Emotion Dysregulation within the CBT-E Model of Eating Disorders: A Narrative Review

Emotion dysregulation has frequently been theorised as a core component of internalising disorders, including eating disorders. However, it remains unclear at which points in the developmental and aetiological chain emotion dysregulation contributes to eating pathology. The current review synthesises the existing literature and theoretical models of eating disorders to illustrate the role of emotion dysregulation in eating pathology, and the corresponding implications for both theory and treatment. Specifically, the review discusses the implications of including emotional dysregulation in the transdiagnostic model of eating disorders (CBT-E model). Taking a lifespan approach, the review places particular importance on examining adolescence as a key developmental period of emotional turmoil and eating disorder onset.

The reviewed literature suggests that emotion dysregulation is an important factor in eating pathology broadly, as well as having associations with multiple specific eating disorder behaviours. Additionally, this review suggests that it is the interplay between emotion dysregulation – a transdiagnostic factor – and weight/shape concerns – an eating disorder-specific factor – that may contribute to the maintenance and potential development of eating disorders.

This review proposes that emotion dysregulation is a key maintenance factor of eating pathology, and adaptations to reflect this should be considered for the CBT-E model. Furthermore, treatments targeting emotion dysregulation for adolescents and adults represent a promising avenue for further development. Further research should explore the potential of emotion dysregulation as a risk factor proceeding eating disorder development.