating because others are eating, and eating while watching television. Significant EAH×time of day interactions were also observed but the pattern of findings was not consistent. Findings suggest that EAH may be a relevant target for reducing food intake in individuals with obesity given its high prevalence and association with perceptions of overeating, although results should be extended using objective measures of food intake. Associations between evening eating episodes and perceptual and environmental factors should be further explored.

Validation of prospective portion size and latency to eat as measures of reactivity to snack foods

In experimental studies that investigate reactivity to the sight and smell of highly palatable snack foods, ad libitum food intake is commonly used as a behavioural outcome measure. However, this measure has several drawbacks. The current study investigated two intake-related measures not yet validated for food cue exposure research involving common snack foods: prospective portion size and latency to eat. We aimed to validate these measures by assessing prospective portion size and eating latencies in female undergraduate students who either underwent snack food exposure or a control exposure. Furthermore, we correlated prospective portion size and latency to eat with commonly used measures of food cue reactivity, i.e., self-reported desire to eat, salivation, and ad libitum food intake. Results showed increases in prospective portion size after food cue exposure but not after control exposure. Latency to eat did not differ between the two conditions. Prospective portion size correlated positively with desire to eat and food intake, and negatively with latency to eat. Latency to eat was also negatively correlated with desire to eat and food intake. It is concluded that the current study provides initial evidence for the prospective portion size task as a valid measure of reactivity to snack foods in a Dutch female and mostly healthy weight student population.

Happy eating: the single target implicit association test predicts overeating after positive emotions

For many years, questionnaires have been considered the standard when examining emotional eating behavior. However, recently, some controversy has arisen about these questionnaires, and their usefulness in identifying emotional eaters has been questioned. The current study aimed to investigate the Single Target Implicit Association Test (ST-IAT) as a measure of emotional eating. Two ST-IATs (assessing food-positive and food-negative associations respectively) and the Dutch Eating Behaviour Questionnaire (DEBQ) were compared in undergraduate students. A positive, negative or neutral mood was induced by means of a film clip, and milkshake consumption was measured during and after the mood induction. It was hypothesized that participants with strong emotion-food associations on the ST-IATs (i.e., IAT-emotional eaters) would consume more food in the emotion induction condition corresponding to that emotion, as compared to those with weak emotion-food associations as well as to those in the neutral condition. Participants who scored high on both the positive and negative ST-IATs ate more during a positive mood induction than during a negative mood induction. This effect did not extend to milkshake consumption after the mood induction procedure. In addition, IAT-positive emotional eaters consumed more food than IAT-non-emotional eaters. No effects of the DEBQ on milkshake consumption were found. It is concluded that the ST-IAT has potential as a measure of emotional eating.

Happy eating: the underestimated role of overeating in a positive mood

Emotional eaters are often presumed to eat in response to negative emotions, while positive emotions have been largely neglected. The current study induced a positive, negative, or neutral mood in a student sample and subsequently measured food intake. In addition, the relation between caloric intake and mood improvement was assessed. It was expected that emotional eaters would consume more food than non-emotional eaters in the emotional conditions, and also more than in the neutral condition. Moderated regression analyses indeed showed a significant increase in food intake for emotional eaters in the positive compared to the neutral condition, and a trend towards higher food consumption than non-emotional eaters. No effects were found in the negative condition. With regard to mood changes during food intake, Pearson correlations demonstrated an association between amount of calories consumed and mood improvement after 5min of food consumption. However, there was no evidence for differences between emotional and non-emotional eaters. The current findings underline the importance of positive emotions in emotional eating, and provide new insights on the relationship between eating and mood melioration.

Emotion and eating disorder symptoms in patients with anorexia nervosa: an experimental study

OBJECTIVE

To evaluate the effect of negative emotion on self-reported eating disorder symptoms and objectively-measured eating behavior in patients with anorexia nervosa (AN).

METHOD

Twenty-eight females with AN were randomized to a negative or neutral mood induction followed by a test meal. Participants completed assessments one week before the experimental session, before (pretest) and after (posttest) the mood induction, and after the test meal.

