Eating Behaviors 23 (2016) 41–47

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Eating Behaviors

The role of shame in emotional eating

Mek Wong, Mingyi Qian ⁎
School of Psychology and Cognitive Science, Peking University, Beijing 100871, PR China
Beijing Key Laboratory of Behavior and Mental Health, Peking University, Beijing 100871, PR China

a r t i c l e i n f o a b s t r a c t

Article history: Two studies were conducted to examine the role of shame in emotional eating. In the first study, 250 women
Received 7 April 2016 (mean age: 29.95 ± 8.78 years; body mass index: 22.46 ± 5.76) reported their experiences of one negative
Received in revised form 6 July 2016 self-conscious emotion (shame), two negative non-self-conscious emotions (anxiety, depression), and emotional
Accepted 13 July 2016
eating. With anxiety and depression controlled for, shame predicted depressive, anxious, angry, and positive
Available online 15 July 2016
emotional eating. In the second study, negative non-self-conscious (anxiety) and self-conscious emotions
Keywords:
(shame) were induced in participants. Five types of snack were used in the study. Emotional eating was mea-
Emotional eating sured by determining participants' binge impulse, actual food intake, and pleasure in eating the five types of
Self-conscious emotion snack. Ninety-one female participants were randomly assigned to either an anxiety-with-shame (n = 45;
Shame mean age: 22.46 ± 3.22 years; body mass index: 20.57 ± 5.42) or anxiety group (mean age: 21.89 ±
2.97 years; body mass index: 21.21 ± 5.58). Participants in the anxiety-with-shame group reported a greater
binge impulse relative to those in the anxiety group. Actual food intake and pleasure in eating the five snacks
did not differ significantly between the two groups. Implications of these findings were discussed.
© 2016 Elsevier Ltd. All rights reserved.

1. Introduction
Emotional eating refers to the impulse to eat following elicitation of
negative emotion (Arnow, Kenardy, & Agras, 1995) and different nega-
tive emotions elicit emotional eating differently (Arnow et al., 1995;
Macht, 1999). Emotional eating is closely related to overweight
(Geliebter & Aversa, 2003). Previous studies have identified emotional
eating as a widespread phenomenon, which exists on a continuum in
both healthy people and those with eating disorders. Emotional eating
could predict bingeing behavior in bulimia and anorexia nervosa and
is related to restriction of eating in anorexia nervosa. Women with a
strong tendency toward emotional eating are more likely to develop
eating disorders (Engelberg, Steiger, Gauvin, & Wonderlich, 2007;
Fioravanti et al., 2014).
Emotional eating is considered a learned behavior. Emotions are re-
peatedly matched to eating and become a trigger for the impulse to eat
(Jansen, Havermans, & Nederkoorn, 2011). Fairburn, Cooper, and
Shafran (2003) posited that emotion regulation maintains abnormal
eating behavior. Some individuals use eating to downregulate negative
emotions (Macht, Haupt, & Ellgring, 2005), which improve shortly after
eating (Bongers, Jansen, Havermans, Roefs, & Nederkoorn, 2013;
Gibson, 2006); therefore, emotional change negatively reinforces eating
behaviors (Engelberg et al., 2007; Fioravanti et al., 2014), which worsen
⁎ Corresponding author. at: School of Psychology and Cognitive Science, Peking
University, Beijing, 100871, PR China.
E-mail address: qmy@pku.edu.cn (M. Qian).
over time (Bongers et al., 2013). Escape theory implies that when indi-
viduals experience negative emotions, they shift their focus to instant,
concrete, physical stimulation by eating, and thoughts concerning emo-
tions are avoided through relatively low self-awareness activities
(Heatherton & Baumeister, 1991).
Numerous studies have examined the relationship between nega-
tive emotions and emotional eating. Emotional eating was positively as-
sociated with depressive symptoms (Konttinen, Männistö, Sarlio-
Lähteenkorva, Silventoinen, & Haukkala, 2010), anxiety (Goossens,
Braet, Van Vlierberghe, & Mels, 2009), and distress (Michels et al.,
2012). However, these studies did not control for the effect of self-con-
scious emotions, which have been linked to emotional eating. For exam-
ple, Wallis and Hetherington (2004) compared ego-threatening (high
self-conscious) and non-ego-threatening (low self-conscious) tasks
and found that the ego-threatening group ate a significantly larger
amount of food relative to the non-ego-threatening group. van Strien,
Ouwens, Engel, and de Weerth (2014) found that typical hunger reduc-
tion was absent in female participants following shame (self-conscious
emotion) elicitation, indicating that self-conscious emotion could exert
a unique effect on emotional eating. Shame, guilt, embarrassment, and
pride are typical self-conscious emotions (Lewis, 1992). This study fo-
cused on the effect of shame as a self-conscious emotion.
The relationship between shame and disordered eating behavior has
been examined in numerous studies, some of which focused on the re-
lationship between shame and emotional eating. Shame, which is im-
portant in eating disorders, is a self-conscious emotion involving
negative self-evaluation and a desire to escape (Lewis, 1971; Lewis,

