Overweight, treatment-seeking adolescents with BED are clearly distinguishable from teens without the disorder on measures of eating-related psychopathology, mood, and anxiety. RECENT-BINGE, but not PAST-LOC, is also associated with significantly greater eating-related and general psychopathology.

The EES-C has good convergent and discriminant validity, and test-retest reliability for assessing emotional eating in children. Further investigation is required to clarify the role emotional eating may play in children's energy intake and body weight.

In women with AN, normalization of weight in the short term is associated with an abnormal distribution of body fat. The implications of these findings for the long-term psychological and physical health of women with AN are unknown.

Objective Anorexia nervosa (AN) is a life threatening and difficult to treat illness with a high relapse rate. Current treatments are inadequate and new approaches to treatment are needed. Method We review the data on anxiety in AN, the relationship between anxiety disorders and AN, and the use of Exposure and Response Prevention in treatment. Results The overlap between AN and anxiety disorders suggest a model of AN in which baseline anxiety features yield eating related fears, avoidance behaviors, and ritualized safety behaviors that promote the underweight state and the perpetuation of the disorder. We propose an Exposure and Response Prevention treatment to prevent relapse in AN. Discussion Overlap between AN and anxiety disorders suggests that Exposure and Response Prevention may be a new and beneficial approach to preventing relapse in individuals with AN.

Objective Existing measures for DSM-IV eating disorder diagnoses have notable limitations, and there are important differences between DSM-IV and DSM-5 feeding and eating disorders. This study developed and validated a new semi-structured interview, the Eating Disorders Assessment for DSM-5 (EDA-5). Method Two studies evaluated the utility of the EDA-5. Study 1 compared the diagnostic validity of the EDA-5 to the Eating Disorder Examination (EDE) and evaluated the test-retest reliability of the new measure. Study 2 compared the diagnostic validity of an EDA-5 electronic application (“app”) to clinician interview and self-report assessments. Results In Study 1, the kappa for EDE and EDA-5 eating disorder diagnoses was 0.74 across all diagnoses (n= 64), with a range of κ=0.65 for Other Specified Feeding or Eating Disorder (OSFED)/Unspecified Feeding or Eating Disorder (USFED) to κ=0.90 for Binge Eating Disorder (BED). The EDA-5 test-retest kappa coefficient was 0.87 across diagnoses. For Study 2, clinical interview versus “app” conditions revealed a kappa of 0.83 for all eating disorder diagnoses (n=71). Across individual diagnostic categories, kappas ranged from 0.56 for OSFED/USFED to 0.94 for BN. Discussion High rates of agreement were found between diagnoses by EDA-5 and the EDE, and EDA-5 and clinical interviews. As this study supports the validity of the EDA-5 to generate DSM-5 eating disorders and the reliability of these diagnoses, the EDA-5 may be an option for the assessment of Anorexia Nervosa, Bulimia Nervosa, and BED. Additional research is needed to evaluate the utility of the EDA-5 in assessing DSM-5 feeding disorders.

Objective COVID-19 is an international public health crisis, putting substantial burden on medical centers and increasing the psychological toll on health care workers (HCW). Methods This paper describes CopeColumbia, a peer support program developed by faculty in a large Urban Medical Center's Department of Psychiatry to support emotional well-being and enhance the professional resilience of HCW. Results Grounded in evidence-based clinical practice and research, peer support was offered in three formats: groups, individual sessions, and town halls. Also, psychoeducational resources were centralized on a website. A Facilitator's Guide informed group and individual work by including: (1) emotional themes likely to arise (e.g., stress, anxiety, trauma, grief, and anger) and (2) suggested facilitator responses and interventions, drawing upon evidence-based principles from peer support, stress and coping models, and problem-solving, cognitive behavioral, and acceptance and commitment therapies. Feedback from group sessions was overwhelmingly positive. Approximately 1/3 of individual sessions led to treatment referrals. Conclusions Lessons learned include: (1) there is likely an ongoing need for both well-being programs and linkages to mental health services for HCW, (2) the workforce with proper support, will emerge emotionally resilient, and (3) organizational support for programs like CopeColumbia is critical for sustainability.

