Examining the associations between beliefs about losing control and eating disorder symptomatology

Cognitive behavioural therapy (CBT) for eating disorders (EDs) does not yield consistent long-term recovery for all patients, highlighting the need to better understand underlying cognitive mechanisms. Recent work suggests that beliefs about losing control - particularly anticipated catastrophic consequences - may serve as key etiological and maintenance factors.

This study examined whether negative beliefs about losing control predict general ED symptomatology in an undergraduate sample.

Data were drawn from a larger psychometric study on control-related constructs and obsessive-compulsive symptoms. A total of 262 undergraduate participants completed the Beliefs About Losing Control Inventory - Second Edition (BALCI-II), Eating Disorder Examination Questionnaire (EDE-Q 6.0), and Depression, Anxiety and Stress Scale (DASS-21).

Simple linear regression indicated that BALCI-II total scores significantly predicted EDE-Q total scores (adj. R²=.08, F_1,260=23.61, p<.001). However, in a hierarchical regression, BALCI-II scores did not account for additional variance in ED symptoms beyond depression (ΔR²=.18, ΔF_1,259=.624, p=.43). Subscale analyses showed that fears of losing control leading to overwhelming emotions significantly predicted ED symptoms (β=.22, t₂₅₉=3.03, p=.006), whereas fears related to madness and dangerous behaviours were not significant predictors.

Beliefs about losing control - especially fears of overwhelming emotions - appear to contribute to ED symptom maintenance. These findings provide initial psychometric support for prior qualitative research and suggest such beliefs may represent a meaningful treatment target within CBT. Future research should investigate causal relationships between these beliefs and ED psychopathology.