Ecological momentary assessment of weight-related stress predicting eating disorder and affective symptoms

Weight-related stress (e.g., experiencing weight stigmatization) is an important factor that contributes to engagement in maladaptive eating behaviors and increased risk for mood and anxiety disorders. Forty-nine adults that met the criteria for binge-eating disorder and/or food addiction completed baseline questionnaires and a 10-day ecological momentary assessment protocol during which they reported experiences of weight-related stress, binge-eating symptoms, dietary restraint, body satisfaction, and negative affect throughout the day. Generalized linear mixed models were used to examine associations between within- and between-subject weight-related stress and binge-eating symptoms, dietary restraint, body satisfaction, and negative affect. Weight-related stress was not associated with binge-eating symptoms; however, at the within-subjects level, experiencing weight-related stress was associated with lower body satisfaction (p = .008) and elevated dietary restraint and negative affect (ps < .001). At the between-subjects level, weight-related stress was associated with increased negative affect (p = .007). Among adults with binge-eating disorder and/or food addiction, weight-related stress may be a relevant social/intrapersonal experience that impacts individual's momentary affective well-being and restraint. Results suggest the need for public health interventions for reducing systemic societal weight-related stigmatization as well as use of individual intervention strategies focused on reframing negative thoughts associated with weight-related stress to reduce its emotional impact.