New research provides evidence that emotion dysregulation plays an important role in eating disorder behaviors among adolescents. The study found that the association between emotion dysregulation and eating disorder behaviors existed both independently and in conjunction with weight and shape concerns. The findings have been published in Research on Child and Adolescent Psychopathology.
“Eating disorders commonly start during adolescence, with up to 1/3 of adolescents experiencing problems with an eating disorder,” said study author Nora Trompeter, a post-doctoral research fellow at King’s College London.
“However, the exact factors that co-occur or contribute to these problems are still poorly understood. I wanted to examine two factors theorized to relate to eating disorder symptoms – weight/shape concern and emotion dysregulation – to further our understanding of eating pathology in adolescents. Hopefully this line of work can contribute to prevention and early intervention programs for eating disorders in adolescents.
For their study, the researchers surveyed a community sample of 2,699 high school students and a clinical sample of 149 adolescents receiving outpatient treatment for an eating disorder
Participants completed assessments of their eating behaviors, weight/shape concerns, and emotion dysregulation. The researchers found that those with greater weight and shape concerns were more likely to engage in binge eating, fasting, and purging in both samples. Additionally, those with greater emotion dysregulation were more likely to engage in binge eating and purging in the community sample, and higher levels of emotion dysregulation was linked to more frequent binge eating and fasting.
Participants with a high level of emotion dysregulation agreed with statements such as “I have difficulty making sense out of my feelings,” “When I’m upset, it takes me a long time to feel better,” and “When I’m upset, I feel guilty for feeling that way.”
“In addition to concerns about one’s weight and/or shape, emotion dysregulation (difficulties in recognizing and regulating negative emotions) is a key factor relating to adolescent’s eating disorder behaviors,” Trompeter told PsyPost. “That means, in addition to installing positive body image in adolescents, they might also benefit from emotion regulation skills.”
Interestingly, the researchers found the strongest association between emotion dysregulation and engaging in binge eating among those with the lowest levels of weight and shape concerns.
“One potential explanation for these unexpected findings may be related to a ceiling effect,” Trompeter and her colleague wrote in their study. “If adolescents already experience high levels of weight and shape concerns, there may be limited additional ‘risk’ from also experiencing high levels of emotion dysregulation. However, for adolescents with lower levels of weight and shape concerns, emotion dysregulation may be amplifying the likelihood of adolescents engage in eating disorder behaviors.”
However, it is unclear whether emotion dysregulation is a cause or consequence of disordered eating.
“One of the biggest caveats of this particular study was that it is cross-sectional, so all data are collected at the same time,” Trompeter explained. “This means that we don’t know what occurs first. Do adolescents have problems with their emotion regulation and then develop problematic eating patterns? Or do they engage in problematic eating and then feel dysregulated emotionally? Or both? This question around time-ordering is really important and requires more research in the future.”
The researchers also examined gender differences.
“Our study included both boys and girls and found very few differences in the examined associations,” Trompeter said. “Public perceptions of eating disorders commonly frame these as ‘female’ disorders, but this is not supported by research and it’s important to recognize the impact of eating disorders on adolescent boys.”
The study, “Emotion Dysregulation and Eating Disorder Symptoms: Examining Distinct Associations and Interactions in Adolescents“, was authored by Nora Trompeter, Kay Bussey, Miriam K. Forbes, Phillipa Hay, Mandy Goldstein, Christopher Thornton, Christopher Basten, Gabriella Heruc, Marion Roberts, Susan Byrne, Scott Griffiths, Alexandra Lonergan, and Deborah Mitchison.
