Cue reactivity in male restrained eaters: The role of negative cognitions as predictors of food intake

  • Anja Hilbert
  • C. Vögele
  • U. Himmelmann
Original Research Paper


OBJECTIVE: While restrained eating is one of the most well-established risk factors of eating disorders in females, its role for eating disturbances in males remains largely unclear. The present study investigates eating behaviour in response to food cues and negative cognitions in male restrained eaters. METHODS: Twenty-four restrained eaters and 21 unrestrained eaters volunteered in a cue reactivity experiment consisting of two exposure trials with and without response prevention. Food and macronutrient intake were monitored, and negative cognitions were assessed using a self-report cognition inventory. RESULTS: Male restrained eaters consumed a larger amount of food, specifically carbohydrates, than unrestrained eaters. This greater food intake was predicted by negative cognitions about self-esteem and occurred in restrained eaters who had reported binge eating episodes in the diagnostic interview. DISCUSSION: Results suggest marked cue reactivity in male restrained eaters with an increased risk of overeating in those who experience low situational self-esteem and who are binge eaters.

Key words

Restrained eating binge eating eating disorders cue exposure cue reactivity negative cognitions men gender differences 


Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.


  1. 1.
    Bish C.L., Blanck H.M., Serdula M.K., Marcus M., Kohl H.W. 3rd, Khan L.K.: Diet and physical activity behaviors among Americans trying to lose weight: 2000 Behavioral Risk Factor Surveillance System. Obes. Res., 13, 596–607, 2005.PubMedCrossRefGoogle Scholar
  2. 2.
    Kruger J., Galuska D.A., Serdula M.K., Jones D.A.: Attempting to lose weight: specific practices among U.S. adults. Am. J. Prev. Med., 26, 402–406, 2004.PubMedCrossRefGoogle Scholar
  3. 3.
    Wardle J., Haase A.M., Steptoe A., Nillapun M., Jonwutiwes K., Bellisle F.: Gender differences in food choice: the contribution of health beliefs and dieting. Ann. Behav. Med., 2, 107–116, 2004.CrossRefGoogle Scholar
  4. 4.
    Westenhöfer J.: Prevalence of eating disorders and weight control practices in Germany in 1990 and 1997. Int. J. Eat. Dis., 29, 477–481, 2001.CrossRefGoogle Scholar
  5. 5.
    Heatherton T.F., Mahamedi F., Striepe M., Field A.E., Keel P.: A 10-year longitudinal study of body weight, dieting, and eating disorder symptoms. J. Abnorm. Psychol., 106, 117–125, 1997.PubMedCrossRefGoogle Scholar
  6. 6.
    Conner M., Johnson C., Grogan S.: Gender, sexuality, body image and eating behaviours. J. Health Psychol., 9, 505–515, 2004.PubMedCrossRefGoogle Scholar
  7. 7.
    Weinstein S.E., Shide D.J., Rolls B.J.: Changes in food intake in response to stress in men and women: Psychological factors. Appetite, 28, 7–18, 1997.PubMedCrossRefGoogle Scholar
  8. 8.
    Westenhöfer J., Stunkard A.J., Pudel V.: Validation of the flexible and rigid control dimensions of dietary restraint. Int. J. Eat. Dis., 26, 53–64, 1999.CrossRefGoogle Scholar
  9. 9.
    Fairburn C.G., Harrison P.J.: Eating disorders. Lancet, 361, 407–416, 2003.PubMedCrossRefGoogle Scholar
  10. 10.
    Jacobi C., Hayward C., de Zwaan M., Kraemer H.C., Agras W.S.: Coming to terms with risk factors for eating disorders: Application of risk terminology and suggestions for a general taxonomy. Psychol. Bull., 130, 19–65, 2004.PubMedCrossRefGoogle Scholar
  11. 11.
    Braun D.L., Sunday S.R., Huang A., Halmi K.A.: More males seek treatment for eating disorders. Int. J. Eat. Dis., 25, 415–424, 1999.CrossRefGoogle Scholar
  12. 12.
    Killen J.D., Taylor B.C., Hayward C., Wilson D.M., Haydel K.F., Hammer L.D., Simmonds B., Robinson T.N., Litt I., Varady A., Kraemer H.: Pursuit of thinness and onset of eating disorder symptoms in a community sample of adolescent girls: A three-year prospective analysis. Int. J. Eat. Dis., 16, 227–238, 1994.CrossRefGoogle Scholar
