Category: Eating Disorders
Keywords: Eating Disorders | Exercise | Randomized Controlled Trial
Presentation Type: Symposium
Prior research has shown that overall levels of stress and negative affect, as well as cognitive, emotional and behavioral reactivity to distress, each confer risk for eating disorders. However, it is unclear whether reductions in one or all of these constructs drive intervention effects. Using secondary data analyses from an RCT of yoga for stress reactivity and affective eating, this study evaluated the efficacy and three potential mediating pathways of a yoga intervention for improving eating disorder symptoms (EDS). Women (N=52) high in perceived stress, dietary restraint, and emotional eating were randomized to 8 weeks of twice-weekly Bikram Yoga or to waitlist control. Validated measures of EDS, frequency/severity of aversive emotional states, cognitive-emotional reactivity, and behavioral responses and expectancies were administered at baseline, weeks 3 and 6, and post-treatment. Multilevel modeling revealed significant effects of condition on change over time in EDS (pp=.01), perceived stress (p=.001), emotional eating (p=.005), eating to manage affect (p=.036), and two subscales of distress tolerance (tolerance: p=.021; absorption: p=.002). We used cross-lagged panel analyses to test the effect of each mediator (individually and together) on subsequent reductions in EDS. Changes in the expectancy that eating relieves negative affect (CI: -1.71, -0.08; PM=.21) emerged as the most robust mediator, followed by the frequency of negative affect itself (CI: -1.09, -0.03; PM=.12). Negative affect-related eating expectancies are a reliable and proximal risk factor for ED; the ability of a non-specific complementary intervention to impact them is thus encouraging. Results suggest that yoga may work primarily via response modulation, the last of Gross’ (1998) five stages of emotion regulation. Specifically, yoga may provide an alternative, more effective regulation strategy, thereby reducing the belief that eating is useful for coping. Though this yoga intervention was not designed or manipulated to target emotion regulation, considering how aspects of emotion regulation may be bolstered to target ED is relevant for future investigations.
Postdoctoral Research Fellow
National Center for PTSD; Center for Innovation to Implementation; VA Palo Alto Health Care System
Saturday, November 18
12:00 PM – 1:30 PM
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