(PS8-A15) Women’s Disordered Eating and Sexual Function: The Role of Interoception

Both women diagnosed with an eating disorder and women exhibiting subthreshold disordered eating behaviors report worse sexual outcomes, including lower drive for sex and more pain during sex. However, it is unclear why disordered eating and sexual difficulties commonly co-occur.  One possible explanation is that interoceptive dysfunction (i.e., altered experience of internal bodily cues) may play a key role in this co-occurrence, above and beyond body image concerns and biomedical factors related to low body weight (e.g., hypogonadism). Indeed, interoceptive dysfunction is implicated in both eating disorders and, more recently, women’s sexual function. Yet, investigations of interoceptive dysfunction in the relationship between disordered eating and sexual function are largely absent from both the disordered eating and women’s sexual health literatures. To that end, the current study examined interoception and dietary restraint as predictors of women’s sexual functioning. Hypotheses for this study were preregistered (https://aspredicted.org/7P1_MSM) and included that interoception would predict sexual function over and above dietary restraint, body image concerns, and BMI.

Women (18 years+, had sex in the last four weeks) were recruited from online venues. A total of 1,230 women (61.6% heterosexual; 27.5% bisexual; M_Age = 25.86; M_BMI  = 25.46) completed online measures of disordered eating pathology (Eating Disorder Examination Questionnaire), interoceptive sensibility (Multidimensional Assessment of Interoceptive Awareness – 2), and sexual function (Female Sexual Function Index). Missing data were imputed using the Amelia II package in R; dominance, regression, and commonality analyses were conducted using the yhat 2.0-2 package. Independent variables included eight facets of interoception and dietary restraint; the dependent variable was sexual function. Dominance analyses revealed that trusting (i.e., tendency to trust body cues) was the most dominant facet of interoception predicting both dietary restraint (dominance weight [DW] = .16) and sexual function (DW = .06). Regression models supported hypotheses and revealed that trusting (b = 1.12, p < .001) predicted sexual function over and above body mass index, body image concerns, and dietary restraint. A commonality analysis revealed that trusting uniquely accounted for the largest portion of R² in sexual function (28.98%), followed by BMI (10.25%) and body image concerns (7.53%). A total of 24.10% of the R² of sexual function was common to both trusting and body image concerns. Results are consistent with work demonstrating that how individuals experience and think about their body is central to both eating pathology and sexual function. Interoception, particularly trusting one’s bodily cues, may contribute to the comorbidity of disordered eating and sexual difficulties. Further, the sizeable commonality between body trust and body image concerns suggests that body trust may be a facet of body image. Cognitive-behavioral approaches that help individuals build trust of their body sensations while simultaneously targeting body dissatisfaction may contributed to improved outcomes for both women’s disordered eating and sexual function.