http://dx.doi.org/10.1016/j.eatbeh.2016.07.004
1471-0153/© 2016 Elsevier Ltd. All rights reserved.
42 M. Wong, M. Qian / Eating Behaviors 23 (2016) 41–47
1992; Scheff & Retzinger, 1991; Tangney, 1995). Eating disorder pa-
tients exhibit higher levels of typical shame behavior, bodily and eat-
ing-related shame, and shame traits relative to healthy individuals.
Further, relative to healthy control groups, eating disorder recover
groups report higher shame levels (Hayaki, Friedman, & Brownell,
2002; McKinley & Hyde, 1996; Noll & Fredrickson, 1998;
Sweetingham & Waller, 2008). Liu (2015) found that when healthy
women's shame was elicited, they ate a higher number of snacks rela-
tive to those whose shame was not elicited.
This study aimed to explore the role of shame in emotional eating. As
anxiety always co-exist with shame and depression is closely related to
shame (Gilbert, 1998, 2000), in order to better investigate the unique
role of shame in emotional eating, anxiety and depression were con-
trolled in the Study 1, and anxiety was used as comparison in Study 2.
Study 1 used questionnaires to examine relationships between emo-
tional eating and shame while controlling for anxiety and depression.
We hypothesize that: anxiety will predict anxious emotional eating,
and depression will predict depressive emotional eating. After control-
ling anxiety and depression, shame will still be a significant predictor
for emotional eating.
Study 2 elicited participants' emotions in laboratory conditions, to
measure actual food intake, binge impulse, and pleasure in eating five
types of snack following emotion elicitation. Shame was elicited in the
experimental group, while anxiety matching that elicited with shame
in the shame-elicitation task was elicited in the control group. We hy-
pothesize that after emotions are triggered, shame group participants
will have stronger bingeing impulse, eat more and have more pleasure
in eating.
2. Study 1
2.1. Method
2.1.1. Participants
Participants were 250 Chinese women recruited via the Internet,
with advertisements posted on the Wechat's network website and
Douban. Wechat is a cellphone chatting software with N 549 million ac-
tive users, 86.2% of them are between 18 to 36 years smart phone users,
and Douban is a Chinese online community with N100 million sub-
scribers, core group of subscribers are well-educated young Chinese.
Participants' mean age, age range, and mean body mass index (BMI)
score were 29.95 ± 8.78 years, 14–62 years, and 22.46 ± 5.76,
respectively.
As the online survey system will require participants to fill all the
blanks when submitting the survey, among the 250 Chinese female
who had finished the survey, no outliers was found therefore no partic-
ipants were excluded.
2.1.2. Questionnaires
2.1.2.1. Emotional eating. The 25-item Emotional Eating Scale (EES),
developed by Arnow et al. (1995), was used to measure emotional
eating behavior after varieties of negative emotions and contains
Table 1
Means, SDs, and correlations between variables.
n Mean SD
1. CESD 250 31.44 10.62
2. SAS 250 42.83 9.95
3. ISS 250 51.93 18.81
4. Depressive emotional eating 250 2.44 1 1
5. Anxious emotional eating 250 1.93 0.94
6. Angry emotional eating 250 1.98 1.02
