Does active regulation of negative emotions lead to binge eating in patients with Binge Eating Disorder?

Negative mood states seem to influence eating disordered behaviors in subjects
with Binge Eating Disorder (BED). A link seems to exist between emotional
disturbances or negative emotional states and binge eating behaviours (Grilo &
Shiffman, 1994) . Food cravings that led to a binge were associated with lower
levels of mood, lower energy, higher levels of tension and lower levels of
hunger than cravings that did not lead to a binge (Waters, Hill, & Waller,
2001). Although mood is worse overall for women with BED, mood is especially
poor before binge episodes (Greeno, Wing, & Shiffman, 2000).
A few studies investigated the effect of negative affect in subjects with BED
by means of an experiment. A negative mood influenced the perception of BED
subjects and therefore the labelling of the eating episode as a binge (Telch &
Agras, 1996)(Chua, Touyz, & Hill, 2004). Agras and Telch (Agras & Telch, 1998)
found that negative mood significantly increased loss of control over eating.
To control these urges to binge or to override negative emotions, subjects need
to exert self-control. Baumeister, Muraven and colleagues (2000) proposed that
*people have a limited quantity of resources available for self-control and
that various acts of self-control draw on this limited stock* (page 247). When
a situation demands two consecutive acts of self-control, performance on the
second (unrelated) act is frequently impaired . For example in a study by Vohs
and Heatherton (2001) chronic female dieters were instructed either to suppress
their emotions while watching an upsetting movie or to show their natural
emotions. Afterwards they all had to complete a ice-taste task. The
participants who were instructed to suppress their emotions ate significantly
more ice cream during the taste task than the participants who were instructed
to act natural. These results support the hypothesis that self-control is
depleted after one act of self-control.

We hypothesized that trying to regulate negative emotions would lead to binge
eating in patients with BED. Patients with BED who actively try to alter their
negative emotions are unable to control or inhibit their desire to resist
(fattening) food and thus subsequently binge. In this study we want to
investigate whether patients with BED who are instructed to suppress their
emotions during an upsetting movie, eat more during a subsequent taste task
compared to patients who are instructed to react naturally.

Procedure
Day 1: Screening: Eating Disorder Examination (EDE) (Jansen, 2000; Cooper &
Fairburn, 1987), Beck Depression Inventory-II (BDI-II-NL)(Van der Does, 2002)

Day 2:
- Participants are randomly allocated to one of the two conditions and are
given instructions about how to regulate their behaviours during the video:
group 1: is instructed to suppress their emotions
group 2: is instructed to show natural emotions
- Completing of mood questionnaire (VAS scales).
- Watching fragment of the movie *the Champ* alone. Duration: 3 to 4 minutes.
- Completing of mood questionnaire (VAS scales).
- Taste task of different kinds of candy. Duration: 10 minutes
- Mood questionnaire (VAS scales)
- assessment of compliance with instructions

Participants have to visit the hospital twice for 45 minutes.