  13. 13.
    Stice E., Akutagawa D., Gagger A., Agras W.S.: Negative affect moderates the relation between dieting and binge eating. Int. J. Eat. Dis., 27, 218–229, 2000.CrossRefGoogle Scholar
  14. 14.
    Stice E., Killen J.D., Hayward C., Taylor T.C.: Age of onset for binge eating and purging during late adolescence: A 4-year survival analysis. J. Abnorm. Psychol., 107, 671–675, 1998.PubMedCrossRefGoogle Scholar
  15. 15.
    Ricciardelli L.A., McCabe M.P.: Dietary restraint and negative affect as mediators of body dissatisfaction and bulimic behavior in adolescent girls and boys. Behav. Res. Ther., 39, 1317–1328, 2001.PubMedCrossRefGoogle Scholar
  16. 16.
    Ricciardelli L.A., Williams R.J., Finemore J.: Restraint as misregulation in drinking and eating. Addict. Behav., 26, 665–675, 2001.PubMedCrossRefGoogle Scholar
  17. 17.
    Womble L.G., Williamson D.A., Martin C.K., Zucker N.L., Thaw J.M., Netemeyer R., Lovejoy J.C., Greenway F.L.: Psychosocial variables associated with binge eating in obese males and females. Int. J. Eat. Dis., 30, 217–221, 2001.CrossRefGoogle Scholar
  18. 18.
    Keel P.K., Klump K.L., Leon G.R., Fulkerson J.A.: Disordered eating in adolescent males from schoolbased sample. Int. J. Eat. Dis., 23, 125–132, 1998.CrossRefGoogle Scholar
  19. 19.
    Wertheim E.H., Paxton S.J., Maude D., Szmukler G.I., Gibbons K., Hiller L.: Psychosocial predictors of weight loss behaviors and binge eating in adolescent girls and boys. Int. J. Eat. Dis., 12, 151–160, 1992.CrossRefGoogle Scholar
  20. 20.
    Carlat D.J., Camargo C.A.: Review of bulimia nervosa in males. Am. J. Psychiatry, 148, 831–843, 1991.PubMedGoogle Scholar
  21. 21.
    Lewinsohn P.M., Seeley J.R., Moerk K.C., Striegel- Moore R.H.: Gender differences in eating disorder symptoms in young adults. Int. J. Eat. Dis., 32, 426–440, 2002.CrossRefGoogle Scholar
  22. 22.
    Ricciardelli L.A., Williams R.J., Kiernan M.J.: Bulimic symptoms in adolescent girls and boys. Int. J. Eat. Dis., 26, 217–21, 1999.CrossRefGoogle Scholar
  23. 23.
    Baucom H.B., Aiken P.A.: Effect of depressed mood on eating among obese and nonobese dieting and nondieting persons. J. Pers. Soc. Psychol., 41, 577–585, 1981.PubMedCrossRefGoogle Scholar
  24. 24.
    Hibscher J.A., Herman C.P.: Obesity, dieting and the expression of “obese” characteristics. J. Comp. Physiol. Psychol., 91, 374–380, 1977.PubMedCrossRefGoogle Scholar
  25. 25.
    Polivy J., Herman C.P.: Experimental studies of dieting. In: Fairburn C.G., Brownell K.D. (Eds.), Eating Disorders and Obesity: A Comprehensive Handbook, 2nd ed. New York, Guilford Press, 2002, pp. 84–87.Google Scholar
  26. 26.
    Williams S.S., Michela J.L., Contento I.R., Gladis M.M., Pierce N.T.: Restrained eating among adolescents: dieters are not always bingers and bingers are not always dieters. Health Psychol., 15, 176–184, 1996.PubMedCrossRefGoogle Scholar
  27. 27.
    Presnell K., Stice E.: An experimental test of the effect of weight-loss dieting on bulimic pathology: tipping the scales in a different direction. J. Abnorm. Psychol., 112, 166–170, 2003.PubMedCrossRefGoogle Scholar
  28. 28.
    Stice E., Presnell K., Groesz L., Shaw H.: Effects of a weight maintenance diet on bulimic symptoms in adolescent girls: an experimental test of the dietary restraint theory. Health Psychol., 24, 402–412, 2005.PubMedCrossRefGoogle Scholar
  29. 29.
    Jansen A.: A learning model of binge eating: Cue reactivity and cue exposure. Behav. Res. Ther., 36, 257–277, 1998.PubMedCrossRefGoogle Scholar
  30. 30.
    Jansen A.: The learned nature of binge eating. In: Leg C.R., Booth D.A. (Eds.), Appetite: Neural and behavioural bases. Oxford, Oxford University Press, 1994, pp. 193–211.CrossRefGoogle Scholar
  31. 31.
