Eating disorders can be viewed on a continuum, with disordered eating not reaching clinical diagnostic criteria but having potentially negative effects including increasing the risk of an eating disorder or obesity. This study investigated disordered eating in relation to emotional processing from an Acceptance and Commitment (ACT) perspective. Body image dissatisfaction is recognised as a risk factor in eating disorders and was therefore included in this study to investigate whether the ACT concept of inflexibility was associated with ‘less acceptance’ of body image and an increased eating disorder risk as well as general mood disturbance (i.e. depression and anxiety). A non-clinical sample of 96, 12-15 year old females at secondary schools in London was used. Eating disorder risk, inflexibility as well as depression and anxiety were measured. When comparing high, low and moderate eating disorder risk groups it was found that the low and moderate eating disorder risk groups had lower levels of inflexibility and the low eating disorder risk group had a higher body image acceptance than the moderate and the high risk groups as predicted. Inflexibility was also associated with higher rates of anxiety and depression and a negative association was found between depression and anxiety in relation to acceptance of body image. Thus providing supporting evidence for the transdiagnostic significance of ‘inflexibility’. Clinical implications of these findings in relation to prevention and treatment are discussed.

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Introduction: Bariatric surgery (BS) is currently the most effective treatment for morbid obesity. However, many individuals fail to lose or maintain adequate weight loss. It is a challenge to understand why some individuals can make the required changes following BS and some cannot. Evidence suggests that emotional eating (EE) may be associated with poorer outcome. However, there is as yet no conclusive research or review of the research in this area. Method: A systematic review was conducted with the aim to examine how EE relates to BS outcome. This review was complimented by a qualitative research project examining the experiences of individuals following weight loss surgery, with a particular focus on what changes and emotional coping. Results: Systematic review results suggest that EE is associated to poorer weight loss following BS. Six superordinate themes emerged from the qualitative research project; Surgery Outcome, Changing Views of the Self, Coping with Emotions, Being Judged Negatively, Being Obese is a Barrier to Living and It’s a Different Addiction. Discussion The overall results suggest that EE is an ongoing issue following bariatric surgery. BS seems to initiate various changes in behaviour, and cognition, together with increased sense of control. However, such changes seem to be attributed to BS, which is suggestive of an underestimation of self efficacy. Perceptions of obesity being the result of an addiction and emphasis on the difficulties associated with losing weight further highlight the issue of reduced self efficacy. This study also highlights that for many, having surgery does not cure all difficulties associated with eating. There are possibly underlying difficulties associated with obesity, such as neurocircuitry pathways that increase desire for food, whilst reducing control and attachment difficulties that reduce emotion regulation capacity. However, much work is required to understand such explanations and develop appropriate psychological interventions. Conclusion: The overall results from this thesis provide support for the view that EE and associated emotion regulation difficulties are related to poorer BS outcome. What seems clear from this research is that, although BS provides many positive changes, the battle against obesity continues for most and services are currently limited in their resources to intervene.

Aim: The aim of the study is to explore the relationships between an adolescent’s weight and parenting style, emotional eating, and emotional regulation and lifestyle behaviours to further develop the understanding of the factors that contribute to the current epidemic of childhood obesity. Design: A cross sectional survey design was used. Method: 112 adolescents, aged between 16 and 18 from three secondary schools in Scotland completed a self-report questionnaire on their mother and father’s parenting style, their own emotional regulation strategies, emotional eating and lifestyle behaviours. Their height and weight was measured by the researcher and used to calculate the adolescents’ BMI. Results: Overall, this study did not find that adolescent’s healthy food habits, exercise and emotional eating predicted BMI. There were no significant relationships found between BMI and parenting style, emotional eating and emotional regulation. Conclusion: These findings suggest that parenting style, emotional eating, emotional regulation and lifestyle behaviours are not related to adolescent weight.

Emotional eating behavior is characterized by eating a large amount of calorie dense sweet and/or high fat foods in an attempt to control, cope with, or avoid negative emotions. Numerous factors are likely to contribute to emotional eating behavior, including attentional factors, such as rumination and avoidance coping. Rumination based emotional eating (attention focused on negative stimuli while mindlessly eating) is often utilized to improve mood while dwelling on problems. However, for those inclined to escape/avoid troublesome thoughts, another type of emotional-eating pattern may be used. By focusing attention on food, emotional eating is believed to distract individuals from negative emotions. However, along with avoiding distressing thoughts, a strong attentional focus on food may also lead to diminished attention resources and subsequently the missing of self-preserving thoughts (e.g. dietary restraint or satiety). While Denke & Lamm (2015) explored neural mechanisms underlying rumination based emotional eating, to the best of our knowledge, no one has investigated the neural correlates underlying avoidance based emotional eating. This study examined how attentional sub-processes contribute to emotional eating behavior among female participants in a task designed to explore escape type emotional-eating behavior. Dense-array EEG and a version of the canonical attentional blink task were used to ascertain the neural correlates underlying the attentional sub-processes and how attentional activation differs for emotional eaters vs. non-emotional eaters. Findings do not support the food fixation escape type emotional-eater hypothesis, but do indicate task validity.

