We aimed to assess and compare emotional responses to different foods in relationship to eating disorder and associated features, across gender and age groups. We hypothesized that negative emotional responses to images of foods would be higher in (i) those with higher body dissatisfaction and (ii) older females.
Five hundred and thirty-six (18% Grade 5, 39% Grade 8 or 9, and 43% Grade 11 or 12) school, and 93 university students participated. Emotive responses to images of foods were assessed with a PowerPoint presentation of 16 differing food and four ‘neutral’ images shown over 30 s intervals. Responses were rated on three 10-cm visual analog scales measuring levels of happiness, fear and disgust. Body image concern was assessed with the nine-item body dissatisfaction subscale of the EDI and eating disorder symptoms with the Eating Disorder Examination Questionnaire.
With increasing age all three emotional responses towards food fell and body dissatisfaction increased. Compared to females, males showed significantly higher levels of a ‘happy’ response to food, and in adult females a fear emotive response correlated positively with eating concern and body dissatisfaction.
In men, positive emotive responses to food may be indicative of broader factors that reduce their vulnerability to eating disorders.
Central to an eating disorder are sufferer's thoughts, behaviors and feelings around food, and the impact of the former on weight and body image. Cognitive and behavioral aspects of eating disorders have been widely recognized as important to the identification, theoretical understanding and development of treatments. For example, key diagnostic criteria for bulimia nervosa (American Psychiatric Association, 1994) comprise cognitive and behavioral features and a specific cognitive behavioral therapy is recognized as having the ‘best evidence’ of any treatment for bulimia nervosa (National Institute for Clinical Excellence, 2004). The contribution of emotional features of eating disorders has had relatively less attention although the DSM-IV criteria for anorexia nervosa include an ‘intense fear of gaining weight’ as a key feature, and there is a wealth of literature addressing specific emotional states for people with eating disorders. For example, many studies have reported higher rates of alexithymia, particularly in anorexia nervosa (Troop, Schmidt, & Treasure, 1995; Zonnevijlle-Bender, van Goozen, Cohen-Kettenis, van Elburg, & van Engeland, 2004) but also in obese women with binge eating disorders (Pinaquy, Chabrol, Simon, Louvet, & Barbe, 2003). (Alexithymia as applied by Troop et al. (1995) and others is a psychological construct, denoting an inability to identify and express emotions, an inability to distinguish between emotional states and physical sensations, to be concrete and utilitarian in speech and thought, and to have a paucity of fantasy; Sifneos, 1973.) Negative emotions such as shame, guilt and disgust around binge eating and purging behaviors (e.g. Davey, Buckland, Tantow, & Dallos, 1998; Pinaquy et al., 2003) and their reinforcement of the diet–binge–purge cycle (Fairburn, 1981) have also been extensively investigated. In addition, high rates of co-morbidity with mood and anxiety disorders are reported (Blinder, Cumella, & Sanathara, 2006; Kaye, Bulik, Thornton, Barbarich, & Masters, 2004).
