(PS8-A20) The Role of Anxiety in Relationships Between Interoception and Disordered Eating

Dysfunctional interoception (i.e., how one experiences internal bodily cues) is linked to disordered eating behaviors. Researchers often imply that dysfunctional interoception causes disordered eating via anxiety. Yet, this claim has not been empirically tested. Network analyses identify distrust in one’s body, a facet of interoception, as the most important bridge symptom linking interoception to both anxiety and disordered eating. This study tested whether anxiety accounted for the association between interoception – specifically the facet of body trust – and a range of disordered eating behaviors.

A total of 213 university students completed measures of body trust (Trusting subscale, Multidimensional Assessment of Interoceptive Awareness-2), hunger/satiety-specific interoception (Intuitive Eating Scale-2), general anxiety (Generalized Anxiety Disorder-7), and disordered eating attitudes and behaviors (Eating Pathology Symptom Inventory), and provided demographic information. Four indirect effect models were tested with body trust as the independent variable, general anxiety as the intervening variable, and binge eating, restricting, cognitive restraint, and purging as the dependent variables. Simple indirect effects (IE) and associated 95% bootstrap confidence intervals (CI) were calculated using the PROCESS macro for SPSSv25 (continuous variables, i.e., binge eating, restricting, and cognitive restraint) and the Model Indirect command of Mplusv8 (zero-inflated variable, i.e., purging). Controlling for BMI, sex, and hunger/satiety-specific interoception, significant indirect effects were observed for the associations between body mistrust and binge eating (IE = -.068, CI [-.140, -.012]), restricting (IE = -.064, CI [-.134, -.013]), and cognitive restraint (IE = -.113, CI [-.279, -.001]). No significant indirect effect emerged for purging behaviors. As anticipated, greater body mistrust was associated with greater anxiety, which was associated with more disordered eating attitudes and behaviors. Anxiety may be a key process by which mistrust in one’s body leads to a subset of disordered eating behaviors. Cognitive behavioral approaches and interoceptive exposures targeting trust of body sensations, may contribute to improved treatment outcomes for disordered eating. Body trust, however, is a single facet of interoception. Future work should examine whether anxiety accounts for the association between other aspects of interoception (e.g., hunger/satiety detection and responsiveness) and disordered eating behaviors. Findings should also be replicated using longitudinal data.