Affective Trajectories of Binge Eating, Purging, and Exercise Among Sexual Minority Men.

Objective: In the context of eating disorders, the negative reinforcement model states that binge eating and purging reduce negative affect. Expanding on prior work mostly conducted with women, this study examines affective trajectories surrounding binge eating, purging, and exercise among sexual minority men.

Method: We conducted a 7-day experience sampling study with a community sample of 529 sexual minority men. Participants received eight daily surveys assessing positive and negative affect, binge eating, purging, and exercise. We assessed affective trajectories pre- and post-behavior using multilevel polynomial regression models.

Results: Across 7 days, 37% of participants binged, 10% purged, and 70% exercised at least once. Before binge eating and purging, negative affect increased and positive affect decreased, indicating worsening mood. After binge eating and purging, negative affect decreased, indicating improved mood. Positive affect increased post-binge but did not change post-purge. Results were consistent on binge-only and purge-only days (i.e., no co-occurrences of binge eating, purging, or exercise on the same day). Exercise followed a different pattern: before exercise, negative affect did not change, and positive affect increased. After exercise, negative affect increased and positive affect decreased, indicating worsening mood. However, negative affect did not increase after exercise-only occasions.

Discussion: These findings support the negative reinforcement model of binge eating and purging among sexual minority men. Surprisingly, exercise was not consistently associated with changes in negative affect and dampened positive affect. These findings suggest clinicians should incorporate affect regulation training in treating binge eating and purging to support sexual minority men navigate stressors.