ABSTRACT
This study evaluated an Internet-delivered computer-assisted health education (CAHE) program designed to improve body satisfaction and reduce weight/shape concerns--concerns that have been shown to be risk factors for the development of eating disorders in young women. Participants were 60 women at a public university randomly assigned to either an intervention or control condition. Intervention participants completed the CAHE program Student Bodies. Measures of body image and disordered eating attitudes were assessed at baseline, postintervention, and 3-month follow-up. At follow-up, intervention participants, compared with controls, reported a significant improvement in body image and a decrease in drive for thinness. This program provides evidence for the feasibility and effectiveness of providing health education by means of the Internet.
Subject(s)
Anorexia Nervosa/prevention & control , Bulimia/prevention & control , Health Education , Internet , Adolescent , Adult , Anorexia Nervosa/psychology , Body Image , Bulimia/psychology , Female , Follow-Up Studies , Humans , Risk Factors , Thinness/psychologyABSTRACT
OBJECTIVE: This study evaluated an eating disorder intervention multimedia program modeled after self-help eating disorder treatment programs. It was hypothesized that women who completed the program would increase their body satisfaction and decrease their preoccupation with weight and frequency of disordered eating behaviors. METHOD: Participants were 57 undergraduate females randomly assigned to either the intervention or control group. Psychological functioning was assessed at baseline, at 3 months postintervention, and at 3 months follow-up. RESULTS: Intervention group subjects significantly improved their scores on all psychological measures over time. When compared to the control group, however, only the intervention group's improvements on the Body Shape Questionnaire were statistically significant. DISCUSSION: This study has demonstrated that minimally effective eating disorder intervention programs can be delivered. A revised program that eliminates interface problems and increases the structure of the intervention is likely to be even better received and more effective.
Subject(s)
Feeding and Eating Disorders/prevention & control , Multimedia , Self Concept , Therapy, Computer-Assisted , Adolescent , Adult , Body Image , Feeding and Eating Disorders/psychology , Female , Humans , Random AllocationABSTRACT
OBJECTIVE: To determine if interpersonal problems reported by individuals with binge eating disorder (BED) are distinct from psychiatric norms, and whether specific types of interpersonal problems are predictive of BED treatment outcome. METHOD: Subjects were 88 females with BED who completed a treatment trial for binge eating and weight loss. Pretreatment data on the Inventory of Interpersonal Problems (IIP) was compared (1) to that of psychiatric and nonpsychiatric norms and (2) for individuals with good versus poor outcome for eating disorder symptoms and weight loss. RESULTS: BED patients reported less distress for problems with being too vindictive (hostile dominance) than psychiatric norms. Patients with good eating disorder outcome reported less distress for problems with social avoidance; patients with good weight loss outcome reported greater distress over problems with vindictiveness. DISCUSSION: BED treatment may be enhanced by an initial focus on specific interpersonal difficulties.
Subject(s)
Feeding and Eating Disorders/psychology , Interpersonal Relations , Personality , Adult , Diet/psychology , Feeding and Eating Disorders/therapy , Female , Humans , Middle Aged , Treatment Outcome , Weight LossABSTRACT
OBJECTIVE: This study was designed to explore among individuals with binge eating disorder (BED) perceptions of others' evaluation of their weight-related behavior and affect aroused by such. METHOD: Prior to treatment for binge eating and weight loss, 47 subjects diagnosed with BED completed a questionnaire designed to assess the perceived evaluation of an understanding and a critical individual in both positive and negative weight-related situations and subjects' affective responses to being evaluated. RESULTS: Subjects exhibited characteristic patterns of affective response to perceived evaluation of their weight-related behavior, with negative situations and critical evaluators evoking greater degrees of negative affect. Negative affect in response to perceived evaluation was associated with poor outcome with weight loss but not binge eating. However, this finding was due to the correlation between negative affect in response to perceived evaluation and global severity of psychopathology (SCL-90-R). DISCUSSION: The results suggest that psychopathology in this population predicts poor outcome with weight loss, and further that independent of its relationship with depression, psychopathology is strongly associated with a tendency to experience negative affect in response to perceived evaluation by others of weight-related behavior.
Subject(s)
Body Weight , Cognitive Behavioral Therapy , Hyperphagia/therapy , Obesity/therapy , Patient Satisfaction , Adult , Body Image , Depression/psychology , Diet, Reducing/psychology , Female , Humans , Hyperphagia/psychology , Internal-External Control , Male , Obesity/psychology , Personality Inventory , Treatment Outcome , Weight LossABSTRACT
OBJECTIVE: The study was designed with the aim of determining whether extending group cognitive-behavioral therapy (CBT) would enhance outcome among individuals with binge eating disorder (BED) who failed to stop binge eating after an initial 12-week CBT intervention. METHOD: Forty-six participants who met diagnostic criteria for BED were randomly allocated to either a 12-week group CBT intervention or a waiting list control condition. At the end of 12 weeks, treated participants who met clinical criteria for improvement subsequently received 12 sessions of behavioral weight loss. Remaining participants received 12 additional sessions of CBT for binge eating. RESULTS: Fifty percent of treated participants improved with the initial 12-week course of CBT. There was a strong trend for the extension of CBT to affect improvement in binge eating among initial nonresponders (6 of 14 subjects no longer met diagnostic criteria for BED). Overall, extending CBT led to clinical improvement in 66.7% of all treated participants, with treatment gains occurring through session 20. DISCUSSION: The results suggest that an extended course of CBT (i.e., longer than 12 weeks) will likely maximize the number of potential responders to treatment.
