An ecological momentary assessment study examining concordance between momentary antecedents and attributions of binge eating in individuals with binge-type eating disorders
Authors:   , Derrigo Karly , LaFata Erica 
Published: April 2023

While a significant amount of retrospective research has revealed commonly reported triggers for binge eating episodes, ecological momentary assessment (EMA) has become the preferred technique to capture the actual momentary antecedents of binge eating episodes (e.g., negative emotions, dietary restraint). However, no research studies to date have directly compared the momentary antecedents and perceived attributions of discrete binge eating episodes to understand potential parallels or disconnects between participants' experiences before and after binge eating. The current EMA study addressed this gap in the literature and hypothesized 1) concordance between emotion-related momentary antecedents (boredom, attentiveness, overall negative, and overall positive) and reported attributions (binge eating due to boredom, to cope with emotions, and because it felt good) and 2) concordance between dietary restraint-related momentary antecedents (limiting food intake, avoiding specific foods, and delaying eating) and reported attributions (waiting too long/restricted eating and giving up on restricting food intake) of discrete binge eating episodes. Participants (N=103) were eligible for the parent research study if they reported binge eating at least once per week. Participants were then asked to complete EMA surveys for 7-14 days. Generalized linear multi-level models (GLMM) were used in all analyses. Consistent with hypotheses, concordance was demonstrated by increased attentiveness before a binge episode being associated with a 71% reduction in the likelihood of attributing that binge episode to boredom (SE=.45, t(165)=-2.76, p=.006). Three findings did not support hypotheses and demonstrated non-concordance. First, the momentary antecedent of attempting to limit food intake before a binge episode was associated with retrospectively attributing that binge eating to coping with emotions (SE=1.28, t(165)=2.29, p=.02). Second, momentary elevations in boredom before a binge episode were associated with a lower likelihood of attributing that binge episode to boredom (SE=.41, t(165)=-3.01, p=.003). Third, increased attentiveness before a binge episode was significantly associated with attributing the binge eating episode to waiting too long to eat and/or restricting eating (SE=.26, t(165)=-2.10, p=.04). The findings first highlight how important momentary increases in attentiveness before a binge episode may be for reducing the likelihood of binge eating due to negative affect (boredom) and dietary restraint. In addition, the substantial amount of categorical non-concordance found emphasizes the discrepancies between clients' reported binge triggers in comparison to the actual momentary precursors. These identified gaps into participant insights may lead to a mismatch in the intervention strategies and could be illuminated in clinical settings by asking participants to self- monitor their moods and behaviors before and after binge eating episodes.