Momentary predictors of binge eating episodes and heavy drinking episodes in individuals with comorbid binge eating and heavy drinking

Eat Weight Disord. 2022 Dec;27(8):3145-3156. doi: 10.1007/s40519-022-01444-0. Epub 2022 Jul 21.

Abstract

Purpose: The co-morbidity of binge eating and heavy drinking (BE + HD) is a serious concern due to the high prevalence rates and associated elevated severity. Clarifying the momentary factors that increase risk for binge eating and heavy drinking among BE + HD is important for expanding theoretical models of BE + HD and informing treatment recommendations. The current study used ecological momentary assessment (EMA) to compare the momentary processes maintaining binge eating between BE + HD and individuals with binge eating only (BE-only) and to identify the momentary risk factors for binge eating episodes and heavy drinking episodes among BE + HD.

Methods: Participants (BE + HD: N = 14; BE-only: N = 37) were adults with clinically significant binge eating who completed between 7 and 14 days of EMA prior to treatment.

Results: The presence of food and within-day dietary restraint predicted higher odds of binge eating for both groups. Among BE + HD, the presence of alcohol and dietary restraint increased risk for subsequent binge eating and subsequent heavy drinking, and the absence of food increased risk for subsequent heavy drinking.

Conclusion: These results offer preliminary support for treatment interventions for BE + HD that focus on reducing dietary restraint and teaching strategies for urge management in situations with palatable food or alcohol. Future research should study the maintenance mechanisms of BE + HD with larger, more diverse samples and using study design approaches with more experimenter control (i.e., laboratory experiments).

Level of evidence: Level IV, multiple time series without intervention.

Keywords: Alcohol; Binge eating; Comorbidity; Eating disorders; Heavy drinking.

MeSH terms

  • Adult
  • Binge-Eating Disorder*
  • Bulimia*
  • Comorbidity
  • Ecological Momentary Assessment
  • Humans
  • Risk Factors