7 Positive emotional eating 250 3.05 0.92
CES-D: Center for Epidemiologic Studies Depression Scale; ISS: Internalized Shame Scale; SAS: Self-Rating Anxiety Scale.
⁎⁎ p b 0.01.
three subscales: anger/hostility, anxiety, and depression. The in-
tensity of each emotional state affecting eating was measured
using a five-point Likert scale ranging from 1 (none) to 5 (strong).
The Chinese EES was developed by Zhu (2012) and includes an ad-
ditional positive emotional eating subscale. The four subscales in
the Chinese EES are as follows: depressive emotional eating (9
items), anxious emotional eating (4 items), angry emotional eating
(5 items), and positive emotional eating (5 items). Cronbach's αs
for the four subscales were 0.92, 0.82, 0.89, 0.84, respectively, in
this study.
2.1.2.2. Shame. Internalized shame was measured using the Internalized
Shame Scale developed by Cook (1993), which originally consisted of 30
items including 24 and six measuring internalized shame and self-es-
teem, respectively. Only the internalized shame subscale was used in
this study. Participants provided responses using a five-point Likert
scale ranging from 0 (never) to 4 (always). Scores range from 0 to 96,
with higher scores indicating greater internal shame experienced the
preceding year. Cronbach's α for the internal shame subscale was 0.95
in this study.
2.1.2.3. Anxiety. Anxiety was evaluated using the Self-Rating Anxiety
Scale developed by Zung (1971), which consists of 20 items (e.g., I feel
afraid for no reason at all) rated on a four-point scale ranging from 1
(some of the time) to 4 (most of the time). Higher scores indicate anxiety
of greater intensity in recent two weeks (Wang, Wang, & Ma, 1999).
Cronbach's α for the scale was 0.82 in this study.
2.1.2.4. Depression. The Center for Epidemiologic Studies Depression
Scale was developed by Radloff (1977) to evaluate depressive symp-
tomatology in the general population and consists of 20 items reflecting
six aspects of depressive symptomatology: depressive affect, guilt and
worthlessness, helplessness and hopelessness, psychomotor retarda-
tion, appetite loss, and sleep problems. Participants indicate the fre-
quency with which symptoms occurred in the preceding week (e.g., I
was bothered by things that usually don't bother me). Participants pro-
vide responses using a four-point scale, ranging from 1 (occasionally or
none, representing less than a day), to 4 (most of the time or persistently;
representing 5–7 days). Scores range from 20 to 80, with higher scores
indicating greater depressive symptom frequency (Wang et al., 1999).
Cronbach's α for the scale was 0.85 in this study.
2.1.2.5. Demographic data. Sex, age, height, current weight, and ideal
weight were reported by participants.
2.1.2.6. Procedure. Questionnaires were completed online. The study was
approved by the Peking University Psychology Department Ethics
Committee.
2.2. Results
Means, standard deviations, and correlations between variables are
presented in Table 1.
1 2 3 4 5 6 7
1 0.32⁎⁎ 0.62⁎⁎ 0.29⁎⁎ 0.23⁎⁎ 0.22⁎⁎ 0.19⁎⁎
1 0.42⁎⁎ 0.27⁎⁎ 0.22⁎⁎ 0.23⁎⁎ 0.04
1 0.41⁎⁎ 0.31⁎⁎ 0.28⁎⁎ 0.20⁎⁎
0.64⁎⁎ 0.60⁎⁎ 0.17⁎⁎
1 0.61⁎⁎ 0.28⁎⁎
1 0.42⁎⁎
1
 M. Wong, M. Qian / Eating Behaviors 23 (2016) 41–47 43

