The link between external and internal shame and binge eating: the mediating role of body image-related shame and cognitive fusion

Eat Weight Disord. 2020 Dec;25(6):1703-1710. doi: 10.1007/s40519-019-00811-8. Epub 2019 Nov 12.


Purpose: Despite the growing interest in binge eating, research on this public health problem in male samples is limited. Indeed, the examination of underlying emotional mechanisms and potential gender differences in binge eating are still needed. This study explored differences between men and women in binge eating severity and related emotional mechanisms. Also, this study explored the impact of external and internal shame on binge eating severity, when mediated by body image-related shame and cognitive fusion, in men and women.

Methods: The sample consists of 787 participants from the general population (144 men and 643 women), aged from 18 to 40 years.

Results: Women presented higher levels of binge eating symptomatology and also of body image-related difficulties, than men. Path analysis results showed that external and internal shame had a significant impact on binge eating severity, and that these relationships were mediated by body image-related shame and cognitive fusion. Multi-group analysis revealed the invariance of this model in both sexes.

Conclusion: Although men and women revealed significant differences in the severity of binge eating and related emotional mechanisms, underlying mechanisms in binge eating seem to be invariant for gender. Indeed, this study suggested that both external and internal shame experiences play an important role in binge eating symptomatology, when associated with body image-related shame and cognitive fusion, both in men and women. These findings seem to support that binge eating may emerge as a maladaptive attempt to cope with shame experiences in both sexes.

Level of evidence: Level III: case control analytic study.

Keywords: Binge eating; Body image-related cognitive fusion; Body image-related shame; External shame; Gender; Internal shame.