Today, we’re looking at three recent studies of disordered eating. First, Le, Vedamtam, Chen, Liu & Forestell (2025) published “Understanding the Association between Conformity to Feminine Norms and Disordered Eating: Emotional eating as a mediator” in Professional Psychology: Research and Practice. Here are the edited abstract and impact statement:
A growing body of research suggests conformity to feminine norms affects the health of university-attending women. The present study examined the association between conformity to three feminine norms—thinness, appearance, and modesty—and disordered eating, and the mediating role of emotional eating. A sample of undergraduate, predominantly White women between the ages of 18–24 years (N = 201, Mage = 19.2 years, SD = 1.3) completed an online survey assessing the constructs of interest. Regression analyses showed that conformity to thinness, appearance, and modesty were each positively associated with disordered eating symptomatology. Furthermore, emotional eating mediated the associations between the norms of thinness and appearance and disordered eating but not the norm of modesty and disordered eating. These findings suggest that feminine norms may contribute to disordered eating in undergraduate women through emotional eating. Clinical considerations for addressing conformity to feminine norms and managing emotional eating are discussed.
The present study highlights how clinicians may consider addressing both feminine norms and emotional eating when working with female college students who engage in disordered eating. Furthermore, clinicians and interventionists broadly may encourage college women to question and challenge traditional female gender norms, in particular investment in thinness, appearance, and modesty.
Although the findings are not surprising, I thought it was helpful to have evidence that gender conformity contributes to disordered eating. Next, Bejarano, Hesse & Cushing (2024) published “Assessing Drivers of Eating Behavior in a Community Sample of Adolescents: Implications for preventive interventions” in Clinical Practice in Pediatric Psychology. The edited abstract and impact statement follow:
Understanding specific drivers of dietary behavior in adolescents can inform preventive models for disordered eating and psychosocial and physical health concerns. The present study examined how eating motives (hedonic appetite, palatable eating motives, controlled dietary motivation), relate to impulsivity and emotional eating to predict binge eating and calorie intake in adolescents. 43 adolescents (Mage = 15.1 years, 72.1% female) self-reported all variables of interest via survey during a study lab visit. Calorie intake was assessed via dietary recall. Models were run in SPSS and post hoc probing was conducted for significant interactions. Significant associations emerged between hedonic appetite and binge eating, emotional eating and binge eating, palatable eating motives and binge eating, and controlled dietary motivation and binge eating. There was a significant interaction of controlled dietary motivation and emotional eating predicting binge eating (β = .23, p < .05) with higher levels of controlled motivation positively associated with binge eating when emotional eating was high. There was a marginally significant interaction (β = .22, p = .05) for hedonic appetite and emotional eating predicting binge eating, with higher levels of emotional eating predicting binge eating when hedonic appetite was high. The present study identified potential risk factors for binge eating in adolescents, highlighting hedonic appetite and emotional eating as important factors to assess to inform preventive intervention. Future studies with larger and more diverse samples, conducted longitudinally in comparison to clinical samples will progress the application of this research.
This study suggests that specific eating motives and behaviors can be risk factors for binge eating in healthy adolescents. Screening for hedonic appetite, emotional eating, and eating motives can inform preventive strategies for disordered eating. Interventions that promote healthful relationships with food can be preventive to the development of disordered eating and related concerns for adolescents.
I thought this was a nice extension of the previous article, despite the low sample size. The distinctions among hedonic appetite (eating as a reward behavior), emotional eating, palatable eating (pleasure in tasty but unhealthy foods), and controlled dietary motivation (motivation by external pressure), as well as their association with binge eating are useful. Next, we turn to anorexia nervosa. Billman Miller et al. (2024) published: “Data Mining Identifies Meaningful Severity Specifiers for Anorexia Nervosa” in Journal of Psychopathology and Clinical Science. Edited abstract and impact statements follow:
The fifth edition of the Diagnostic and Statistical Manual of Mental Disorders defines anorexia nervosa (AN) severity based on body mass index (BMI). However, BMI categories do not reliably differentiate the intensity of AN and comorbid symptoms. Shape/weight overvaluation has been proposed as an alternative severity specifier. The present study used structural equation model (SEM) Trees to empirically determine specific levels of BMI and/or shape/weight overvaluation that differentiate AN severity. We also compared whether the SEM Tree-derived severity groups outperformed existing AN severity definitions. Participants were 1,666 adolescents and adults with AN who were receiving eating disorder treatment at one of the three levels of care (outpatient, partial hospital program, or residential). Participants completed self-reported questionnaires assessing eating pathology and comorbid symptoms. SEM Tree analyses first specified an outcome model of AN severity, and then recursively partitioned the outcome model into subgroups based on all values of BMI and shape/weight overvaluation. One-way analyses of variance and t tests determined which severity definition explained the most variance in clinical characteristics. SEM Tree analyses yielded five severity groups, all of which were defined based on increasing intensities of shape/weight overvaluation: < 2.25, 2.25–3.24, 3.25–4.24, 4.25–5.24, and ≥ 5.25. No groups were defined based on BMI. SEM Tree-derived groupings explained more variance in clinical characteristics than existing severity definitions. Taken together, shape/weight overvaluation appears to be a more accurate marker of AN severity than BMI. The empirically determined AN severity scheme accounted for the most variance in clinical characteristics. Future research should assess the predictive value of these empirically defined AN severity indicators.
We assessed whether anorexia nervosa severity was better determined by empirically derived levels of shape/weight overvaluation or body mass index. The model yielded four unique cutpoints on shape/weight overvaluation, creating five severity subgroups. Subgroups consistently differed on eating disorder symptoms, depressive symptoms, and anxiety symptoms. The empirically determined severity scheme accounted for more variance in outcomes than two existing severity definitions. These findings suggest that shape/weight overvaluation may be superior to body mass index in capturing anorexia nervosa severity.
I had read that BMI is no longer seen as valuable and this work reinforces that notion with respect to anorexia nervosa. It makes sense to me that shape/weight overvaluation is an important assessment criterion.