Exploration and comparison of cognitions and metacognitions related to eating, weight and shape described by obese people who do and do not report binge eating.

Abstract Background: Binge Eating Disorder (BED) commonly, although not exclusively, occurs in obesity. Currently, the cognitions and cognitive processes involved in BED are not fully understood. The self-regulatory executive function model (S-REF; Wells & Matthews, 1994, 1996) is the dominant model regarding the role of metacognition in psychopathology. Metacognition has not yet been explored in BED or obesity. A cognitive model of Bulimia Nervosa (BN) (Cooper, Todd, & Wells, 2009) provides a detailed explanation of the cognitions and cognitive processes involved in the binge eating (BE) cycle within BN. Research suggests aspects of the model could be relevant to obese binge eaters. Aim: To explore and compare the cognitions and metacognitions related to eating, weight and shape reported by obese people with and without BE. Method: Semi-structured interviews were conducted with ten obese participants, five with and five without BE (aged 23 to 61 years; BMI values from 36.2 to 67.9). Template analysis was used to analyse the data. Six self-report questionnaires and one demographics information sheet were included to contextualise the qualitative findings. Results: The a priori themes of ‘metacognitive knowledge’, ‘positive and negative beliefs about eating’ and ‘permissive thoughts’ were supported by the interview data for the obese binge eaters. Additional data-driven themes of ‘negative self-beliefs’ and ‘reflections’ emerged. For the non-binge eaters, the a priori themes of ‘positive and negative beliefs about eating’ were supported by the interview data. Additional data-driven themes of ‘negative self-beliefs’ and ‘metacognitive knowledge’ emerged. The quantitative data supported the qualitative results. Conclusions: The study is preliminary in nature. The results suggest both the S-REF and cognitive model of BN (Cooper et al., 2009) are potentially useful to enhance iv understanding of the cognitions and metacognitions important in both obese people with and without BE