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Examining a mediation model of body image-related cognitive fusion, intuitive eating, and eating disorder symptom severity in a clinical sample

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Abstract

Purpose

This study sought to explore the associations between Intuitive Eating (IE), eating disorder (ED) symptom severity, and body image-related cognitive fusion within a clinical sample. IE was also examined as a possible mediator in the relationship between body image-related fusion and ED symptoms.

Methods

This study includes cross-sectional analyses with data from 100 adult females and 75 adolescent females seeking residential treatment for an ED. Self-reported demographic information, ED symptoms, IE behaviors, and body image-related cognitive fusion were collected from participants within the first week of treatment following admission to the same residential ED treatment facility.

Results

ED symptom severity was significantly negatively associated with three of the four domains of IE; unconditional permission to eat, reliance on hunger and satiety cues, and body-food choice congruence. A significant mediational effect of IE on the relationship between body image-related fusion and ED symptoms through IE behaviors was observed (β = 11.3, SE = 0.003, p < 0.001). This effect was only observed for the unconditional permission to eat (β = 0.13, p = 0.003) and reliance on hunger and satiety cues (β = 0.10, p = 0.005) domains of IE when the domains were subsequently analyzed individually.

Conclusion

Unconditional permission to eat and reliance on hunger and satiety cues appear to be particularly influential domains of IE in the relationship between body image-related fusion and ED symptom severity. It is possible that changes in these IE domains may be mechanisms through which body image-related fusion influences ED symptoms. Future longitudinal research is needed to better understand the relationship between body image-related cognitive fusion and IE and the potential for targeting these constructs specifically in the context of ED treatment.

Level of evidence

Level V, cross-sectional analysis from descriptive study.

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Data availability

The data set analyzed for this study is not publicly available; however, the data may be provided from the corresponding author upon reasonable request.

Code availability

The statistical code used for analyses in this study is available from the corresponding author upon reasonable request.

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Funding

No funds, grants, or alternative financial supports were received to conduct this study.

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Authors and Affiliations

  1. Department of Psychology, Utah State University, 2810 Old Main Hill, Logan, UT, 84322, USA

    Jennifer L. Barney, Tyson S. Barrett & Michael P. Twohig

  2. Avalon Hills Eating Disorder Specialists, 175 E 100 N, Logan, UT, 84321, USA

    Tera Lensegrav-Benson & Benita Quakenbush

Authors
  1. Jennifer L. Barney
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  2. Tyson S. Barrett
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  3. Tera Lensegrav-Benson
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  4. Benita Quakenbush
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  5. Michael P. Twohig
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Corresponding author

Correspondence to Jennifer L. Barney.

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Conflict of interest

The authors have no conflicts of interest or competing interests to declare.

Ethics approval

All questionnaires and methodology for the current study were approved by the Utah State University Institutional Review Board [Ref #]. All procedures used in the study adhered to the tenets of the Declaration of Helsinki.

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Prior informed consent was obtained from all participants (and parents for all adolescent participants). The consent forms were examined and approved by the above Institutional Review Board.

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Informed consent for publication of analyses using the obtained data was included in the aforementioned written consents.

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Barney, J.L., Barrett, T.S., Lensegrav-Benson, T. et al. Examining a mediation model of body image-related cognitive fusion, intuitive eating, and eating disorder symptom severity in a clinical sample. Eat Weight Disord 27, 2181–2192 (2022). https://doi.org/10.1007/s40519-021-01352-9

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