Exploring reactivity to EMA and consumer-grade wearable measurement of physical activity among individuals with binge-eating spectrum disorders
Elizabeth W. Lampe, Sasha Gorrell, Ahhyun Lee, Emily K. Presseller, Stephanie M. ManasseObjective
Advances in wearable technology offer new opportunities to comprehensively and objectively measure exercise in eating disorder (ED) samples; however, concerns persist that consumer-grade wearables may increase ED symptoms. To date, no studies have explicitly reported on reactivity to sensor-based activity assessment in binge-spectrum ED samples, limiting information on potential risks in this population.
Method
Adults with binge-spectrum EDs (N=30; 43.3% male) completed the Eating Disorder Examination (EDE) Interview and 28 days of 6-daily ecological momentary assessments (EMA) while wearing a consumer-grade activity tracker. We compared EMA-reported symptoms to EDE report and examined short-term variability (within-week) and long-term change (over 28 days) in physical activity (PA; steps, moderate-vigorous PA [MVPA], total PA) and ED symptoms (loss-of-control [LOC] eating, dietary restraint, body dissatisfaction, maladaptive exercise episodes). All models covaried for sex, BMI, and EMA compliance.
Results
Across the EMA period, participants reported fewer maladaptive exercise episodes (M
diff
=-26.43, p<.001), non-maladaptive exercise (M
diff
=-16.83, p=.020), and other compensatory behaviors (M
diff
=-15.90, p=.007), and episodes of dietary restraint (M
diff
=-7.97,
Conclusion
Findings suggest limited reactivity to wearable monitoring in binge-spectrum EDs. Decreases in some ED symptoms may reflect increased awareness, behavior change, or over-reporting at baseline. Minimal changes in ED symptoms and PA support feasibility of wearables in binge-spectrum ED research, with low risk of harm.