    Herman C.P., Polivy J.: A boundary model for the regulation of eating. In: Stunkard A.J., Stellar E. (Eds.), Eating and its Disorders. New York, Raven, 1984, pp. 141–156.Google Scholar
  32. 32.
    Lafay L., Thomas F., Mennen L., Charles M.A., Eschwege E., Borys J.M., Basdevant A.: Gender differences in the relation between food cravings and mood in an adult community: Results from the Fleurbaix Laventie Ville Santé Study. Int. J. Eat. Dis., 29, 195–204, 2001.CrossRefGoogle Scholar
  33. 33.
    Ouwens M.A., Van Strien T., Van der Staak C.P.: Tendency toward overeating and restraint as predictors of food consumption. Appetite, 40, 291–298, 2003.PubMedCrossRefGoogle Scholar
  34. 34.
    Van Strien T., Engels R.C., Van Leeuwe J., Snoek H.M.: The Stice model of overeating: tests in clinical and non-clinical samples. Appetite, 45, 205–213, 2005.PubMedCrossRefGoogle Scholar
  35. 35.
    Asbeck I., Mast M., Bierwag A., Westenhofer J., Acheson K.J., Muller M.J.: Severe underreporting of energy intake in normal weight subjects: use of an appropriate standard and relation to restrained eating. Public Health Nutr., 5, 683–690, 2005.Google Scholar
  36. 36.
    Fedoroff I.C., Polivy J., Hermann C.P.: The effect of pre-exposure to food cues on the eating behavior of restrained and unrestrained eaters. Appetite, 28, 33–47, 1997.PubMedCrossRefGoogle Scholar
  37. 37.
    Jansen A., van den Hout M.: On being led into temptation: “Counterregulation” of dieters after smelling a “preload”. Addict. Behav., 16, 247–253, 1991.PubMedCrossRefGoogle Scholar
  38. 38.
    Lattimore P., Maxwell L.: Cognitive load, stress, and disinhibited eating. Eat. Behav., 5, 315–324, 2004.PubMedCrossRefGoogle Scholar
  39. 39.
    Wallis D.J., Hetherington M.M.: Stress and eating: the effects of ego-threat and cognitive demand on food intake in restrained and emotional eaters. Appetite, 43, 39–46, 2004.PubMedCrossRefGoogle Scholar
  40. 40.
    Neudeck P., Florin I., Tuschen-Caffier B.: Food exposure in patients with bulimia nervosa. Psychother. Psychosom., 70, 193–200, 1997.CrossRefGoogle Scholar
  41. 41.
    Vögele C., Florin I.: Psychophysiological responses to food exposure: An experimental study in binge eaters. Int. J. Eat. Dis., 21, 147–157, 1997.CrossRefGoogle Scholar
  42. 42.
    Bramon-Bosch E., Troop N.A., Treasure J.L.: Eating disorders in males: A comparison with female patients. Eur. Eat. Dis. Rev., 8, 321–328, 2000.CrossRefGoogle Scholar
  43. 43.
    Grilo C.M., Masheb R.M.: Onset of dieting vs binge eating in outpatients with binge eating disorder. Int. J. Obes. Relat. Metab. Disord., 24, 404–409, 2000.PubMedCrossRefGoogle Scholar
  44. 44.
    Spitzer R.L., Devlin M.J., Walsh B.T., Hasin D., Wing R.R., Marcus M.D., Stunkard A., Wadden T., Yanovski S., Agras W.S., Nonas C.: Binge eating disorder: A multisite field trial of the diagnostic criteria. Int. J. Eat. Dis., 11, 191–203, 1992.CrossRefGoogle Scholar
  45. 45.
    Pudel V., Westenhöfer J.: Fragebogen zum Essverhalten (FEV) — Handanweisung. Göttingen, Hogrefe, 1989.Google Scholar
  46. 46.
    Stunkard A.J., Messick S.: The Three-Factor Eating Questionnaire to measure dietary restraint, disinhibition, and hunger. J. Psychosom. Res., 29, 71–83, 1985.PubMedCrossRefGoogle Scholar
  47. 47.
    Garner D.M., Olmstead M.P., Polivy J.: Development and validation of a multidimensional eating disorder inventory for anorexia nervosa and bulimia. Int. J. Eat. Dis., 2, 15–34, 1983.CrossRefGoogle Scholar
  48. 48.
    Thiel A., Paul T.: Entwicklung einer deutschsprachigen Version des Eating Disorder Inventory (EDI). Z. Diff. Diag. Psychol., 9, 267–278, 1988.Google Scholar
  49. 49.
    De Castro J.M.: The relationship of cognitive restraint to the spontaneous food and fluid intake of free-living humans. Physiol. Behav., 57, 287–295, 1995.PubMedCrossRefGoogle Scholar
  50. 50.
    Derogatis L.R.: SCL-90-R, administration, scoring procedures manual-II for the R(evised) version and other instruments of the Psychopathology Rating Scale Series. Townson, Clinical Psychometric Research, 1992.Google Scholar
