Direct and indirect effects of alexithymia on eating disorder symptoms in a non-clinical female sample: determining the role of negative affect

Alexithymia, a multifaceted personality construct, characterised by difficulties identifying and describing one’s feelings, and by an externally focused cognitive style. Alexithymia is risk factor for negative affect and disordered eating. Previous work involving patients with anorexia nervosa revealed that high levels of alexithymia were directly linked to eating disorder symptoms and also indirectly linked via negative affect. Our aim was to establish if these findings generalised to subclinical disordered eating symptoms. A non-clinical sample of females (n=206) completed measures of depression, anxiety, alexithymia, and disordered eating. As expected, negative affect (combined depression and anxiety) mediated the effect of alexithymia (difficulty identifying feelings and difficulty describing feelings) on disordered eating symptoms (drive for thinness, bulimia, and body dissatisfaction). However, also as expected, direct effects of these alexithymia facets on disordered eating were still evident after controlling for negative mood. Our findings confirm that the relationships observed in patients with clinically diagnosed eating disorders are also evident in those with subclinical disordered eating. Targeted interventions to reduce deficits in recognising and describing one’s feelings could potentially ameliorate disordered eating in ‘at risk’ participants.

Commentary on disordered eating symptoms and bariatric/metabolic surgery

Objective: This article presents an argument for the rethinking of concerns around bariatric/metabolic surgery in people with disordered eating. Conclusion: Practice has usually been cautious but disordered eating and eating disorders should not be a contraindication other than exceptional cases. Further research directions are suggested.