Stress in Eating Disorders and Obesity

Stress has long been implicated in the development and maintenance of both eating disorders and obesity. In this chapter, evidence for the most commonly implicated putative stressors, as culled from cross-sectional and longitudinal studies, is reviewed within the framework of the diathesis-stress model. These stressors include childhood maltreatment and sexual violation; military combat and military sexual violation; traumatic stress, injury, and illness; occupational stress; sociocultural pressure to be thin; and negative appearance-related feedback. Constructs that may mediate or moderate pathways from stressors to problematic eating are identified within the framework of the maladaptive coping model, wherein stress initiates a cascade of events potentially leading to disordered eating. Methodological challenges are identified and new directions based on recent analytic advances are proposed.