目标:尽管文献暗示感觉脂肪在暴饮暴食症的维持中(ED;例如,神经性贪食症,binge-ED),这方面的研究很小,新生,并依赖回顾性自我报告。当前的研究试图了解感觉脂肪的时间模式及其作为ED行为的沉淀和后果的作用。
方法:总共106名寻求治疗的患有狂暴频谱ED的成年人完成了7-14天的生态瞬时评估。他们评价感觉肥胖,负面影响状态,并每天报告六次ED行为。多层次模型评估了感觉脂肪是否介导了负面影响状态和ED行为之间的前瞻性联系,评估负面影响状态是否介导感觉脂肪对ED行为的前瞻性关联,并研究了感觉肥胖与ED行为之间的双向前瞻性关联。
结果:感觉脂肪在清晨(上午6-8:59)最高。与那些具有稳定和高水平的感觉脂肪的神经性贪食症的人相比,患有暴饮症频谱ED的人在感觉脂肪方面表现出更大的变异性。内疚,悲伤,焦虑,时间2的总体NA介导了时间1感觉脂肪和时间3饮食限制之间的前瞻性关联,实际的饮食限制,和补偿性锻炼。感觉肥胖和暴饮暴食之间存在双向前瞻性关联。
结论:感觉脂肪是内疚和暴饮暴食之间前瞻性关联的近端预测因子和中介因子。感觉肥胖和暴饮暴食是相辅相成的。
■对于暴饮暴食症患者在自然环境中感觉发胖的经历,人们知之甚少。我们发现,在早晨和晚上有感觉肥胖的经历的风险很高。感觉到脂肪会引发内疚,焦虑,和悲伤,反过来,增加参与饮食限制/限制和代偿运动。感觉到脂肪也会引发暴饮暴食,暴饮暴食会导致肥胖。
OBJECTIVE: Although literature implicates feeling fat in the maintenance of binge-spectrum eating disorders (EDs; e.g., bulimia nervosa, binge-ED), research in this area is small, nascent, and relies on retrospective self-report. The current study sought to understand the temporal pattern of feeling fat and its role as a precipitant and consequence of ED behaviors.
METHODS: Totally 106 treatment-seeking adults with binge-spectrum EDs completed 7-14-day ecological momentary assessments. They rated feeling fat, negative affect states, and reported on ED behaviors six times per day. Multilevel models evaluated whether feeling fat mediates prospective links between negative affect states and ED behaviors, assessed if negative affect states mediate the prospective association of feeling fat on ED behaviors, and examined the bidirectional prospective association between feeling fat and ED behaviors.
RESULTS: Feeling fat was highest in the early morning (6-8:59 a.m.). Individuals with binge-ED-spectrum EDs demonstrated greater variability in feeling fat than those with bulimia nervosa-spectrum EDs who had stable and high levels of feeling fat. Guilt, sadness, anxiety, and the overall NA at Time 2 mediated the prospective associations between at Time 1 feeling fat and Time 3 dietary restraint, actual dietary restriction, and compensatory exercise. There was a bidirectional prospective association between feeling fat and binge eating.
CONCLUSIONS: Feeling fat serves as a proximal predictor and mediator of the prospective association between guilt and binge eating. Feeling fat and binge eating mutually reinforce each other.
UNASSIGNED: Little is understood regarding the experience of feeling fat in natural environments among individuals with binge-spectrum eating disorders. We found that the risk for having the experience of feeling fat is high in the morning and evening. Feeling fat triggers guilt, anxiety, and sadness which in turn, increases engagement in dietary restraint/restriction and compensatory exercise. Feeling fat also triggers binge eating, and binge eating leads to feelings of fatness.