RESULTS

Participants in the negative emotion condition had an increase in negative affect from pretest to posttest that was accompanied by significantly greater increases in self-reported eating disorder symptoms than were exhibited by participants in the neutral emotion condition, who had no increase in negative affect. There was no effect of emotion condition on eating behavior.

DISCUSSION

Results suggest that negative emotions influence the expression of cognitive eating disorder symptoms in individuals with AN, which may have implications for the identification of treatment targets.

The dark side of food addiction

In drug addiction, the transition from casual drug use to dependence has been linked to a shift away from positive reinforcement and toward negative reinforcement. That is, drugs ultimately are relied on to prevent or relieve negative states that otherwise result from abstinence (e.g., withdrawal) or from adverse environmental circumstances (e.g., stress). Recent work has suggested that this "dark side" shift also is a key in the development of food addiction. Initially, palatable food consumption has both positively reinforcing, pleasurable effects and negatively reinforcing, "comforting" effects that can acutely normalize organism responses to stress. Repeated, intermittent intake of palatable food may instead amplify brain stress circuitry and downregulate brain reward pathways such that continued intake becomes obligatory to prevent negative emotional states via negative reinforcement. Stress, anxiety and depressed mood have shown high comorbidity with and the potential to trigger bouts of addiction-like eating behavior in humans. Animal models indicate that repeated, intermittent access to palatable foods can lead to emotional and somatic signs of withdrawal when the food is no longer available, tolerance and dampening of brain reward circuitry, compulsive seeking of palatable food despite potentially aversive consequences, and relapse to palatable food-seeking in response to anxiogenic-like stimuli. The neurocircuitry identified to date in the "dark" side of food addiction qualitatively resembles that associated with drug and alcohol dependence. The present review summarizes Bart Hoebel's groundbreaking conceptual and empirical contributions to understanding the role of the "dark side" in food addiction along with related work of those that have followed him.

A laboratory-based study of mood and binge eating behavior in overweight children

PURPOSE

Associations between negative mood and binge eating in the laboratory are well-established in adults, but such data are limited in youth. We investigated the relation between mood and binge eating in children using a laboratory feeding paradigm.

METHOD

Overweight girls, aged 6-12 years, with (BE; n=23) and without (control, CON; n=23) reported objective and/or subjective binge eating underwent both sad and neutral mood inductions, followed by multi-item buffet meals.

RESULTS

The Group × Mood Condition interaction for overall energy intake was non-significant. However, BE girls consumed more energy from fat in the sad condition as compared to the neutral condition. Baseline mood predicted BE girls' likelihood of reporting loss of control during the sad condition test meal.

CONCLUSIONS

Results suggest that emotional eating episodes in children reporting aberrant eating may be characterized by the experience of loss of control, rather than the consumption of objectively large amounts of food. Interventions focused on affect regulation may minimize the adverse consequences of pediatric binge eating.

Asymmetric prefrontal cortex activation in relation to markers of overeating in obese humans

Dietary restraint is heavily influenced by affect, which has been independently related to asymmetrical activation in the prefrontal cortex (prefrontal asymmetry) in electroencephalograph (EEG) studies. In normal weight individuals, dietary restraint has been related to prefrontal asymmetry; however, this relationship was not mediated by affect. This study was designed to test the hypotheses that, in an overweight and obese sample, dietary restraint as well as binge eating, disinhibition, hunger, and appetitive responsivity would be related to prefrontal asymmetry independent of affect at the time of assessment. Resting EEG recordings and self-report measures of overeating and affect were collected in 28 overweight and obese adults. Linear regression analyses were used to predict prefrontal asymmetry from appetitive measures while controlling for affect. Cognitive restraint and binge eating were not associated with prefrontal asymmetry. However, disinhibition, hunger, and appetitive responsivity predicted left-, greater than right-, sided prefrontal cortex activation independent of affect. Findings in this study add to a growing literature implicating the prefrontal cortex in the cognitive control of dietary intake. Further research to specify the precise role of prefrontal asymmetry in the motivation toward, and cessation of, feeding in obese individuals is encouraged.

