Eating Disorders—The Regulation of Positive as well as Negative Emotion Experience

Disordered eating behaviors are often conceptualized as maladaptive emotion regulation strategies. The present study investigated links between emotional experience, schematic belief systems, and psychological themes associated with eating disorders. In contrast to the majority of studies, which focus on just one or two emotions and use nonclinical samples, this study compared the full range of emotional experience in women with eating disorders to a control group. Measures used include the Differential Emotional Scale-IV, Youngs Early Maladaptive Schema Questionnaire, and Eating Disorder Inventory-2. The study provides the first empirical evidence that women diagnosed with eating disorders report experiencing pleasant as well as unpleasant emotions more frequently than do controls. A surprising finding was that pleasant emotions (joy, interest, surprise) correlated with eating disorder themes (EDI-2 subscales) more consistently than unpleasant emotions in the eating disorder group, while the reverse was true of the control group. Also of note, eating-disordered women reported significantly less anger and similar levels of fear vs. controls. While eating-disordered women scored more highly than do controls on all maladaptive schema (suggesting high levels of distress in women with eating disorders), the pattern of correlations between schema and emotion experience was distinctly different for each group and counterintuitive for the eating disorder group. In particular, pleasant emotion was highly correlated with maladaptive schema in the eating-disordered group but not in the control group. These marked group differences in the pattern of relationships between emotion experience, eating disorder themes, and belief systems suggest that it is not valid to draw conclusions about eating disorders from research that employs only nonclinical samples. The authors discuss these findings, and suggest that women with eating disorders are proficient at using disordered eating behaviors to manipulate their experience of both positive and negative emotional states, and that this dynamic should be recognized as an important maintenance factor.     

The Struggle Continues: Addressing Concerns About Eating and Weight for Older Women’s Well-Being

Eating disorders and concern about weight are generally associated with younger women. This article first reviews the limited literature addressing the prevalence of disordered eating concerns in older women, both related to and independent of weight issues. Excessive concern about weight, body image and restricted eating/fasting appears to continue into the 60s and even 70s. Although bulimia nervosa and anorexia drop markedly in prevalence among older women, binge eating disorder continues to be evident. The article then provides an overview of Kristeller’s Mindfulness-Based Eating Awareness Training (MB-EAT) with particular focus on how the program appears well-matched to the concerns of many older women, including those with binge eating disorder. MB-EAT is a non-dieting approach that emphasizes heightened engagement with mind–body awareness, including hunger and satiety cues, and non-judgmental approaches to food choices and weight management. Evidence from an NIH-funded clinical trial shows that women above age 50 (45% of participants) responded significantly more strongly to the intervention on measures of self-acceptance and non-restrictive aspects of eating behavior and attitudes. Overall, the evidence suggests that further attention needs to be given to these issues in helping older women cultivate an optimally healthy and fulfilling lifestyle.