The central role of body image in the explanation of the engagement in disordered eating attitudes and behaviors

Abstract

Shame is a universal emotion, that has been emphasized as a pathogenic phenomenon in well-being and mental health. In fact, although shame has been considered an adaptive defensive response, higher levels of this painful emotion are strongly associated with different mental health conditions. The current study aimed to test whether the association of external shame with eating psychopathology would be explained by the mechanisms of body image-related cognitive fusion, psychological inflexibility, and also dietary restraint. A path analysis testing a mediational model was conducted in a sample of 787 women from the general community, aged between 18 and 51 years old. The tested model accounted for 71% of the variance of eating psychopathology and revealed an excellent fit to the data. Results demonstrated that external shame's impact on disordered eating attitudes and behaviors is indirect, carried through increased body image-related cognitive fusion, psychological inflexibility related to physical appearance, and dietary restraint. These findings seem to support the association between shame and eating psychopathology. Furthermore, these data add to literature by suggesting that individuals who present higher levels of shame may present increased tendency to engage in dietary restraint and other maladaptive eating behaviors, through higher levels of body image-related psychological inflexibility and cognitive fusion. The current study seems to hold important clinical implications, highlighting the importance of developing intervention programs in the community which target shame and body image-related maladaptive attitudes and behaviors and, in turn, promote adaptive emotion regulation strategies (e.g., acceptance abilities).

Disclosure of interest

The authors have not supplied their declaration of competing interest.