Background: Recent years have witnessed an increasing prevalence of binge eating tendencies in adolescence-warranting a clearer understanding of their underlying predisposing and precipitating factors. The current study investigated whether the interaction between high levels of anxiety and stress predicted increased levels of binge eating tendencies in a prospective cohort of adolescents (N = 324).
Methods: Measurements were taken over three waves (M ages: 13.33, 14.48, 15.65) as part of the CogBIAS Longitudinal Study. Longitudinal associations between levels of anxiety and stress with binge eating tendencies were estimated using a random intercept cross-lagged panel model (RI-CLPM), which calculates within-person fluctuations over time while accounting for individual trait-like stability and between-person variations. Binge eating tendencies were measured by the Cognitive Restraint, Uncontrolled Eating, and Emotional Eating styles from the Three-Factor Eating Questionnaire-R18. Two models were created for each binge eating tendencies variable: (1) a basic model with anxiety and stress as independent variables; (2) an interaction model with an additional anxiety*stress interaction term. Model fit was assessed by SEM fit indices: X2, CFI, NFI, TLI, RMSEA, SRMR. Superior model fit was ascertained by a chi-square difference test (p < .05).
Results: For Cognitive Restraint, the interaction model demonstrated superior fit to the data (p < .05). The anxiety*stress interaction at Waves 1 and 2 was significantly negatively associated with Cognitive Restraint at Waves 2 (β = -0.18, p = .002) and 3 (β = -0.14, p = .002)-suggesting that anxiety and stress interacted to predict increased binge eating tendencies linked with cognitive restraint over and above their independent effects. In contrast, the interaction term between anxiety*stress did not predict levels of Uncontrolled Eating or Emotional Eating over time.
Conclusions: The results highlight the importance of increasing awareness of the interaction between concurrently high anxiety and stress as a potential risk factor for binge eating tendencies in young people.
Trial registration: Not applicable.
Keywords: Adolescence; Anxiety; Binge eating; Eating behaviour; Eating disorder; Longitudinal; RI-CLPM; Risk factor; Stress; Structural equation modeling.
Binge eating tendencies have become an increasingly common phenomenon in adolescent populations. These behaviours involve consuming large amounts of food in a short period of time, during which one feels out of control and unable to stop. Episodes are often followed by marked emotional distress that can serve to perpetuate and maintain these tendencies. The current study examined a group of adolescents aged 13 to 16 over three testing periods spaced 12 to 18 months apart, to investigate whether high levels of anxiety and stress interacted to increase likelihood of binge eating tendencies in individuals over time. Results revealed that participants who experienced higher anxiety and stress than usual were more likely to score highly on binge eating tendencies measures, compared to when they experienced lower levels of anxiety and stress. Correspondingly, we recommend raising greater awareness in parents, educators, and health professionals of the link between high anxiety and stress and increased risk of binge eating tendencies, in order to facilitate better prevention, detection, and early intervention.
© 2021. The Author(s).