Objective-Interpersonal psychotherapy (IPT) is effective at reducing binge episodes and inducing weight stabilization in obese adults with binge eating disorder.Method-We piloted the administration of IPT to girls at-risk for excess weight gain (BMI 75 th -97 th percentile; IPT-WG) with and without loss of control (LOC) eating. Thirty-eight girls (12-17y) were randomized to IPT-WG or a standard-of-care health education group.Results-All 38 girls completed the programs and all follow-up visits through 6 months. Thirtyfive of 38 returned for a complete assessment visit at 1 year. Among girls with baseline LOC (n=20), those in IPT-WG experienced greater reductions in such episodes than girls in health education (p=.036). Regardless of LOC status, over 1 year girls in IPT-WG were less likely to increase their BMI as expected for their age and BMI percentile (p=.028).Discussion-IPT-WG is feasible and acceptable to adolescent girls at-risk for adult obesity and may prevent excess weight gain over 1 year. KeywordsObesity prevention; interpersonal psychotherapy; adolescence; loss of control eating Binge eating disorder (BED) is associated with overweight and obesity.1 , 2 Although fullsyndrome BED is less common in youth than adults, the prevalence of loss of control (LOC) eating among overweight adolescents is substantial.3 LOC eating is defined as episodes of eating during which loss of control is experienced, regardless of the amount of food consumed. Prevalence estimates for LOC eating range from 6% to 40% in adolescent , two well-tested treatments for BED, were both developed from therapies designed to treat depression. IPT for BED is based on the assumption that binge eating occurs in response to poor social functioning and consequent negative moods.20 IPT focuses upon improving the interpersonal difficulties, and social deficits21 that may perpetuate LOC eating.22 IPT may be particularly appropriate for adolescents at high-risk for adult obesity19 since heavier youth report teasing, social isolation, and compromised interpersonal functioning.23 Indeed, improving social support has been shown to increase weight loss and assist with weight maintenance in overweight adults24 and children.25 Importantly, IPT has been adapted for the treatment of adolescent depression26 and has been shown to effectively improve interpersonal functioning and negative affect in such youth.27 , 28 IPT has also been adapted and studied as a preventive intervention for otherwise healthy adolescents with elevated depressive symptoms.29We therefore conducted a pilot study of IPT for the prevention of excessive weight gain (IPT-WG) in adolescents at-risk for inappropriate gain by virtue of their current body mass index (BMI, kg/m 2 ). We hypothesized that IPT-WG would be acceptable to adolescent girls. Secondarily, we expected that compared to a standard-of-care health education (HE) program, girls assigned to IPT-WG would be more likely to stabilize or reduce their BMI growth. Because the main purpose of this study was to demonstrate...

The most prevalent disordered eating pattern described in overweight youth is loss of control (LOC) eating, during which individuals experience an inability to control the type or amount of food they consume. LOC eating is associated cross-sectionally with greater adiposity in children and adolescents and seems to predispose youth to gain weight or body fat above that expected during normal growth, thus likely contributing to obesity in susceptible individuals. No prior studies have examined whether LOC eating can be decreased by interventions in children or adolescents without full-syndrome eating disorders or whether programs reducing LOC eating prevent inappropriate weight gain attributable to LOC eating. Interpersonal psychotherapy, a form of therapy that was designed to treat depression and has been adapted for the treatment of eating disorders, has shown efficacy in reducing binge eating episodes and inducing weight stabilization among adults diagnosed with binge eating disorder. In this paper, we propose a theoretical model of excessive weight gain in adolescents at high risk for adult obesity who engage in LOC eating and associated overeating patterns. A rationale is provided for interpersonal psychotherapy as an intervention to slow the trajectory of weight gain in at-risk youth, with the aim of preventing or ameliorating obesity in adulthood.