Worsening binge eating over time following an unsupervised low-carbohydrate diet

To investigate the associations and changes of adherence to a low-carbohydrate diet (LCD) on binge eating and food craving among Brazilian university students over a 3-mo period.

A two-wave evaluation study analyzing secondary data from a previously conducted cross-sectional study. The study was conducted remotely via online surveys targeting university students in southeastern Brazil. A total of 853 university students were initially included. Participants were categorized into four groups based on diet adherence and disordered eating (DE) symptoms: Control (CT), control with DE (CT + DE), LCD, and LCD with DE (LCD + DE). The study focused on observing self-reported adherence to an LCD and its associations with eating behaviors. Changes in binge eating symptoms (Binge Eating Scale), food craving (Food Craving Questionnaire-FCQ-T and FCQ-S), and dietary intake were evaluated over a 3-mo period. Statistical analyses were performed using IBM SPSS Statistics v.22.0. Group differences were assessed using bivariate tests. Logistic regression was conducted to identify predictors of LCD adherence.

Participants adhering to an LCD exhibited significant increases in Binge Eating Scale in both waves compared to controls (P < 0.001). The LCD + DE group reported the highest binge eating and food craving scores. Rice consumption, a culturally significant food, was inversely associated with LCD adherence, with lower consumption linked to increased binge eating episodes (OR = 0.76). Cognitive restraint levels were initially higher in the LCD group but equalized across groups over time. Individuals with moderate to severe binge eating symptoms had significantly higher odds of adhering to an LCD (OR = 7.23, P < 0.001).

Adherence to an LCD was associated with higher DE behaviors, particularly binge eating in both waves. Elevated FCQ-T scores were also present in individuals following an LCD. The restriction of culturally meaningful foods such as rice may contribute to heightened food craving and binge-eating episodes, emphasizing the need for culturally sensitive dietary adherence. Future research should explore long-term psychological and physiological consequences of LCD adherence and address potential risks associated with restrictive eating behaviors, particularly in populations vulnerable to DE.