The impact of stress and self-awareness on food intake in children and adolescents with and without loss of control eating – an experimental test of the escape from self-awareness model

Loss of control eating (LOC-E) is the most common form of disordered eating in childhood and adolescence. Negative emotions and stress play a crucial role in its development and maintenance. The purpose of this study is to experimentally test the escape from self-awareness model, which proposes that LOC-E occurs because individuals attempt to reduce their emotional distress by shifting their focus from an aversive self-perception to the immediate environment, such as food. We investigated the effect of stress (false negative or positive performance feedback) and self-awareness (opened or closed full-body mirrors) inductions on desire to eat (DTE) and food intake in adolescents with and without LOC-E. While there were no effects of stress on DTE irrespective of group membership, participants with and without LOC-E ate less (rather than more, as hypothesized) in the high stress condition. Neither of these effects interacted with the self-awareness condition. Because the stress induction had the unintended effect of increasing participants’ self-awareness, we found evidence that participants decreased their food intake when experiencing stress and high self-awareness concurrently. The results of this study contribute to a further understanding of the role of stress and self-awareness on DTE and food intake in children and adolescents with and without LOC-E.