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Executive functioning (EF) problems may serve as vulnerability or maintenance factors for Binge-Eating Disorder (BED). However, it is unclear if EF problems observed in BED are related to overweight status or BED status. The current study extends this literature by examining EF in overweight-BED (n=32), normal-weight BED (n=23), overweight healthy controls (n=48), and normal-weight healthy controls (n=48). Participants were administered an EF battery which utilized tests from the National Institutes of Health (NIH) toolkit and Delis-Kaplan Executive Function System (D-KEFS). After controlling for years of education and minority status, overweight individuals with and without BED performed more poorly than normal-weight individuals with and without BED on a task of cognitive flexibility (p < 0.01) requiring generativity and speed and on psychomotor performance tasks (p < 0.01). Normal-weight and overweight BED performed worse on working memory tasks compared to normal-weight healthy controls (p = 0.04). Unexpectedly, normal-weight BED individuals out-performed all other groups on an inhibitory control task (ps < 0.01). No significant differences were found between the four groups on tasks of planning. Our findings support a link between poorer working memory performance and BED status. Additionally, overweight status is associated with poorer psychomotor performance and cognitive inflexibility. Replication of the finding that normal-weight BED is associated with enhanced inhibitory control is needed. / Psychology

Body image concerns in Binge Eating Disorder (BED) have been examined almost exclusively in overweight individuals with BED. The current study extends past research by including overweight and normal weight BED and non-BED groups to assess the multifactorial construct of body image using subscales of the Eating Disorder Examination 16.0 (EDE-16.0) and a Body Comparison Task. Independent of weight status and when controlling for age and race, women with BED are distinguished from those without BED by significantly greater overvaluation of shape and weight on the EDE -16.0 and significantly reduced weight satisfaction after a Body Comparison Task. Both BED diagnosis and weight status were independently associated with weight and shape concern subscales on the EDE-16.0. Taken together, these data provide further support for the consideration of body image concerns in the diagnostic criteria for BED. / Psychology

The purpose of this dissertation is to identify the variables associated with abstinence from binge-eating disorder and Bulimia Nervosa in the twelve-step recovery program of Overeaters Anonymous. The data were gathered through the completion of a survey by 231 active members of Overeaters Anonymous in the Washington metropolitan area. In addition to assessing the demographic composition of the aforementioned population, the variables that were assessed comprise the 'tools' of Overeaters Anonymous. They include: attendance at OA meetings, reading/writing from the Twelve Step literature, adhering to a food plan, having a sponsor, giving service, taking time for prayer and meditation, and making phone calls to other members. The activities of binge eating and bulimic participants were also examined to determine whether or not statistically significant differences exist between these two populations. Results revealed the typical OA participant to be a college educated (80%), Caucasian (89%) female (84%), between the ages of 34 and 44 (30%), married or living with a partner (44%), and employed in a full-time capacity (71%). Eight-four percent of the respondents were binge eaters, 15% were bulimic, and 1% anorexic. Multiple regression analyses revealed longer lengths of involvement in OA, a decrease in the frequency of relapse or 'slips', performing service, greater attendance at meetings, and progress on the ninth step, to be predictors of abstinence at the .05 level of significance. A lower frequency of relapse was predicted by longer lengths of involvement in OA, greater adherence to a food plan, increased frequency of phone calls to other members, and more time spent writing about one's thoughts and feelings at the .05 level of significance. Lastly, Independent Sample t-tests revealed bulimics to have significantly longer mean lengths of abstinence than did binge eaters. Alternately, the difference in the frequency of relapse or 'slips' between the two populations was not significant, suggesting that both bulimics and binge eaters have a comparable likelihood to relapse or slip back into eating disordered behaviors. / Ph. D.

In a survey sent to the senior women's administrator at all three hundred and thirty (N= 330) NCAA Division I intercollegiate athletic departments across the nation, this study examines the differences between Division I athletic department's having an eating disorder (ED) policy and those that that do not and the variables that lead to those differences. Over a 12-month period, from March 2004 through March 2005, one variable that this study addresses is whether having an ED policy influences the number of reported incidences. Likewise, another variable is whether education on ED for the student-athletes influences the number of reported incidences. Lastly, the final variable investigates those intercollegiate athletic departments that have other policies for their student-athletes such as alcohol, tobacco, and drug, and whether this influences having an ED policy. As the following research indicates, ED primarily affects the female gender. In addition, although ED are deemed a medical issue in which the head athletic trainer or the team physician is likely to work closely in treating the athlete, the senior women's administrator is chosen to complete the survey because of their gender, and this study focuses more on the policy itself, from an administrative prospective. For those universities surveyed who do not have such a policy, this paper examines the need, along with the legal responsibilities that intercollegiate athletic programs have toward their student-athletes concerning ED. / Ed. D.