Table 2
Regression analysis of depressive emotional eating.

R2 adjR2 ΔR2 F P Β β T p 95% CI

0.12 0.11 0.11 16.97⁎⁎⁎ b0.001

CESD 0.02 0.02 3.66⁎⁎⁎ b0.001 0.01, 0.03
SAS 0.02 0.02 3.12⁎⁎ 0.002 0.01, 0.03
0.18 0.17 0.06 18.49⁎⁎⁎ b0.001
CESD 0.01 0.05 0.66 0.51 −0.01, 0.02
SAS 0.01 0.12 1.81a 0.07 −0.001, 0.02
ISS 0.02 0.33 4.30⁎⁎⁎ b0.001 0.01, 0.03

CES-D: Center for Epidemiologic Studies Depression Scale; ISS: Internalized Shame Scale; SAS: Self-Rating Anxiety Scale.
⁎⁎⁎ p b0.001.
⁎⁎ p b 0.01.
a
p b 0.10.

Stepwise linear regression was performed to assess the effect of
shame on emotional eating, beyond the influence of depression or anx-
iety. The first step included depression and anxiety, and the second step
included shame. Emotional eating was divided into depressive, anxious,
angry, and positive emotional eating.
With depression and anxiety controlled for, shame was a significant
predictor of depressive emotional eating (β = 0.33, p b 0.001; Table 2),
anxious emotional eating (β = 0.23, p b 0.01; Table 3), and angry emo-
tional eating (β = 0.20, p b 0.05; Table 4) and a marginally significant
predictor of positive emotional eating (β = 0.15, p = 0.07; Table 5).
3. Study 2
3.1. Method
3.1.1. Participants
Participants were 91 female college students aged 18–29 years who
were attempting to lose weight, recruited from the online Bulletin
Board System college weight-loss community. They were informed
that the purpose of the study was to determine the effect of attempted
weight loss on food preference. Participants were randomly assigned to
two groups: the control (anxiety) group consisted of 46 women (mean
age: 22.46 ± 3.22 years; BMI: 20.57 ± 5.42) and the experimental (anx-
iety-with-shame) group consisted of 45 women (mean age: 21.89 ±
2.97 years; BMI: 21.21 ± 5.58).
awkwardness, and shame. Participants were asked to rate the intensity
of their emotions using a seven-point scale ranging from 1 (not at all) to
7 (very strongly). Mean scores for these items reflected the intensity of
participants' anxiety and shame. Higher scores indicated emotion of
greater intensity.
3.1.2.4. Emotion-elicitation material. The shame-elicitation process de-
veloped by Gruenewald, Kemeny, Aziz, and Fahey (2004) was used to
elicit shame in the anxiety-with-shame group. Participants delivered a
3-min speech regarding a student union presidential campaign. They
were allowed 2 min to prepare the speech and asked to deliver it
alone in a room in front of an iPad used to record the speech. Partici-
pants watched the video with the experimenter and evaluated their
performance.
Anxiety was elicited in the anxiety group via a 3-minute video clip
excerpt from the American television program, Hannibal. The video
clip was about the evening of a young woman, who drove home, fed
her pet bird, and found and fixed a leak in the roof above her bedroom.
Upon returning to her bedroom, she was dragged underneath her bed.
The clip elicited anxiety-related emotions (anxiety, fear, and tension)
in participants in a pilot study.
Five types of snack were chosen, based on the pilot study results, and
placed before participants in the following order: potato chips (100 g),
chocolate (150 g), biscuit (100 g), shredded squid (150 g), and egg
roll (150 g).

3.1.2. Measures 3.1.2.5. Flavor rating scale. Participants evaluated the appearance, smell,
saltiness, sweetness, spiciness, and crispness of the snacks. The rating
3.1.2.1. Demographic data. Age, sex, current weight, and height were re- scale served only to engage participants in the food-tasting task; results
ported by participants. were not analyzed.

3.1.2.2. Hunger. Participants reported the intensity of the feeling of full- 3.1.2.6. Binge impulse. Participants rated the extent to which they
ness, which varied between 0% and 100%; each rank represented a wanted to binge using a seven-point scale ranging from 1 (not at all)
10% difference. to 7 (very strongly).

3.1.2.3. Self-rated emotion. To eliminate the effect of wording, three items 3.1.2.7. Actual eating behavior. Actual eating behavior was evaluated via
were used to measure each emotion. Anxiety was measured using ten- the amount of food consumed, which was weighed using electronic
sion, anxiety, and fear, while shame was measured using loss of face, scales (reading accuracy: 0.1 g).

Table 3
Regression analysis of anxious emotional eating.

R2 adjR2 ΔR2 F P Β β T p 95% CI

0.08 0.07 0.08 10.25⁎⁎⁎ b 0.001

CESD 0.02 0.18 2.79⁎⁎ 0.01 0.01, 0.03
SAS 0.02 0.16 2.47⁎⁎ 0.01 0.003, 0.03
0.11 0.09 0.03 7.73⁎ 0.01
CESD 0.01 0.06 0.75 0.46 −0.01, 0.02
SAS 0.01 0.11 1.57 0.12 −0.002, 0.02
ISS 0.01 0.23 2.78⁎⁎ 0.01 0.003, 0.02

CES-D: Center for Epidemiologic Studies Depression Scale; ISS: Internalized Shame Scale; SAS: Self-Rating Anxiety Scale.
⁎⁎⁎ p b 0.001.
⁎⁎ p b 0.01.
⁎ p b 0.05.
44 M. Wong, M. Qian / Eating Behaviors 23 (2016) 41–47

Table 4
Regression analysis of angry emotional eating.

