Are affective states associated with disordered eating behaviors in the daily lives of sexual minority and heterosexual young women?: an ecological momentary assessment study.

Affective state-disordered eating associations are often studied to evaluate emotion regulation models of eating disorders. Disordered eating is common among sexual minority women, yet little is known about affect-disordered eating associations among this group. Ecological momentary assessment (EMA) was used to assess affect preceding and following disordered eating among sexual minority and heterosexual young women (ages 18-30) who binge eat. Five daily EMA surveys assessed affective states and disordered eating for 2 weeks among 146 sexual minority and 151 heterosexual cisgender women. Concurrent and time-lagged multilevel models were tested with sexual orientation as a moderator. Higher negative affect was associated with a greater likelihood of emotional eating in the next several hours. Higher positive affect was associated with a lower likelihood of subsequent emotional eating for both heterosexual and sexual minority women, and both higher and lower positive affect than average was associated with a lower likelihood of loss of control eating and dietary restraint for heterosexual women only. Negative affect was higher following emotional eating, and skipping meals for both groups, and higher following loss of control eating for heterosexual women only. Positive affect was higher for both groups following times when they did not report emotional eating. Sexual minority and heterosexual women generally showed similar affect-disordered eating patterns, but several critical differences were noted. In particular, among young sexual minority women, higher positive affect was not associated with lower likelihood of loss of control eating and dietary restraint, whereas it was for heterosexual women. Future research considering how unique sociocultural pressures (eg, heterosexist discrimination, community norms) impact sexual minority women could improve understanding of disordered eating for this at-risk and understudied group.