  51. 51.
    Franke G.H.: SCL-90-R. Die Symptom-Checkliste von Derogatis - Deutsche Version. Weinheim, Beltz, 1995.Google Scholar
  52. 52.
    American Psychiatric Association. Diagnostic and Statistical Manual of Mental Disorders, 4th ed. Washington, DC, American Psychiatric Press, 1994.Google Scholar
  53. 53.
    Margraf J.: Mini-DIPS. Diagnostisches Kurzinterview bei psychischen Störungen. Berlin, Springer, 1994.CrossRefGoogle Scholar
  54. 54.
    Souci S.W., Fachmann W., Kraut H.: Die Zusammensetzung der Lebensmittel. Nährwert- Tabellen. Stuttgart, Medpharm, 2000.Google Scholar
  55. 55.
    Bonifazi D.Z., Crowther J.H.: In vivo cognitive assessment in bulimia nervosa and restrained eating. Behav. Ther., 27, 139–158, 1996.CrossRefGoogle Scholar
  56. 56.
    Cohen J.: Statistical power analysis for the behavioral sciences, 2nd ed. Hillsdale, Erlbaum, 1988.Google Scholar
  57. 57.
    Van Strien T., Cleven A., Schippers G.: Restraint, tendency toward overeating and ice cream consumption. Int. J. Eat. Dis., 28, 333–338, 2000.CrossRefGoogle Scholar
  58. 58.
    Polivy J., Coleman J., Herman C.P.: The effect of deprivation on food cravings and eating behavior in restrained and unrestrained eaters. Int. J. Eat. Dis., 38, 301–309, 2005.CrossRefGoogle Scholar
  59. 59.
    Greeno C.G., Wing R.R., Shiffman S.: Binge antecedents in obese women with and without binge eating disorder. J. Consult. Clin. Psychol, 68, 95–102, 2000.PubMedCrossRefGoogle Scholar
  60. 60.
    Niego S.H, Pratt E.M., Agras W.S.: Subjective or objective binge: Is the distinction valid? Int. J. Eat. Disord., 22, 291–298, 1997.PubMedCrossRefGoogle Scholar
  61. 61.
    Pratt E.M., Niego S.H., Agras W.S.: Does the size of a binge matter? Int. J. Eat. Dis., 24, 307–312, 1998.CrossRefGoogle Scholar
  62. 62.
    Leit R.A., Pope H.G. Jr, Gray J.J.: Cultural expectations of muscularity in men: the evolution of playgirl centerfolds. Int. J. Eat. Dis., 29, 90–93, 2001.CrossRefGoogle Scholar
  63. 63.
    Spitzer B.L., Henderson K.A., Zivian M.T.: Gender differences in population versus media body sizes: A comparison over four decades. Sex Roles, 40, 545–565, 1999.CrossRefGoogle Scholar
  64. 64.
    Drewnowski A., Kurth C.L., Krahn D.D.: Effects of body image on dieting, exercise, and anabolic steroid use in adolescent males. Int. J. Eat. Dis., 17, 381–386, 1995.CrossRefGoogle Scholar
  65. 65.
    O’Dea J.A., Abraham S.: Eating and exercise in young college men. J. Am. Coll. Health, 50, 273–278, 1997.CrossRefGoogle Scholar
  66. 66.
    McFarlane T., Polivy J., Herman C.P.: Effects of false weight feedback on mood, self-evaluation, and food intake in restrained and unrestrained eaters. J. Abnorm. Psychol., 107, 312–318, 1998.PubMedCrossRefGoogle Scholar
  67. 67.
    Stice E., Shaw H.: Eating disorder prevention programs: a meta-analytic review. Psychol. Bull., 130, 206–227, 2004.PubMedCrossRefGoogle Scholar
  68. 68.
    Herman C.P., Polivy J., Pliner P., Threlkeld J., Munic D.: Distractibility in dieters and nondieters: An alternative view of externality. J. Pers. Soc. Psychol., 36, 536–548, 1978.PubMedCrossRefGoogle Scholar
  69. 69.
    Westenhöfer J., Broeckmann P., Pudel, V.: Cognitive control of eating behaviour and the disinhibition effect. Appetite, 23, 27–41, 1994.CrossRefGoogle Scholar
  70. 70.
    Van Strien T.: Success and failure in the measurement of restraint: notes and data. Int. J. Eat. Dis., 25, 441–449, 1999.CrossRefGoogle Scholar

Copyright information

© Editrice Kurtis 2007

Authors and Affiliations

  1. 1.Department of Psychology, Clinical Psychology and Psychological TherapyPhilipps University of MarburgMarburgGermany
  2. 2.School of Human and Life Sciences, Clinical and Health Psychology Research Centre, Whitelands CollegeRoehampton UniversityLondonUK

Personalised recommendations