R2 adjR2 ΔR2 F p Β β T p 95% CI

0.08 0.07 0.08 10.03⁎⁎⁎ b0.001

CESD 0.02 0.16 2.47⁎⁎ 0.01 0.003, 0.03
SAS 0.02 0.18 2.74⁎⁎ 0.01 0.01, 0.03
0.10 0.09 0.02 5.74⁎ 0.02
CESD 0.01 0.05 0.69 0.49 −0.01, 0.02
SAS 0.01 0.13 1.93a 0.06 0.00, 0.03
ISS 0.01 0.20 2.40⁎ 0.02 0.002, 0.02

CES-D: Center for Epidemiologic Studies Depression Scale; ISS: Internalized Shame Scale; SAS: Self-Rating Anxiety Scale.
⁎⁎⁎ p b 0.001.
⁎⁎ p b 0.01.
⁎ p b 0.05.
a
p b 0.10.

3.1.2.8. Pleasure in eating. Participants rated the extent to which they
enjoyed eating on an 11-point scale ranging from 1 (not at all) to 10
(very strongly).
3.1.3. Procedure
The study was advertised to the online Bulletin Board System college
weight-loss community. Participants were informed that the study pur-
pose was to assess the influence of attempting weight loss on food pref-
erence. Participants were not required to refrain from eating before the
experiment but a level of hunger that would allow swimming when ar-
riving was required. Participants were randomly allocated to anxiety
group and anxiety-with-shame group.
Participants provided demographic information, rated their current
emotional states and hunger, and performed emotion-elicitation tasks.
The procedure is shown in Fig. 1.
There was no time limit for the food-tasting task; upon completion,
participants entered the waiting room and waited for the researcher.
Participants were informed of the real study purpose and provided
with the researcher's telephone number; they were asked to call if
they felt uncomfortable about the experiment and advised that the ex-
perimenter would arrange follow-up intervention. Participants were
paid and released.
3.2. Results
Age, BMI, and fullness at Time 1 did not differ significantly between
groups (Table 6).
3.2.1. Manipulation check
A repeated measures ANOVA was performed to examine the effects
of emotion elicitation. The interaction between time and emotion elici-
tation exerted a significant effect on shame (F(1,89) = 51.78, p b 0.001,
η2partial = 0.37). The main effects of time (F(1,89) = 24.29, p b 0.001,
η2partial = 0.23) and emotion elicitation (F(1,89) = 41.19, p b 0.001,
η2partial = 0.32) were significant. Before the emotion-elicitation task,
shame did not differ significantly between groups (F(1,89) = 0.45,
p = 0.51, η2partial = 0.01), but after the task, the anxiety-with-shame
group (mean: 3.45 ± 1.52) experienced significantly greater shame rel-
ative to the anxiety group (mean: 1.23 ± 0.57; F(1,89) = 86.01,
p b 0.001, η2partial = 0.49; Table 7).
The interaction between time and emotion elicitation exerted a sig-
nificant effect on anxiety (F(1,89) = 15.10, p b 0.001, η2partial = 0.15).
The main effects of time (F(1,89) = 209.37, p b 0.001, η2partial = 0.70)
and emotion elicitation (F(1,89) = 5.22, p = 0.03, η2partial = 0.06)
were significant. Before the emotion-elicitation task, anxiety did not dif-
fer significantly between groups (F(1,89) = 0.07, p = 0.79, η2partial =
0.001), but after the task, the anxiety group (mean: 4.97 ± 1.66) expe-
rienced significantly greater anxiety relative to the anxiety-with-shame
group (mean: 3.79 ± 1.64; F(1,89) = 13.40, p b 0.001, η2partial = 0.13;
Table 7). Anxiety intensity was controlled for in the subsequent analysis,
to determine the effect of shame on eating.
3.2.2. Eating
A MANCOVA was performed to examine differences in desire to
binge, pleasure in eating, and actual food intake between groups. To de-
termine the effects of shame accurately, anxiety was controlled for as
covariates. We hypothesized that relative to that in the anxiety group,
shame in the anxiety-with-shame group would be more strongly relat-
ed to emotional eating, eliciting a stronger tendency toward eating.
The MANCOVA showed a significant effect of group, F(3, 86) = 3.41,
p = 0.02, η2partial = 0.11. Binge impulse differed significantly (F(1,90) =
9.15, p = 0.003, η2partial = 0.09), but pleasure in eating (F(1,90) = 1.49,
p = 0.23, η2partial = 0.02) and actual food intake (F(1,90) = 0.21, p =
0.65, η2partial = 0.002) did not differ significantly, between the anxiety-
with-shame (means: 2.69 ± 1.50, 6.35 ± 1.69, and 42.40 ± 34.17, re-
spectively) and anxiety (means: 1.96 ± 1.26, 6.04 ± 2.31, and
36.78 ± 28.05, respectively) groups (see Table 8).
4. Discussion
To our knowledge, this was the first study to examine the role of
shame in emotional eating while controlling for depression and anxiety.
Shame played an important role in emotional eating in two studies with
different designs (correlational and experimental) and measurement

