Exploring the Contributions of Affective Constructs and Interoceptive Awareness to Feeling Fat

Abstract Purpose Feeling fat, a subjective feeling of being overweight that does not correspond with body weight, is commonly-reported in patients with eating disorders (EDs). Research suggests that feeling fat relates to deficits in interoceptive awareness (IA), the perception and integration of signals related to body states. Relatedly, recent work has linked feeling fat to affective constructs, such as depressive symptoms and guilt. The current study explores the unique relationships between feeling fat, self-reported and objective IA, guilt, alexithymia, and depressive symptoms. Method Female undergraduates (N = 128) completed the 11th item of the Eating Disorder Examination Questionnaire, the Toronto Alexithymia Scale, the Guilt subscale of the Positive and Negative Affect Schedule, and the Beck Depression Inventory-II. Participants also completed two IA measures: a heartbeat perception task and the Multidimensional Assessment of Interoceptive Awareness. Results Results indicated that all collected measures explained 56% of the variability in feeling fat. Depressive symptoms, self-reported IA, and BMI accounted for significant variability in feeling fat. Relative weights analyses revealed that depressive symptoms accounted for the most variability in feeling fat. Conclusions Our results replicate previous findings that depressive symptoms relate significantly to feeling fat and extend this work by suggesting that, for ED patients with interoceptive deficits, depressed affective states contribute to feeling fat. Clarifying this relationship may provide novel targets for ED treatments. For example, endorsement of feeling fat during an intake assessment may alert clinicians to assess for depressive symptoms and focusing on these depressive symptoms in treatment may improve feeling fat. Level of Evidence: Level I: Evidence obtained from an experimental study