Neural correlates of individual differences related to appetite

Using neuroimaging technologies to compare normal weight and obese individuals can reveal much about the pathophysiological state of obesity but such comparisons tell us little about what makes some normal weight individuals susceptible to obesity or about important individual differences amongst obese individuals. The current review therefore reviews neuroimaging research on individual difference measures that can illuminate these important topics. After introducing three neuropsychological models of the nature of motivation to approach rewarding stimuli, neuroimaging research on measures of impulsivity, craving, binge eating, restrained eating and disinhibited eating is reviewed. Although neuroimaging research on individual differences measures of brain activity related to appetite is in its infancy, existing studies suggest that such research could enrich the understanding, prevention and treatment of disordered eating and obesity.

The moderating effect of avoidant coping on restrained eaters' risk for disinhibited eating: implications for dietary relapse prevention

Avoidant coping style was tested as a moderating variable for the effect of ego threat on chronic dieters' (restrained eaters) risk for disinhibited eating. Young women (n=146) were randomly assigned to a speech threat or to a no threat condition and then participated in a bogus ice cream taste test. Analyses of covariance revealed that restrained eaters who scored higher on a standardized measure of avoidant coping consumed significantly more ice cream than restrained eaters who scored lower on avoidant coping regardless of the threat condition to which they were assigned. The findings suggest that dieters prone to using avoidant coping strategies may be particularly vulnerable to overeating and, therefore, could be at risk for lapses in dietary restraint. Hence, dietary relapse prevention programs might target dieters who tend to use avoidant coping strategies for cognitive-behavioral therapy to teach them adaptive coping skills.

Inspiring or dispiriting? The effect of diet commercials on snack food consumption in high school and college-aged women

OBJECTIVE

Recent research offers conflicting views of whether women high in dietary restraint are inspired or demoralized after viewing thin-ideal images. We conducted two studies to explore the impact of diet commercials featuring the thin-ideal image on snack food consumption.

METHOD

In Study 1, 91 high school women watched a sad movie interrupted with diet or neutral commercials. In Study 2, 102 college women saw diet commercials early or midway through a sad movie.

RESULTS

In Study 1, high restraint participants consumed more snacks after exposure to diet commercials than to neutral commercials. In Study 2, early commercials reduced snacking in low restraint women but not in high restraint women.

DISCUSSION

Thin-ideal images embedded in diet commercials do not inspire high restraint women but can modify the eating of low restraint women.

Food and emotion

The relationship between eating and emotion has always interested researchers of human behavior. This relationship varies according to the particular characteristics of the individual and according to the specific emotional state. We consider findings on the reciprocal interactions between, on the one hand, emotions and food intake, and, on the other, the psychological and emotional consequences of losing weight and dieting. Theories on the relationship between emotions and eating behaviors have their origin in the literature on obesity. The psychosomatic theory of obesity proposes that eating may reduce anxiety, and that the obese overeat in order to reduce discomfort. The internal/external theory of obesity hypothesizes that overweight people do not recognize physiological cues of hunger or satiety because of faulty learning. It thus predicts that normal weight people will alter (either increase or decrease) their eating when stressed, while obese people will eat regardless of their physiological state. The restraint hypothesis postulates that people who chronically restrict their food intake overeat in the presence of disinhibitors such as the perception of having overeaten, alcohol or stress. These theories are examined in the light of present research and their implications on eating disorders are presented.

Frontal brain asymmetry in restrained eaters

It is well known that the eating patterns that restrain chronic dieters (restrained eaters) can be disinhibited by anxiety, which in turn has been associated with relative right frontal brain activity in independent electroencephalographic (EEG) studies. Combining these two lines of evidence, the authors tested the hypothesis that chronic restrained eating is associated with relative right frontal asymmetry. Resting anterior brain asymmetry and self-reported measures of anxiety and depression were collected in 23 restrained and 32 unrestrained eaters. As hypothesized, groups differed in tonic frontal activity, with restrained eaters showing more relative right frontal activity. Furthermore, relative right frontal activity was associated with greater self-reported restraint. Right-sided prefrontal asymmetry may thus represent a diathesis associated with increased vulnerability toward restrained eating.