Momentary predictors of binge eating episodes and heavy drinking episodes in individuals with comorbid binge eating and heavy drinking

Abstract Purpose – The co-morbidity of binge eating and heavy drinking (BE+HD) is a serious concern due to the high prevalence rates and associated elevated severity. Clarifying the momentary factors that increase risk for binge eating and heavy drinking among BE+HD is important for expanding theoretical models of BE+HD and informing treatment recommendations. The current study used ecological momentary assessment (EMA) to compare the momentary processes maintaining binge eating between BE+HD and individuals with binge eating only (BE-only) and to identify the momentary risk factors for binge eating episodes and heavy drinking episodes among BE+HD. Methods – Participants (BE+HD: N = 14; BE-only: N = 37) were adults with clinically-significant binge eating who completed between 7 – 14 days of EMA prior to treatment. Results – The presence of food and within-day dietary restraint predicted higher odds of binge eating for both groups. Among BE+HD, the presence of alcohol and dietary restraint increased risk for subsequent binge eating and subsequent heavy drinking, and the absence of food increased risk for subsequent heavy drinking.Conclusion - These results offer preliminary support for treatment interventions for BE+HD that focus on reducing dietary restraint and teaching strategies for urge management in situations with palatable food or alcohol. Future research should study the maintenance mechanisms of BE+HD with larger, more diverse samples and using study design approaches with more experimenter control (i.e., laboratory experiments). Level of Evidence: Level IV, multiple time series without intervention