Table 5
Regression analysis of positive emotional eating.

R2 adjR2 ΔR2 F p Β β T p 95% CI

0.04 0.03 0.04 4.69⁎ 0.01

CESD 0.02 0.20 2.99⁎⁎⁎ b0.001 0.01, 0.03
SAS 0.002 −0.02 −0.32 0.75 −0.01, 0.01
0.05 0.04 0.01 3.21a 0.07
CESD 0.01 0.12 1.45 0.15 −0.004, 0.02
SAS −0.01 −0.06 −0.84 0.40 −0.02, 0.01
ISS 0.01 0.15 1.79a 0.07 0.001, 0.02

CES-D: Center for Epidemiologic Studies Depression Scale; ISS: Internalized Shame Scale; SAS: Self-Rating Anxiety Scale.
⁎⁎⁎ p b 0.001.
⁎ p b 0.05.
a
p b 0.10.
 M. Wong, M. Qian / Eating Behaviors 23 (2016) 41–47
methods (self-report and behavioral measures). Study 1 used a self-re-
port questionnaire to explore the effect of shame (self-conscious emo-
tion) on emotional eating, beyond anxiety and depression (non-self-
conscious emotion). With anxiety and depression controlled for in the
first regression step, shame continued to predict depressive, anxious,
angry, and positive emotional eating. In Study 2, shame and anxiety
(non-self-conscious emotion) were elicited in both groups. The anxi-
ety-with-shame group exhibited stronger binge desire relative to the
anxiety group. Pleasure in eating and actual food intake did not differ
between groups.
Previous research reported a positive link between negative emo-
tions and emotional eating (van Strien et al., 2014). Liu (2015) found
that, relative to a neutral control group, a shame group consumed a larg-
er amount of food. In Study 1, shame predicted emotional eating, be-
yond the effects of anxiety and depression. In accordance with Liu
(2015), shame played an important role in emotional eating. In previous
studies, anxiety and depression were positively related to emotional
eating, but these studies did not differentiate between different types
of emotional eating (Goossens et al., 2009; Konttinen et al., 2010). In
Study 1, anxiety predicted depressive, anxious, and angry emotional
eating, and depression predicted depressive, anxious, angry, and posi-
tive emotional eating; however, the effects of anxiety and depression
decreased after shame was added to the regression model and shame
predicted depressive, anxious, angry, and positive emotional eating.
Arnow, Kenardy, and Agras (1992) found that 42% of participants report
feeling anger/frustration, 37% reported feeling anxiety/agitation, 16%
feeling sadness/depression, 5% reports regret before bingeing. Our result
indicate that underlining the relationship between anxiety-anxious
emotional eating, depression-depressive emotional eating, shame
played a common role in different kinds of emotional eating. This
added new information to the field.
Study 2 further explored the role of shame in emotional eating. As
anxiety was elicited with shame in the shame-elicitation task, it was
elicited with the same intensity in the anxiety group. However, the anx-
iety group's anxiety was significantly greater relative to that of the anx-
iety-with-shame group. Anxiety was controlled for in the analysis, to
determine the effect of shame accurately. Actual food intake and plea-
sure in eating did not differ significantly between groups; however,
the anxiety-with-shame group reported a higher binge impulse relative
Table 6
Participants' mean age, fullness, and BMI.
Condition n Mean SD t p
Age Anxiety group 46 22.46 3.22 0.87
Anxiety with shame group 45 21.89 2.97
Fullness Anxiety group 46 6.33 1.79 −0.97
Anxiety with shame group 45 6.71 2.01
BMI Anxiety group 46 20.57 5.42 −0.56
Anxiety with shame group 45 21.21 5.58
BMI: body mass index; SD: standard deviation.
45
Fig. 1. Experimental procedure.
to that of the anxiety group. According to escape theory, emotional eat-
ing is a means of avoiding emotional experiences by focusing on bodily
stimuli (Heatherton & Baumeister, 1991). Shame, as a self-conscious
emotion, involved overall self-appraisal, which along with shame, is rel-
atively stable (Rohleder, Chen, Wolf, & Miller, 2008). As mentioned in
previous literatures, when experiencing shame, individuals exhibited a
strong tendency toward escape (Lewis, 1971; Lewis, 1992; Scheff &
Retzinger, 1991; Tangney, 1995). Therefore, it is understandable that
