Disorganized attachment predicts body mass index via uncontrolled eating

Int J Obes (Lond). 2020 Feb;44(2):438-446. doi: 10.1038/s41366-019-0378-0. Epub 2019 Jun 4.

Abstract

Background/objectives: Previous research has demonstrated relationships between attachment orientations (expectations of ourselves and others in interpersonal relationships), eating behaviours and obesity. However, such research has been limited to investigations of 'organised' forms of attachment orientations (reflecting coherent and predictable patterns of behaviour). Theoretically, aberrant eating behaviours and body mass index, should also be related to 'disorganized attachment.'

Subjects: Here we test these relationships for the first time in a general population. Secondary data analyses of a pre-existing dataset were conducted (N = 537).

Methods used: Questionnaire measures of organised (avoidant and anxious) and disorganized attachment were included alongside eating behaviour measures (emotional eating, uncontrolled eating and cognitive restraint) and body mass index (BMI).

Results: Parallel multiple mediation analysis (PROCESS) showed that uncontrolled eating (but not emotional eating or cognitive restraint) significantly mediated a relationship between disorganized attachment and body mass index (significant indirect relationship; LLCI = 0.02 ULCI = 0.16) when both attachment anxiety and avoidance were included as covariates.

Conclusions: We suggest that the mechanism underpinning this indirect relationship is a form of maladaptive affect regulation, but that the behavioural motivators differ from those observed in anxiously attached individuals. Rather than eating being a premeditated strategy used by individuals high in disorganized attachment to manage emotion, opportunities to eat are simply taken as they present themselves. Professionals engaged in addressing eating problems and weight management should consider attachment orientations in their patient assessments and be mindful that attachment disorganized individuals are especially likely to engage in uncontrolled eating behaviours that are associated with a higher BMI.

MeSH terms

  • Adolescent
  • Adult
  • Body Mass Index*
  • Emotions / physiology*
  • Feeding Behavior / psychology*
  • Feeding and Eating Disorders / psychology
  • Female
  • Humans
  • Hyperphagia / psychology
  • Interpersonal Relations*
  • Male
  • Obesity / epidemiology
  • Obesity / psychology*
  • Surveys and Questionnaires
  • Young Adult