Examining a momentary mediation model of appearance related stress, anxiety, and eating disorder behaviors in adult anorexia nervosa
PurposeAppearance related stress may result from appearance focused events such as seeing one's reflection, seeing media images, and shopping for clothes. The purpose of this study was to examine the prospective association between momentary appearance related stress and eating disorder (ED) behaviors (i.e. binge eating and vomiting) among women with anorexia nervosa (AN) using ecological momentary assessment (EMA) We hypothesized that appearance related stress at Time 1 would predict binge eating and vomiting at Time 2, and that this prospective association would be mediated by momentary anxiety at Time 2 (controlling for anxiety at Time 1).MethodsWomen with AN completed a 2 week EMA protocol involving repeated daily assessments of experiences and behaviors.ResultsMomentary appearance related stress preceded binge eating and vomiting, and momentary anxiety mediated the prospective association between appearance related stress and ED behaviors.ConclusionsTargeted momentary interventions delivered in the natural environment that address appearance related stress may have utility in the treatment of ED behaviors.
Eating and Weight Disorders Studies on Anorexia, Bulimia and Obesity