Fear of fat in eating disorders: The mediating role of individual differences in self-disgust

Abstract

Although the fear of fat is considered central to the transdiagnostic conceptualization and treatment of eating disorders, the origin of this fear is unclear. Self-disgust, the profound revulsion at one's own character or actions, has been linked with various eating disorder symptoms, including drive for thinness, and may be a mechanism that partially explains the fear of fat observed among those with eating disorders. The present study examines the extent to which self-disgust explains the association between an eating disorder diagnosis and fear of fat. The sample consisted of community adult females diagnosed with an eating disorder (n = 30) and healthy comparisons (n = 30). Participants completed validated measures of fear of fat, self-disgust, and depression. Compared to healthy participants, individuals with an eating disorder reported significantly more fear of fat (t(58) = 9.51, p < .001, d = -2.45), self-disgust (t(46.58) = 8.87, p < .001, d = -2.29, and depression (t(41.17) = 8.30, p < .001, d = -2.14). Mediation analyses revealed self-disgust significantly mediated the relationship between an eating disorder diagnosis and fear of fat after controlling for depression (Effect = 6.10, SE = 1.41). Findings suggest that individuals with an eating disorder may employ various maladaptive strategies to prevent gaining weight (i.e., purging) that partially originate from a profound revulsion of the self. The implications for a transdiagnostic conceptualization and treatment of self-disgust in eating disorders as well as limitations and suggestions for future research directions are discussed.