Men who engage in both subjective and objective binge eating have the highest psychological and medical comorbidities
Introduction
When referring to binge eating, two unique patterns of discrete eating episodes are generally recognized: 1) objective binge episodes (OBEs), or eating an unambiguously large amount of food while experiencing loss of control (LOC); and 2) subjective binge episodes (SBEs), or eating what is perceived as an excess amount of food, but is not objectively large, while experiencing LOC (Fairburn & Cooper, 1993). Research in women and children highlights the central role that LOC, relative to amount of food consumed, plays in psychopathology and weight. When comparing women who endorsed either OBEs or SBEs, there were no significant differences in eating disorder or depressive symptoms (Fitzsimmons-Craft et al., 2014; Latner, Hildebrandt, Rosewall, Chisholm, & Hayashi, 2007; Palavras, Morgan, Borges, Claudino, & Hay, 2013), or changes in comorbid psychopathology over time (Palavras, Hay, Lujic, & Claudino, 2015). LOC is also a better predictor of distress experienced before and after an overeating episode than the amount of food consumed (Goldschmidt et al., 2012). Pediatric studies also suggest that, even when comparable amounts of food are consumed, the presence of perceived LOC is associated with greater psychosocial symptoms (Allen, Byrne, La Puma, McLean, & Davis, 2008; Shomaker et al., 2010; Tanofsky-Kraff et al., 2004). Likewise, in adults, OBEs predict depressive symptoms and odds of being overweight, while objective overeating episodes without LOC (or OEs) do not (Sonneville et al., 2013).
Extant studies challenge the validity of requiring OBEs in eating disorder diagnoses (Latner & Clyne, 2008; Watson, Fursland, Bulik, & Nathan, 2013) and suggest targeting LOC eating in prevention efforts (Tanofsky-Kraff et al., 2011). However, it remains unclear whether the observed patterns among LOC, episode size, excess weight, and psychopathology are consistent among men. According to some data (Hudson, Hiripi, Pope, & Kessler, 2007; Striegel-Moore et al., 2009; Udo et al., 2013), but not all (Bentley, Mond, & Rodgers, 2014), rates of LOC eating and degree of associated impairments are comparable among men and women. One study did not find gender variations in the association between weekly OBEs (vs OEs), overweight/obesity and elevated depressive symptoms (Sonneville et al., 2013). In a sample of primarily Caucasian men, both weekly OBEs and SBEs were associated with reduced quality of life (Mitchison, Mond, Slewa-Younan, & Hay, 2013). While these preliminary data support the idea that the presence of LOC is most indicative of comorbid concerns in men, it is difficult to draw firm conclusions. Extant studies only included men who reported weekly binge eating, consistent with the requirements for binge eating disorder (American Psychiatric Association, 2013). Data from these men would not generalize to those who endorse less frequent LOC eating. Moreover, few studies have integrated assessments of disordered eating symptoms which may be particularly relevant to men's LOC eating, such as muscularity concerns and excessive exercise (Kelly, Cotter, Tanofsky-Kraff, & Mazzeo, 2015).
The goal of the current study is to examine how specific features of perceived overeating, including LOC and amount consumed, relate to weight concerns and eating disorder pathology in young men. We hypothesized that men with recent OBE(s) and/or SBE(s) would report higher BMI, weight-related medical diagnoses, dietary restraint, body image concerns, and excessive exercise than those with recent OE(s) or no instances of disordered eating. We further hypothesized that men with recent OBE(s) or SBE(s) would not significantly differ from one another in these variables. These eating groups were created to allow for comparisons of comorbid concerns by both presence of LOC and amount of food consumed.
Section snippets
Participants and procedures
Participants were recruited via Qualtrics Panels, who partners with market research panels and utilizes social media outlets to recruit a diverse pool of survey respondents nationwide. Men were invited to participate if they were 18–30 years old; lived in the U.S.; understood English; and identified as White/Caucasian, African American, Hispanic/Latino, or Asian/Asian American. This age range was selected because LOC behavior is particularly prevalent among men under the age of 30 (
Participants
A total of 1114 men completed the current study (Mage = 24.1 ± 3.6 y; MBMI = 25.4 ± 6.2 kg/m2; 33.7% ≥ 4-year college degree; 62.6% not in college; 63.4% single; 25% annual income less than $19,999; 28.4% White/Caucasian, 23.4% African American, 23.9% Asian/Asian American, 24.3% Hispanic/Latino); 40% of participants reported no disordered eating in the prior 28 days; 9.2% reported only OE(s) (Mepisodes = 3.9 ± 5.1); 11.9% SBE(s) only (MSBEepisodes = 3.1 ± 2.6; MOEepisodes = 0.7 ± 2.0); 16%
Discussion
Consistent with some data from women (Mond et al., 2006), men who reported both SBE(s) and OBE(s) presented with the greatest likelihood of having a weight-related medical comorbidities and the highest dietary restraint, concerns about body fat, and excessive exercise. Those with no disordered eating habits had the lowest medical and psychosocial concerns. Group differences generally remained present after controlling for frequency of disordered eating, which has been postulated to function as
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