We review the literature on the relationship between obesity and sexual functioning. Eleven population‐based studies, 20 cross‐sectional non‐population‐based studies, and 16 weight loss studies are reviewed. The consistency of findings suggests that the relationship between obesity and reduced sexual functioning is robust, despite diverse methods, instruments, and settings. In most population‐based studies, erectile dysfunction (ED) is more common among obese men than among men of recommended weight. Studies of patients in clinical settings often include individuals with higher degrees of obesity, with most studies showing a relationship between obesity and lower levels of sexual functioning, especially ED. The few studies that include both genders generally report more problems among women. Most studies of patients with comorbidities associated with obesity also find an association between obesity and reduced sexual functioning. Most weight loss studies demonstrate improvement in sexual functioning concurrent with weight reduction despite varying study designs, weight loss methods, and follow‐up periods. We recommend that future studies (i) investigate differences and similarities between men and women with respect to obesity and sexual functioning, (ii) use instruments that go beyond the assessment of sexual dysfunction to include additional concepts such as sexual satisfaction, interest, and arousal and, (iii) assess how and the degree to which obese individuals are affected by sexual difficulties. Given the high prevalence of obesity and the inverse association between body mass and sexual functioning, we also recommend that sexual functioning should be more fully addressed by clinicians, both in general practice and in weight loss programs.

The purpose of this study was to examine the relationship between caloric restriction (CR) and binge eating (BE) using ecological momentary assessment (EMA). Participants included 133 women with bulimia nervosa (BN) who completed an EMA protocol for 2 weeks. Logistic regression analyses tested whether CR increased the probability of BE episodes. The results revealed that the odds of BE increased on the day that restriction occurred as well as on the following day. In addition, both restriction and BE on one day predicted the likelihood of BE the subsequent day, but restriction for two days prior to the episode failed to add additional information for predicting BE. These findings support the cognitive-behavioral therapy (CBT) model of BN, suggesting that self-reported dietary restriction is predictive of subsequent BE episodes, and that reducing dietary restriction in treatment may lead to improvements in bulimic symptoms.

The purpose of our study was to examine exercise dependence (EXD) in a large community-based sample of runners. The secondary purpose of this study was to examine differences in EXD symptoms between primary and secondary EXD. Our sample included 2660 runners recruited from a local road race (M age = 38.78 years, SD = 10.80; 66.39% women; 91.62% Caucasian) who completed all study measures online within 3 weeks of the race. In this study, EXD prevalence was lower than most previously reported rates (gamma = .248, p < .001) and individuals in the at-risk for EXD category participated in longer distance races, F(8,1) = 14.13, p = .01, partial eta squared = .05. Group differences were found for gender, F(1,1921) 8.08, p = .01, partial eta squared = .004, and primary or secondary group status, F(1,1921) 159.53, p = .01, partial eta squared = .077. Implications of primary and secondary EXD differences and future research are discussed.

Few studies have systematically explored exercise as a part of treatment among patients with AN. Findings of the current review suggest a need for developing further research, but currently the field may benefit from standardized guidelines for treating excessive exercisers with AN.

Objective The purpose of this study was to examine weight suppression (WS) as a predictor of treatment outcome among individuals with binge eating disorder (BED) and bulimia nervosa (BN). Method Participants were diagnosed with BED or BN and took part in separate treatment studies. The current study examined WS as a predictor of treatment completion, weight change during treatment, and symptomatic abstinence, as well as percent reduction in binge eating and purging frequency. Results WS did not significantly predict treatment completion or treatment outcome in either group. Discussion Contrary to some previous findings, these results failed to demonstrate that WS was predictive of outcome at the end of treatment in BN. In addition, WS was not predictive of treatment outcome or dropout status in BED.

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Laxatives have been used for health purposes for over 2000 years, and for much of that time abuse or misuse of laxatives has occurred. Individuals who abuse laxatives can generally be categorized as falling into one of four groups. By far the largest group is made up of individuals suffering from an eating disorder such as anorexia or bulimia nervosa. The prevalence of laxative abuse has been reported to range from approximately 10% to 60% of individuals in this group. The second group consists of individuals who are generally middle aged or older who begin using laxatives when constipated but continue to overuse them. This pattern may be promulgated on certain beliefs that daily bowel movements are necessary for good health. The third group includes individuals engaged in certain types of athletic training, including sports with set weight limits. The fourth group contains surreptitious laxative abusers who use the drugs to cause factitious diarrhoea and may have a factitious disorder. Normal bowel function consists of the absorption of nutrients, electrolytes and water from the gut. Most nutrients are absorbed in the small intestine, while the large bowel absorbs primarily water. There are several types of laxatives available, including stimulant agents, saline and osmotic products, bulking agents and surfactants. The most frequently abused group of laxatives are of the stimulant class. This may be related to the quick action of stimulants, particularly in individuals with eating disorders as they may erroneously believe that they can avoid the absorption of calories via the resulting diarrhoea. Medical problems associated with laxative abuse include electrolyte and acid/base changes that can involve the renal and cardiovascular systems and may become life threatening. The renin-aldosterone system becomes activated due to the loss of fluid, which leads to oedema and acute weight gain when the laxative is discontinued. This can result in reinforcing further laxative abuse when a patient feels bloated and has gained weight. Treatment begins with a high level of suspicion, particularly when a patient presents with alternating diarrhoea and constipation as well as other gastrointestinal complaints. Checking serum electrolytes and the acid/base status can identify individuals who may need medical stabilization and confirm the severity of the abuse. The first step in treating laxative misuse once it is identified is to determine what may be promoting the behaviour, such as an eating disorder or use based on misinformation regarding what constitutes a healthy bowel habit. The first intervention would be to stop the stimulant laxatives and replace them with fibre/osmotic supplements utilized to establish normal bowel movements. Education and further treatment may be required to maintain a healthy bowel programme. In the case of an eating disorder, referral for psychiatric treatment is essential to lessen the reliance on laxatives as a method to alter weight and shape.

The workplace may be an ideal venue for engaging African American women in behavioral interventions for weight reduction. This study examines the effectiveness of a culturally-enhanced EatRight dietary intervention among a group of predominately African American women in a workplace setting. Thirty-nine women volunteered for this cross-over design study, with 27 completing. The control period involved observation of participants for 22 weeks after receiving standard counseling on lifestyle methods to achieve a healthy weight; following the control period, participants crossed over to the 22-week intervention period. The intervention was culturally-enhanced using feedback derived from formative assessment and delivered as 15 group sessions. The primary outcome measure was the difference in weight change between the control and intervention periods; changes in waist circumference and quality of life were secondary outcomes. Most participants were obese with a mean baseline body mass index of 36 kg/m2, weight of 97.9 kg and waist circumference of 111 cm. Weight increased during the control period by 0.7 kg but decreased by 2.6 kg during the intervention (net difference = −3.4 kg, p<0.001), with 30% of participants losing ≥5% of body weight. Compared to the control period, there was a significant decrease in waist circumference (−3.6 cm, p = 0.006) and improvement in weight-related quality of life (5.7, p = 0.03). This pilot study demonstrated the feasibility of a culturally-enhanced behavioral weight loss intervention in a predominately African American workplace setting. The workplace may be conducive for targeting African American women who are disproportionately affected by obesity.