shame elicited a strong binge impulse, as participants could have had
a strong escape impulse. Future studies should measure the escape im-
pulse among shame and other non-self-conscious emotions directly to
provide further support for the relation among shame-escape-binge.
As actual food intake did not differ between groups, it could have
been affected by the laboratory environment, which involved moni-
tored food intake. The anxiety-with-shame group could have sup-
pressed their eating behavior despite a desire to binge, which is
consistent with typical hiding behavior patterns observed when people
experience shame. In previous research, when individuals consumed
self-regulatory resources in one task (e.g., suppressing the eating im-
pulse), their performance in subsequent self-regulation tasks deterio-
rated (Svaldi, Griepenstroh, Tuschen-Caffier, & Ehring, 2012). Future
studies should explore this further.
Shame and emotional eating might begin a vicious cycle which
might lead to the onset of eating disorder. Our study finds that shame
explains additional variances of emotional eating above and beyond
other negative emotions, suggesting shame playing a unique role in
the development and maintenance of disordered eating behaviors. We
speculate there might be vicious cycle between shame and emotional
eating. That is, emotional eating might be used as a way to escape
from negative emotion, including shame. Macht and Mueller (2007)
found that negative emotions reduce after emotional eating so it rein-
forces emotional eating. However, emotional eating does not reduce
shame but leads to more shame as it is likely to reduce self-appraisal.
Thus forming a vicious cycle, which might contribute to the onset and
development of eating disorder. Indeed, Goss and Gilbert (2002) also
proposed a shame-shame model of eating disorder. Consistent with
this speculation, previous research also found that eating disorder pa-
tients have more shame (Hayaki et al., 2002; McKinley & Hyde, 1996;
Noll & Fredrickson, 1998; Sweetingham & Waller, 2008).
Table 7
d Self-reported emotional states at Times 1 and 2.
0.38 0.87
Anxiety group Anxiety with shame group
0.34 0.97 Time 1 Time 2 Time 1 Time 2
n Mean SD n Mean SD n Mean SD n Mean SD
0.58 0.56 Anxiety 46 2.03 1.24 46 4.97 1.66 45 2.10 1.21 45 3.79 1.64
Shame 46 1.53 1.03 46 1.23 0.57 45 1.68 1.15 45 3.45 1.52
SD: standard deviation.
46 M. Wong, M. Qian / Eating Behaviors 23 (2016) 41–47
Table 8
Desire to binge, desire to eat, pleasure in eating and total food intake.
Group Mean SD
Pleasure in eating Anxiety group 6.04 2.31
Anxiety-with-shame group 6.35 1.69
Actual food intake Anxiety group 36.78 28.05
Anxiety-with-shame group 42.40 34.17
Binge impulse Anxiety group 1.96 1.26
Anxiety-with-shame group 2.69 1.50
SD: standard deviation.
Macht (1999) found that in a joyful condition, participants exhibited
greater pleasure in eating relative to anger, fear, and sadness. No differ-
ence was observed between these three types of negative emotion. In
accordance with Macht (1999), in Study 2, pleasure in eating did not dif-
fer between the anxiety-with-shame and anxiety groups.
As mentioned, self-consciousness was neglected in previous re-
search. Our study examined shame as a self-conscious emotion, which
plays an important role in eating disorders (Goss & Gilbert, 2002;
Hayaki et al., 2002; McKinley & Hyde, 1996; Noll & Fredrickson, 1998;
Sweetingham & Waller, 2008), to determine its role in emotional eating.
Shame and other self-conscious emotions involve self-appraisal, where-
by individuals compare themselves with social standards and experi-
ence strong self-awareness. When shame was elicited, individuals
experienced a strong impulse to escape (Tangney, 1995). According to
escape theory, individuals actively shift their focus toward eating, to
avoid experiencing emotion (Heatherton & Baumeister, 1991). There-
fore, self-conscious emotions would have triggered a stronger eating
impulse, as participants were highly self-aware. In Study 1, with depres-
sion and anxiety controlled for, shame predicted emotional eating. In
