Examining the associations between beliefs about losing control and eating disorder symptomatology

Background: Cognitive behavioural therapy (CBT) for eating disorders (EDs) does not yield consistent long-term recovery for all patients, highlighting the need to better understand underlying cognitive mechanisms. Recent work suggests that beliefs about losing control – particularly anticipated catastrophic consequences – may serve as key etiological and maintenance factors. Aim: This study examined whether negative beliefs about losing control predict general ED symptomatology in an undergraduate sample. Method: Data were drawn from a larger psychometric study on control-related constructs and obsessive-compulsive symptoms. A total of 262 undergraduate participants completed the Beliefs About Losing Control Inventory – Second Edition (BALCI-II), Eating Disorder Examination Questionnaire (EDE-Q 6.0), and Depression, Anxiety and Stress Scale (DASS-21). Results: Simple linear regression indicated that BALCI-II total scores significantly predicted EDE-Q total scores ( adj. R 2 =.08, F 1,260 =23.61, p <.001). However, in a hierarchical regression, BALCI-II scores did not account for additional variance in ED symptoms beyond depression ( ΔR 2 =.18, ΔF 1,259 =.624, p =.43). Subscale analyses showed that fears of losing control leading to overwhelming emotions significantly predicted ED symptoms ( β =.22, t 259 =3.03, p =.006), whereas fears related to madness and dangerous behaviours were not significant predictors. Conclusion: Beliefs about losing control – especially fears of overwhelming emotions – appear to contribute to ED symptom maintenance. These findings provide initial psychometric support for prior qualitative research and suggest such beliefs may represent a meaningful treatment target within CBT. Future research should investigate causal relationships between these beliefs and ED psychopathology.