Emotion Regulation as a Predictor of Body Dissatisfaction in Individuals With Eating Disorders

Body dissatisfaction (BD) plays a key role in the development and maintenance of eating disorders (EDs). BD might be influenced by emotion regulation. The maladaptive emotion regulation strategy suppression, aimed at inhibiting emotional responses, may increase BD by intensifying negative body-related affect. Adaptive strategies like cognitive reappraisal, involving the reinterpretation of emotional situations, may reduce BD by reshaping emotional responses to body-related cues. This study explored whether these strategies predicted BD at two follow-up waves, one after 7-11 months and the second after 19-23 months, and whether ED status (current or recovered) moderated these effects.

Data were drawn from three consecutive waves (T0), (T1), and (T2) of the longitudinal naturalistic Netherlands Eating disorder Registry (NER; n = 364), including individuals with current EDs (n = 276) and recovered individuals (n = 84). Two linear mixed-effects models examined the effects of suppression and reappraisal on BD, with ED status as a moderator.

Higher suppression levels were significantly associated with greater BD in individuals with EDs compared to recovered individuals at T0 (B = 3.08, p < 0.001). Neither reappraisal nor suppression predicted BD over time, nor did ED status moderate this relationship (reappraisal: p = 0.970 and p = 0.125, suppression: p = 0.884 and p = 0.582). Random effects indicated considerable individual variability in BD.

The study found no evidence that suppression or cognitive reappraisal predicted longitudinal changes in BD. Only an association between suppression and BD was found, suggesting that suppression and BD do appear to co-occur in EDs and may reinforce each other.