Research reportNegative affect and cue-induced overeating in non-eating disordered obesity
Introduction
Obesity nowadays is increasingly prevalent worldwide, and one of the main questions is why the obese overeat. Overeating is a phenomenon that has been studied extensively, but this mainly happened in relation to eating disorders. Risk factor models for eating disorders and self-reports during treatment put forward that, in particular, negative mood states and food exposure-induced urges are triggers of overeating in samples with eating disorders (see e.g., Carter, Bulik, McIntosh, & Joyce, 2001; Jansen, 1998, Jansen et al., 1990; Jansen, Broekmate, & Heymans, 1992; Martinez-Mallén et al., 2007, Stice, 2001, Stice, 2002, Toro et al., 2003, Vanderlinden et al., 2004, Vögele and Florin, 1996).
Laboratory experiments studying disinhibited eating in obese clinical groups are however rather scarce. One study in which obese eating disorder patients participated showed that a sad mood triggered overeating in the obese with eating disorders (Chua, Touyz, & Hill, 2004), but this was not the case in another study (Telch & Agras, 1996). Experiments using analogue samples of highly restrained eaters do support that both a negative mood induction and exposure to food cues, like seeing, smelling, and tasting flavorsome high calorie foods, are triggers that elicit overeating in unsuccessful restrained eaters (Jansen & van den Hout, 1991; Schotte, Cools, & McNally, 1990). A robust finding in all these experiments with analogue samples is, however, that normal non-eating disordered samples show opposite eating behavior. Contrary to the overeating of clinical samples, they do eat less in a sad mood and after food exposure compared to control conditions (e.g., Jansen & van den Hout, 1991; Schotte et al., 1990).
In some recent studies, eating disorders were subtyped along dimensions of negative affect and most of the studies showed, among other things, that increased negative affect signaled more severe eating disorder symptoms, including overeating and vulnerability to disinhibition (Grilo, Masheb, & Wilson, 2001; Stice & Agras, 1999; Stice et al., 2001, Stice et al., submitted for publication). The non-eating disordered obese are also at increased risk of depression, compared to normal weight people (Scott et al., 2008, Werrij et al., 2006). However, the association between obesity and depression typically is weaker in the non-eating disordered obese than in clinical samples, implicating that obesity in itself is not necessarily depressing (Carr, Friedman, & Jaffe, 2007; Wardle, Williamson, Johnson, & Edwards, 2006). In line with this, Jansen, Havermans, Roefs, and Nederkoorn (submitted for publication) recently subtyped a non-eating disordered overweight and obese sample along a negative affect dimension. The cluster analysis classified the sample into two mutually exclusive groups of about the same size, based on similarity in scores on diverse negative affect measures that each taps a slightly different facet of negative affect, with minimal within-group and maximal between-group variation. Jansen et al. (submitted for publication) demonstrated the existence of a subtype that is high in negative affect and a subtype that is low in negative affect within this non-eating disordered sample of overweight and obese people.
Considering this recent subtyping of the non-eating disordered obese in a subtype that is high in negative affect and a subtype that is low in negative affect, it would be of theoretical and clinical interest to test experimentally whether the two subtypes show different eating responses to triggers of overeating. It could be hypothesized that it is a specific state-trait interaction that facilitates overeating. It might, in other words, be expected that the high negative affect overweight/obese subtype is more vulnerable to overeating in the presence of a disinhibiting cue (negative mood induction or food exposure) than the overweight/obese subtype that is low in negative affect. In the present study, it is tested whether the typically disinhibiting cues food exposure and negative mood induction, elicit overeating in the overweight/obese subtype that is high in negative affect. The low negative affect overweight/obese subtype might be expected to show the opposite behavior, like normal non-eating disordered samples do; eating less in a sad mood and after food exposure compared to control conditions. More specifically, the hypotheses that will be tested in the present study are: (1) high negative affect overweight/obese participants will overeat after negative mood induction and after food exposure compared to a control condition, and (2) low negative affect overweight/obese participants will eat less after negative mood induction and food exposure compared to a control condition. For all normal weight participants a same intake pattern as in the low negative affect overweight/obese participants is predicted; they are expected to consume less after a disinhibiting cue than without one.
Section snippets
Design, assessment and analysis
The dependent variable food intake was assessed during a bogus taste test after three different manipulations: negative mood induction, smelling tasty foods (exposure) and a control manipulation during which participants viewed a local festival movie. A between subjects design was used. Participants completed negative affect and eating disorder questionnaires before participating in the experiment. They were clustered into groups along the dimensions negative affect (high/low) and overweight
Manipulation check
Changes in state mood, appetite and craving from before to after the manipulation were analyzed for all manipulations. Table 2 gives the mean scores and standard deviations. Paired pre–post t-tests show that all manipulations succeeded: during food exposure both appetite and craving significantly increased whereas mood did not change. During the negative mood induction, mood significantly decreased (higher scores mean worse mood) and also appetite decreased whereas craving did not change
Discussion
In the present study, it was tested whether the high negative affect subtype of a non-eating disordered overweight and obese sample overate after negative mood induction and after exposure to the smell of tasty foods, compared to a neutral condition. It was found that they did: the high negative affect overweight/obese subtype ate significantly more after negative mood induction and tasty food exposure than after a neutral manipulation, whereas the low negative affect overweight/obese subtype
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