Exploring Gender Differences in Associations Between Appetitive Traits, Negative Affect, and Binge Eating in Treatment-Seeking Adults with Overweight or Obesity

Abstract

Abstract Binge eating (BE) in adults with overweight or obesity (OW/OB) is associated with negative affect and appetitive traits (i.e., food responsiveness, satiety responsiveness, and reward-based eating). While these risk factors may be important intervention targets, they have not been evaluated concurrently, nor for gender consistency. Multigroup structural equation modeling assessed gender differences in associations between negative affect, appetitive traits, and BE among 293 treatment-seeking adults with OW/OB (m age = 46.6; m body mass index[BMI] = 34.5; 81.2% female; 20.1% Latinx, 60.8% white non-Latinx), adjusting for age, race/ethnicity and BMI. Separate models examined BE measured by the BE Scale (BES) total score and past month binge days measured by the Eating Disorder Examination Questionnaire (EDEQ). Both models demonstrated good model fit (CFI > 0.99, RMSEA < 0.03, SRMR < 0.06). BES scores were associated with negative affect (F:β = 0.17; M:β = 0.14) and appetitive traits (F:β = 0.57; M:β = 0.57) among both females and males (p’s ≤ 0.01). Binge days were associated with negative affect (β = 2.14) and appetitive traits (β = 1.48) in females (p’s < 0.01), but not males (p’s ≤ 0.30). A consistent covariance was observed between negative affect and appetitive traits across genders (r’s = 0.42–0.47, p’s ≤ 0.001). Conceptual models of BE should consider the joint role of negative affect and appetitive traits, as together these constructs may represent a larger risk factor for BE, particularly in adults with OW/OB. Future studies should evaluate potential gender bias in existing BE measurement tools, as the present study demonstrated inconsistent associations in males depending upon how BE was assessed.