Predicting Binge Eating and Body Dissatisfaction in a Naturalistic Environment Among Women Who Binge Eat From an Attachment Theory Perspective

Introduction: The current study examined naturalistic and momentary relationships among binge eating, body dissatisfaction, negative affect, depressive symptoms, social self-esteem, emotion dysregulation, and attachment anxiety and avoidance. Method: Participants were 55 undergraduate women who owned a mobile phone and who had binge eaten at least once during the past 28 days. All participants were screened to confirm the presence of binge eating and then completed measures of attachment anxiety and attachment avoidance. Participants then received seven text messages per day for 14 days. These text messages contained links to measures of state negative affect, state depressive symptoms, state social self-esteem, state emotion dysregulation, recent binge eating, and state body dissatisfaction. Results: Depressive symptoms and low social self-esteem predicted subsequent binge eating. Negative affect, depressive symptoms, and low social self-esteem predicted subsequent body dissatisfaction. Attachment anxiety moderated the relationship between negative affect and subsequent body dissatisfaction such that greater negative affect was associated with greater body dissatisfaction for those lower in attachment anxiety, but not for those higher in attachment anxiety. Findings revealed several significant pathways wherein different aspects of emotion dysregulation mediated interactions between attachment anxiety and negative affect and/or social self-esteem, on binge eating and/or body dissatisfaction. Discussion: Momentary psychological states predict subsequent binge eating and heightened body dissatisfaction, and the strength of these relationships depends on womens levels of attachment anxiety. Interventions for binge eating and body dissatisfaction should address attachment insecurity and emotion dysregulation, as well as eating disorder symptoms, in order to maximize therapeutic benefit.