Affect, interoception, and disordered and intuitive eating behaviors: Examining momentary mediational associations among women with eating disorder pathology

Abstract

Objective Affect and interoception (the ability to sense/connect with bodily sensations) are transdiagnostic self-regulatory factors that promote maladaptive eating behaviors at the between-person level (via cross-sectional research). However, no research has examined the mechanistic role of interoception dimensions in associations between affect, and disordered and intuitive eating behaviors (DEBs, IEBs) at the within-person level via ecological momentary assessment (EMA). Method The present study addressed this research gap by examining whether: (1) momentary interoception dimensions (“not distracting,” “self-regulation,” “body listening and trust”) differentially mediated momentary associations between negative and positive affect (predictors), and DEBs (dietary restriction, overeating, loss of control eating) and IEBs (“eating for physical versus emotional reasons,” “reliance on hunger and satiety cues,” “unconditional permission to eat,” “body-food choice congruence”) outcomes; (2) these associations varied across affect, interoception, and eating behavior types. Women (N = 150) with eating disorder pathology (Mage = 20.95, SD = 4.14) completed 4 EMA surveys on mobile devices daily for 10 days. Results Multilevel structural equation models showed that greater momentary negative affect was associated with more distracting from uncomfortable/painful bodily sensations at subsequent assessments (i.e., less “not distracting” interoception) and, in turn, less “eating for physical versus emotional reasons” IEB later that day. Greater momentary positive affect was associated with greater subsequent “body listening and trust” interoception and, subsequently, greater “reliance on hunger and satiety cues” IEB. No momentary indirect effects linking affect, interoception, and DEBs were significant. Conclusions These results may be leveraged to optimize eating disorders research and novel real-time interventions.