Abstracts

Rationale: Binge eating puts individuals at risk for dropout of weight loss treatments andweight regain after treatment. However, treatments for binge eating have not beensuccessful at influencing weight. To improve obesity treatment, research needs toexamine binge eating with new theoretical approaches, interdisciplinary paradigms thatspan physiological, psychological, and behavioral bases, and designs that enable study ofeating behaviors within real world settings. The current study examined stress and bingeeating, with a design that integrated ecological momentary assessment (EMA) of stressand binge eating behavior with psychophysiological monitoring of the autonomic nervoussystem (ANS). The ANS is crucial for self-regulation, especially responding to andbalance the sympathetic and parasympathetic nervous systems, and low ANS flexibility isrelated to numerous psychological and physical health stressors. Measures of heart ratevariability (HRV) are indicators of ANS flexibility and can be obtained through noninvasive,ambulatory methods. The specific aims were to: 1) examine if lab-based HRVat baseline and when stressed by an experimental protocol is related to binge eatingbehaviors recalled from the previous four weeks and during a seven day at-home datacollection period; 2) analyze if self-reported stress precedes binge eating during a sevenday at-home data collection period; and 3) describe the experience of wearing a portableHR monitor and using a smartphone with EMA and the feasibility for clinical use inassessment and intervention.Design: 32 male and female participants with obesity completed a single lab visit tomeasure HRV and assess binge eating in the previous four weeks. HRV was measuredthrough a lab protocol containing 5 minute recordings during a baseline period and amental stressor. A subsample (n=16) of participants also completed a seven day at-homeprotocol for EMA assessment of stress and binge eating using a smartphone. During theseven days, participants self-reported stress using the 4-item version of the CohenPerceived Stress Scale before each eating episode and reported their eating behaviorsafter they finished eating. Participants wore a HR monitor for one day of the seven daysof the at-home protocol. At the end of the at-home protocol, these 16 participantsunderwent a semi-structured interviews and completed self-report questionnairesassessing their experience in the study and exploring the potential feasibility and clinicalutility of systems using the study devices. Multiple linear regression, longitudinalmultilevel mixed effects models, and qualitative, thematic content analysis wereperformed.Results: The sample was comprised of mostly female, non-Hispanic/Latino white orAfrican American single participants,and a range of household incomes. At the first lab visit, many HRV measures (RMSSD,HF, LFn, HFn, LF/HF ratio) were significantly different between the baseline andstressed conditions (p = 0.01 to p < 0.001). Significant relationships were found betweenHRV variables at baseline and both