Momentary Changes in Gastrointestinal Visceral Sensitivity and Associations With Disordered Eating in a High-Risk...

Aversive conditioning theories posit that hypersensitivity to and anxiety about gastrointestinal sensations (i.e., gastrointestinal [GI] visceral sensitivity) maintains disordered eating. We hypothesized (1) that GI visceral sensitivity would demonstrate within-person variability across a 14-day period. Other hypotheses included: (2) within-person increases in GI visceral sensitivity would temporally precede restricting and compensatory behaviors, and (3) these behaviors would be followed by a subsequent decrease in GI visceral sensitivity.

Eighty-seven high-risk university students completed a 14-day ecological momentary assessment study (six prompts/day). Participants reported on their current GI visceral sensitivity and disordered eating behaviors since the last prompt. Four dynamic structural equation models (DSEM) tested bidirectional effects between GI visceral sensitivity and disordered eating behaviors (restricting, purging, weight/shape-motivated exercise, and binge eating [exploratory]).

GI visceral sensitivity demonstrated significant within-person variability. Consistent with hypotheses, within-person increases in GI visceral sensitivity preceded compensatory behaviors (purging, weight/shape-motivated exercise). Following compensatory behaviors, decreased within-person visceral sensitivity was observed. Bidirectional effects in restricting models were nonsignificant. Exploratory models demonstrated within-person decreases in GI visceral sensitivity preceding binge eating episodes, which were followed by within-person increases in GI visceral sensitivity.

This is the first study to examine momentary variability in GI visceral sensitivity. Findings are consistent with aversive conditioning theories and should be replicated in clinical samples and after accounting for GI symptoms. Just-in-time interventions targeting GI visceral sensitivity might be considered, including for binge eating.