Subject(s)
Cognitive Behavioral Therapy , Feeding and Eating Disorders/therapy , Adult , Feeding and Eating Disorders/psychology , Female , Humans , Male , Middle Aged , Obesity , Treatment OutcomeABSTRACT
OBJECTIVE: The purpose of this study was to compare individuals who meet all the diagnostic criteria for binge eating disorder (BED), except loss of control, to individuals with BED and eating disorder not otherwise specified (EDNOS) on weight history variables. METHOD: Subjects were solicited among new participants in weight loss programs, with 35 meeting BED criteria, 47 meeting criteria for EDNOS, and 6 meeting criteria for BED without loss of control. RESULTS: Groups were not found to differ on age of onset of overweight or dieting, age of first binge, rate of largest weight loss, or number of times of losing 10 + lb. Groups did differ on highest weight ever and current body mass index (BMI). Subjects with BED without loss of control had a significantly higher highest weight and current BMI than both BED and EDNOS subjects. DISCUSSION: The results suggest that individuals reporting all the symptoms of BED except loss of control may be "former" BEDs who have "given up" on efforts to control their binge eating.
Subject(s)
Bulimia/psychology , Diet, Reducing/psychology , Hyperphagia/psychology , Internal-External Control , Adult , Body Mass Index , Bulimia/diagnosis , Female , Humans , Hyperphagia/diagnosis , Male , Middle Aged , Obesity/diagnosis , Obesity/diet therapy , Obesity/psychology , Treatment FailureABSTRACT
OBJECTIVE: This study investigated two issues: the level of weight and shape concerns, and the self-reported tendency to eat in response to negative emotions among obese individuals with binge eating disorder (BED), eating disorder not otherwise specified (EDNOS), and no eating disorder (CONTROL). METHOD: On the basis of demographic and diagnostic surveys, 156 participants in a weight loss program were categorized on two dimensions, eating disorder category and weight (BED vs. EDNOS vs. CONTROL/low vs. high body mass index), yielding a 2 x 3 experimental design. RESULTS: Individuals with BED reported a greater tendency to eat in response to negative mood states than CONTROL subjects and low weight EDNOS subjects, but not high weight EDNOS subjects. Weight did not influence self-reported weight and shape concerns. Individuals with BED expressed greater concern for weight and shape than non-eating disordered CONTROLs. DISCUSSION: The findings suggest that overconcern with weight and shape be further investigated as a diagnostic feature of BED and that emotional eating is associated with BED but not obesity per se.
Subject(s)
Body Image , Body Weight , Emotions , Hyperphagia/psychology , Adult , Bulimia/psychology , Female , Humans , Male , Middle Aged , Obesity/psychologyABSTRACT
The tendency of some dieters to overeat and gain weight prior to beginning a diet is well known. We examined whether emotional variables might account for this phenomenon among a group of 86 obese individuals preparing to begin a treatment program for binge eating and weight loss. Whereas subjects' baseline mood state (anger, anxiety, and depression) did not influence pretreatment weight variability, the self-reported tendency to overeat in response to specific negative emotions had a significant influence. Specifically, subjects who characteristically overeat in response to anger and depression gained weight pretreatment, whereas subjects who overeat in response to anxiety lost weight. The findings are discussed in relation to the influence of specific cognitive and emotional responses to the prospect of dieting.
Subject(s)
Affect , Diet, Reducing/psychology , Adult , Analysis of Variance , Anger , Anxiety , Body Weight , Cognition , Depression , Female , Humans , Male , Middle Aged , Weight GainABSTRACT
The Three Factor Eating Questionnaire was administered to 47 clinical binge eaters at the end of days on which they had and had not binged. Scores on each of the subscales of the questionnaire differed significantly for binge versus nonbinge days. Implications for methodological improvements in future studies are suggested.
Subject(s)
Bulimia/psychology , Diet, Reducing/psychology , Hyperphagia/psychology , Obesity/psychology , Adult , Body Mass Index , Bulimia/diet therapy , Female , Humans , Hyperphagia/diet therapy , Middle Aged , Obesity/diet therapy , Personality Assessment , Weight LossABSTRACT
Recent research on the eating behavior of restrained eaters following a dietary preload indicates that both dieting and self-esteem may influence consumption. While Polivy, Heatherton, and Herman (Journal of Abnormal Psychology, 97, 354-356, 1988) found a forced preload to lead to increased consumption by low self-esteem restrained eaters, Lowe, Whitlow, and Bellwoar (International Journal of Eating Disorders, 10, 461-471, 1991) found restrained dieters to decrease their consumption following a dietary preload. The current study was designed to investigate the influences of self-esteem and dieting on the eating behavior of restrained eaters while in a negative mood state. Subjects were 80 normal weight undergraduate women in a 2 x 2 x 2 design (Restrained/Unrestrained by Success/Failure by Low Self-Esteem/High Self-Esteem). Current dieting, though not self-esteem, was found to influence consumption. Restrained dieters consumed significantly less in a negative mood state than when in a positive mood state, while nondieters, irrespective of restraint status, consumed comparable amounts in both mood states.
Subject(s)
Diet, Reducing/psychology , Feeding Behavior , Satiety Response , Self Concept , Adolescent , Adult , Affect , Body Image , Body Mass Index , Female , Humans , Personality Inventory , Reference ValuesABSTRACT
We compared cognitive-behavior therapy (CBT) with and without exposure and response prevention (ERP) in the treatment of eating disorder patients who both binged and purged, and reported abnormal attitudes concerning body weight and shape. Both treatments produced significant and comparable reductions in binge-eating and purging, eating patterns, and attitudes about weight and shape at posttreatment. Treatment effects were generalized to improvements in different measures of general psychopathology, and were maintained over follow-ups of 3 and 12 months. The findings are consistent with prior research showing that CBT is an effective treatment for patients with the core features of bulimia nervosa. Furthermore, the data suggest that the addition of in-session exposure and response prevention does not enhance the effectiveness of the basic CBT program.
