Attachment and eating: A meta-analytic review of the relevance of attachment for unhealthy and healthy eating behaviors in the general population

Abstract

Attachment relationships play an important role in people's wellbeing and affliction with physical and mental illnesses, including eating disorders. Seven reviews from the clinical field have consistently shown that higher attachment insecurity-failure to form trusting and reliable relationships with others-systematically characterized individuals with eating disorders. Nevertheless, to date, it is unclear whether (and if so how) these findings apply to the population at large. Consequently, the objective of the present meta-analysis is to quantify the relationship between attachment and unhealthy and healthy eating in the general population. Data from 70 studies and 19,470 participants were converted into r effect sizes and analysed. Results showed that higher attachment insecurity (r = 0.266), anxiety (r = 0.271), avoidance (r = 0.119), and fearfulness (r = 0.184) was significantly associated with more unhealthy eating behaviors, ps = 0.000; conversely, higher attachment security correlated with lower unhealthy eating behaviors (r = -0.184, p = 0.000). This relationship did not vary across type of unhealthy eating behavior (i.e., binge eating, bulimic symptoms, dieting, emotional eating, and unhealthy food consumption). The little exploratory evidence concerning healthy eating and attachment was inconclusive with one exception-healthy eating was associated with lower attachment avoidance (r = -0.211, p = 0.000). Our results extend previous meta-analytic findings to show that lack of trusting and reliable relationships does not only set apart eating disordered individuals from controls, but also characterizes unhealthy eating behaviors in the general population. More evidence is needed to determine how attachment and healthy eating are linked and assess potential mechanisms influencing the attachment-eating relationship.

Exploring the reciprocal relationships between adolescents' perceptions of parental and peer attachment and disordered eating: A multiwave cross‐lagged panel analysis

“…Overall, the results indicated that better attachment to mother prospectively predicted less pronounced disordered eating among girls and boys, as pointed out by other authors (Jewell et al, 2016;Ward, Ramsay, & Treasure, 2000). However, in contrast to a recent meta-analysis which did not find any differences regarding the attachment figure (Faber et al, 2018), our results underline the differential role that fathers and This study supported the protective influence of a better attachment towards mother on disordered eating in both genders, thus extending previous cross-sectional evidence (Bäck, 2011;Boone, 2013). Our results parallel some prospective studies showing that less secure attachment to mother predicted increases in ED symptoms (Burge et al, 1997;Goossens et al, 2012).…”

“…Our findings suggest that building secure attachment relationships with parents may prevent the emergence of unhealthy eating behaviors in adolescents (Faber et al, 2018). Our findings suggest that building secure attachment relationships with parents may prevent the emergence of unhealthy eating behaviors in adolescents (Faber et al, 2018).…”

“…This research has important implications for prevention. Our findings suggest that building secure attachment relationships with parents may prevent the emergence of unhealthy eating behaviors in adolescents (Faber et al, 2018). It would be of interest to implement programs that provide parents with the communication skills necessary to manage conflicts, so that the adolescent's normative process of autonomy is facilitated while the parent-child relationship is preserved (Allen & Tan, 2016).…”

“…When caregivers are inconsistent or not available in responding to the needs of their children, insecure attachment patterns may give rise to more inflexible and self-critical IWMs (Mikulincer & Shaver, 2012). Insecurely attached individuals report poor self-worth and fear of rejection by others which increase the risk for developing disordered eating (Cole-Detke & Kobak, 1996;Faber, Dubé, & Knäuper, 2018). Insecure adolescents may direct the attention toward their bodies in terms of aesthetic standards in an attempt to gain acceptance by others and to suppress the distress related to their diminished self-esteem (Cole-Detke & Kobak, 1996).…”

Influence of Emotional Determinants on the Food Choices of the Portuguese

“…According to van Strien et al [41], high overconsumers are usually overweighted, have higher degrees of dietary restraint and also higher degrees of emotional and of external eating. They are also more often female and better educated.…”