More than a third of all adults in the United States are considered obese. Due to the high costs of health care for obese adults and children, obesity has become a national health crisis. Many government programs have been developed to curtail obesity in adults and children. Unfortunately, there has only been limited success. Past research has shown that obesity has been linked to stress and eating while stressed. Emotional eating occurs when individuals respond to certain emotions, such as stress, by eating to cope with the emotion. Research has shown a correlation between nursing and disordered eating. Given the stressful working environment of mental health workers, the purpose of this study was to explore the experiences of mental health workers who self-identify as emotional eaters. Selye's stress response theory and Heatherton and Baumeister's affect regulation model provided the theoretical framework for this study. Participants included 12 purposefully selected individuals from a specific mental health agency who responded to semi-structured interview questions. Data were analyzed for themes and patterns. The major themes included stress related to mental health work, food patterns altered due to stress, and ways to manage emotional eating. Future research should include a larger sample size across different geographical regions and agencies and the inclusion of individuals who do not self-identify as emotional eaters. With greater knowledge and understanding on the reasons people choose to eat when stressed, individuals and employers may be able to gain insight and make changes that would allow them to manage stress at work without food.

Emotional and external eating are common eating behaviours in the general population, while not disordered eating per se they have been linked to overeating, obesity and problems engaging in health behaviours. Theories of emotional and external eating have been around for decades however little is known of the factors that contribute to these eating behaviours. Emotional and external eating tend to co-occur, and high correlations between them have been reported. Some theorists have argued that they are not distinct constructs. The current study aimed to provide further understanding on the nature and distinction between emotional and external eating in a non-clinical sample. The associations of impulsivity, alexithymia and negative affect in emotional and external eating were investigated, utilising a cross-sectional design. These variables have been shown to be related to eating behaviour in clinical samples however there has been limited research in non-clinical samples. Emotional eating was positively associated with alexithymia, negative affect and lack of perseverance, the relationship with urgency was less clear. External eating was indirectly associated with depression through the mediating variable urgency. The results indicated that emotional and external eating do show some similarities in the variables associated with them, however, the pattern of associations were different for the two eating behaviours. It appears from this study that the theoretical distinction between emotional eating and external eating is warranted with emotional eating appearing to be directly associated with problems with affect regulation whereas external eating is indirectly associated with negative affect.

Previous studies have shown that overweight and obesity in youth and adolescents is one of the leading risk factors for developing Type 2 diabetes mellitus (T2DM). Besides being "at–risk” for T2DM, the possibility also exists for development of major psychological issues. Thus, overweight adolescents who are "at–risk” for T2DM may have increased levels of emotional eating, and poor self–esteem and body image. The design of this pilot study ("R. U. A Healthy Kid”) was a prospective cohort of 17 free–living middle school students "at–risk” for T2DM. Each participant was previously screened and found to have three or more risk factors for T2DM. The intervention targeted four main topics: Family Meals, Healthy Snacks, Physical Activity and "Unique U” (emotional eating, self–esteem, body image and stress management). The "Unique U” component forms the basis of the current study. After three months in the program, participants’ self–esteem significantly increased since the beginning of the program. Many relationships were found between self–esteem, body image, stress and emotional eating questions. Community– based lifestyle interventions that include issues such as improving self–esteem, body image, stress and emotional eating are critical in helping adolescents who are "at–risk” for T2DM.

abstract: Childhood obesity is associated with many well established health risks as well as high annual public health costs. Because of this, the childhood obesity literature has highlighted the need to detect at-risk groups in order to implement targeted preventions. Emotional eating has been identified as an unhealthy behavior and a risk factor for overweight status among children though very little is known about what predisposes children to emotionally eat. Stress has often been found to elicit emotional eating but most studies looking at this relationship have relied on self-reports in adult and clinical samples. Thus, the current study seeks to investigate the relationship between stress reactivity (measured using heart rate variability) and emotional eating in a sample of 247 children between the ages of 4-6. Furthermore, levels of control may moderate the relationship between stress reactivity (HRV) and emotional eating. Linear regression analysis was used to explore these relationships. It was expected that higher levels of reactivity to stress would predict an increased likelihood of emotional eating. This association was expected to be attenuated among children with higher levels of inhibitory control and attentional focusing as well as lower levels of impulsivity. However, the hypothesized findings were not supported by the data. Despite these null findings, and in light of several limitations, it is still hypothesized that emotional eating involves physiological and impulsivity/effortful control processes. Implications of future research are discussed. / Dissertation/Thesis / Masters Thesis Psychology 2016