Die vorliegende Literatursichtung belegt, gerade im Lichte neuen Störungswissens und für neue diagnostische Kategorien, die Notwendigkeit, die Wirksamkeit bestehender Therapieformen zu erhöhen und/oder neue Behandlungen für Essstörungen, speziell für Bulimia Nervosa und Binge Eating-Störung, zu entwickeln. Ein wesentlicher Erkenntnisgewinn wird zudem von einer systematischen Analyse des therapeutischen Prozesses sowie von Moderatoren und Mediatoren erwartet. Darüber hinaus stellen die Dissemination evidenzbasierter Therapiemethoden in die Praxis und eine Überprüfung gestufter Behandlungsmodelle wichtige Aufgaben zukünftiger Forschung dar. / The consideration of existing literature, especially in light of new knowledge of eating disorders and new diagnostic categories, highlights the necessity to increase the efficacy of current forms of therapy, and to develop novel therapies for eating disorders. This pertains, in particular, to bulimia nervosa and binge eating disorder. A considerable gain in knowledge is to be expected from a systematic analysis of the therapeutic process as well as the moderators and mediators. Furthermore, dissemination of evidence-based treatment methods in practical settings and an examination of stepped care models are important avenues of future research.

Binge-eating disorders are a common problem affecting up to 5 percent of the American population in any given 6-month period. Currently, the most widely accepted treatment is some variation of Cognitive Behavior Therapy. Although there is an abundance of research showing positive effects, the abstinence rates following this type of treatment are currently around 50%. A recent study by Bosch, Miltenberger, Gross, Knudson, and Brower-Breitwieser (2008) explored the effects of extinction on binge-eating behavior that was hypothesized to be maintained by relief from negative emotional responding. The study involved four women who engaged in binge-eating behavior, one of whom met the diagnostic criteria for Bulimia Nervosa. The treatment was successful, with three of the four participants obtaining abstinence. To date, this has been the only study examining this procedure and with only four participants. The purpose of the current study was to further evaluate extinction of binge eating maintained by automatic negative reinforcement with women who met diagnostic criteria for Bulimia Nervosa. Four young women enrolled in the study, three of whom met criteria for Bulimia Nervosa. The results showed that the treatment decreased binge eating to zero for all four women, although one dropped out of the study shortly after beginning the intervention.

Introduction: Eating disorders are serious psychiatric disorders that often require specialized care. Associated psychiatric comorbidity is frequent, with the most common comorbid conditions being anxiety and mood disorders. Eriksbergsgården in Örebro is one of Sweden’s specialized eating disorder treatment units.Aim: Primary aims were to describe clinical characteristics of the adult patient group at Eriksbergsgården and to evaluate treatment outcome and patient satisfaction at the one-year follow-up. An additional aim was to examine if factors such as psychiatric comorbidity affected treatment outcome.Methods: This study used data from Riksät and Stepwise, two large-scale Swedish registers for eating disorder treatment. Data for this study was registered into Stepwise and Riksät at Eriksbergsgården between August 2010 and December 2017 and 489 adult patients of both genders constituted the study group. Patient characteristics and DSM-IV axis I psychiatric comorbidity were assessed at the initial evaluation. At the one-year follow-up, treatment outcome and patient satisfaction were evaluated.Results: The most common diagnoses in this patient material were eating disorder not otherwise specified, 56.6 %, followed by bulimia nervosa, 26.4 %. At the initial evaluation, 62.0 % of the patients suffered from psychiatric comorbidity. Of the patients with initial comorbidity, 43.3 % were recovered at the one-year follow-up, compared to 62.8 % of the patients with no initial comorbidity, p=0.021.Conclusion: Our results confirm the previously known fact that psychiatric comorbidity among eating disorder patients is common. Also, the results identify psychiatric comorbidity as a possible factor to have negative effect on the treatment outcome.

Objective: Weight bias has strong associations with psychopathology in overweight and obese individuals. However, self-evaluative processes, as conceptualized in the process model of self-stigma, and implications for other health-related outcomes, remain to be clarified. Design and Methods: In a representative general population sample of N = 1158 overweight and obese individuals, the impact of core self-evaluation as a mediator between weight bias internalization and mental and global health outcomes as well as between weight bias internalization and health care utilization, was examined using structural equation modeling. Results: In overweight and obese individuals, greater weight bias internalization predicted lower core self-evaluation, which in turn predicted greater depression and anxiety, lower global health, and greater health care utilization. These mediational associations were largely stable in subsample analyses and after controlling for sociodemographic variables. Conclusions: The results show that overweight and obese individuals with internalized weight bias are at risk for impaired health, especially if they experience low core self-evaluation, making them a group with which to target for interventions to reduce self-stigma. Weight bias internalization did not represent a barrier to health care utilization, but predicted greater health care utilization in association with greater health impairments.