Study 2, with anxiety controlled for, the anxiety-with-shame group re-
ported a strong binge impulse. Our results provided some evidence to
support escape theory. Future studies should match control and
shame groups according to the emotion elicited with shame, to deter-
mine the effect of shame accurately. Other self-conscious emotions,
e.g. guilt, should be studied to determine whether differences are ob-
served between emotions other than shame and anxiety or there is a
common distinction between self-conscious and non-self-conscious
emotions.
4.1. Implications
Our findings have some implications for future clinical eating disor-
der interventions. In previous research, emotional eating was closely re-
lated to eating disorders and obesity. In our study, shame played an
important role in emotional eating, as it led to a stronger binge impulse
and tendency toward emotional eating. Previous research showed that,
relative to healthy control participants, those who had recovered from
eating disorders exhibited greater shame, and Wilson and Pike (2004)
reported that 34% of eating disorder patients relapsed after CBT inter-
ventions for eating behavior management and body image correction.
Unresolved shame problem could relate to the high relapse rates. Our
findings suggested that emotional eating and shame do not merely co-
exist in eating disorders, and shame could lead to eating behavior that
is more disordered in nature. Clinical interventions targeting shame
and shame-related emotion regulation could be useful.
4.2. Limitations
Only snacks were used in the food-tasting task; future studies should
include various foods to determine whether different emotions elicit
different food preferences. Further, participants completed a laborato-
ry-based experimental task with limited food choice, and this unnatural
environment could have affected eating behavior; future studies should
use natural settings. Control group in Study 2 watched a video clip to
elicit their anxiety, however it also elicit fear. Fear and anxiety are highly
overlapping emotions centered on threats. Anxiety is related to antici-
pation of threats whereas fear is elicited by an identifiable fear stimulus
N (Öhman, 2008). Besides the co-existence of anxiety and fear, the video
46
clip scenario was not the most commonly experienced anxiety type in
45 daily life, future studies should try to use other methods to elicit more
46 normatively experienced anxiety (e.g. anxiety about a deadline) to com-
45 pare with shame, it could be clinically more helpful. Moreover, the stud-
46
ies included nonclinical samples of women, with only female college
45
students included in Study 2. Future research should examine differ-
ences between self-conscious and non-self-conscious emotions in
other populations. Future studies should include other self-conscious
and non-self-conscious emotions to determine whether differences
exist between them or shame and other emotions.
5. Conclusions
With anxiety and depression controlled for, shame, as a self-con-
scious emotion, predicted depressive, anxious, angry, and positive emo-
tional eating. Further examination showed that, relative to the anxiety
group, the anxiety-with-shame group reported a greater binge impulse.
Actual food intake and pleasure in eating did not differ significantly be-
tween groups. Shame was strongly related to unhealthy eating.
Role of funding sources
Funding for this study was provided by Prof. Mingyi Qian.
Contributors
Mek Wong and Mingyi Qian designed the study. Mek Wong conducted literature
searches, provided summaries of previous research studies, conducted the statistical anal-
ysis and wrote the first draft of the manuscript and all authors contributed to and have ap-
proved the final manuscript.
Conflict of interest
All other authors declare that they have no conflicts of interest.
Acknowledgements
We owe thanks to many people including Dr. Yin Yang, Ms. Wenting Mu, and Ms.
Xinfang Ding for comments on this and earlier drafts and Ms. Mingzhu Li for her friendship
and warm support.
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