Ecological momentary assessment of eating episodes in obese adults.
OBJECTIVE
The context of eating episodes in obesity is poorly understood. This study examined emotional, physiological, and environmental correlates of pathological and nonpathological eating episodes in a heterogeneous sample of obese adults.


METHODS
Community-based participants (n = 50; 84% female [n = 42]; mean [standard deviation] body mass index = 40.3 [8.5]; mean [standard deviation] age = 43.0 [11.9]) recorded all eating episodes and their emotional, physiological, and environmental correlates via ecological momentary assessment for 2 weeks. Generalized estimating equations examined relations between these variables and eating episodes characterized by both self-identified loss of control (LOC) while eating and overeating (binge eating; BE), LOC only, overeating only (OE), and neither LOC nor OE (nonpathological eating).


RESULTS
Episodes involving loss of control (BE and LOC) were associated with heightened preepisode and postepisode negative effects (Wald χ range, 15.67-24.39; p values < .001), whereas those involving overeating (BE and OE) were associated with the lowest preepisode and postepisode hunger (Wald χ range, 18.14-39.75; p values <.001). LOC episodes were followed by heightened postepisode cravings (Wald χ = 25.87; p < .001) and were most likely to occur when participants were alone (Wald χ = 13.20; p = .004).


CONCLUSIONS
BE and LOC eating were more consistently associated with emotional and physiological cues than OE and nonpathological eating, whereas most environmental variables did not differ among eating episode types. Results support distinctions among the different constructs characterizing aberrant eating and may be used to inform interventions for obesity and related eating pathology.
From the Department of Psychiatry and Behavioral Neuroscience (A.B.G.), The University of Chicago, Chicago, Illinois; Departments of Biostatistics (R.D.C., L.C.) and Clinical Research (S.G.E., S.A.W.), Neuropsychiatric Research Institute, Fargo, North Dakota; Department of Clinical Neuroscience (R.D.C., S.G.E., S.A.W.), University of North Dakota School of Medicine and Health Sciences, Fargo, North Dakota; Department of Psychiatry (N.D., K.C.B., S.J.C., C.B.P.), University of Minnesota Medical School, Minneapolis, Minnesota; Department of Clinical Operations (H.M.B.), Medtronic, Minneapolis, Minnesota; and Department of Research (S.J.C.), The Emily Program, St Paul, Minnesota.
Andrea B
AB
Goldschmidt
Ross D
RD
Crosby
Li
L
Cao
Scott G
SG
Engel
Nora
N
Durkin
Heather M
HM
Beach
Kelly C
KC
Berg
Stephen A
SA
Wonderlich
Scott J
SJ
Crow
Carol B
CB
Peterson
D000328:Adult; D015992:Body Mass Index; D002032:Bulimia / Q000503:physiopathology / Q000523:psychology*; D005247:Feeding Behavior / Q000502:physiology / Q000523:psychology*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009765:Obesity / Q000503:physiopathology / Q000523:psychology*