Objective: The coronavirus pandemic has led to a dramatically different way of working for many therapists working with eating disorders, where telehealth has suddenly become the norm. However, many clinicians feel ill equipped to deliver therapy via telehealth, while adhering to evidence-based interventions. This article draws together clinician experiences of the issues that should be attended to, and how to address them within a telehealth framework.Method: Seventy clinical colleagues of the authors were emailed and invited to share their concerns online about how to deliver cognitive-behavioral therapy for eating disorders (CBT-ED) via telehealth, and how to adapt clinical practice to deal with the problems that they and others had encountered. After 96 hr, all the suggestions that had been shared by 22 clinicians were collated to provide timely advice for other clinicians.Results: A range of themes emerged from the online discussion. A large proportion were general clinical and practical domains (patient and therapist concerns about telehealth; technical issues in implementing telehealth; changes in the environment), but there were also specific considerations and clinical recommendations about the delivery of CBT-ED methods.Discussion: Through interaction and sharing of ideas, clinicians across the world produced a substantial number of recommendations about how to use telehealth to work with people with eating disorders while remaining on track with evidencebased practice. These are shared to assist clinicians over the period of changed practice.

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Our findings provided no evidence of a psychological identity unique to obese adults with BED although their eating behaviors are markedly hedonically driven-i.e., more responsive to factors external to physiological needs.

These findings demonstrate the utility of the stress process model for predicting family functioning in this population, and suggest potential targets of intervention for clinicians working with caregivers.

Response to psychomotor stimulants is highly variable across individuals. Such inconsistencies are influenced by many factors including drug dose and polymorphic differences in genes that encode proteins, such as the dopamine transporter (DAT1), which are relevant to the site of action of these substances. The current study used a double blind, crossover (methylphenidate vs placebo) design to assess DAT1 genotype differences on appetite ratings to a snack-food cue in subjects with binge eating disorder (BED) (n=32) and healthy age-matched controls (n=46). ANOVA results indicated a significant genotype x diagnostic group interaction whereby BED subjects with at least one copy of the 9-repeat allele showed a significant suppression of appetite in response to methylphenidate compared with controls with this allele, or to subjects with the 10/10 genotype (irrespective of diagnosis) whose drug response was indistinguishable from placebo. The most probable explanation for these findings is that some, currently unknown, genetic variant, which is overrepresented in those with BED, interacts with DAT1 to suppress appetite in response to stimulant administration. The current findings have implications for treatment response to drugs currently in use (or being developed) for the treatment of overeating and overweight.

The aim of this study was to retrospectively identify clinical variables assessed prior to treatment which were predictive of patients' dropping out versus completing a 10-week group cognitive-behavioral treatment program for bulimia nervosa. Following a lengthy initial assessment, 81 women meeting DSM-Ill-R criteria for bulimia nervosa (BN) were referred to one of twelve 10-week groups of 8 to 12 patients having bulimic symptoms. The dropout rate for those meeting full DSM-Ill-R criteria for BN was found to be 28.7%. A series of seven discriminant function analyses were performed to determine whether dropouts differed from completers in terms of depression, anxiety, difficulties in trust and relating to others, bulimic symptom severity, family environment, weight history and symptom duration, and severity of bulimic cognitions. Of these, only the factor assessing difficulties trusting and relating to others was found to significantly discriminate dropouts from completers. Implications of the findings are discussed in terms of clinical and research relevance in the field of eating disorders. 0

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Prognostic indicators of short‐term outcome were identified in 69 women with the DSM‐III‐R diagnosis of bulimia nervosa who participated in a weekly 10‐session structured cognitive‐behavioral outpatient group program. Prior to treatment, all subjects completed the computerized Diagnostic Interview Schedule (DIS), the Moos Family Environment Scale (FES), the Diagnostic Survey for Eating Disorders (DSED), the Beck Depression Inventory (BDI), the Hopkins Symptom Checklist, Revised (SCL‐90‐R), the Bulimic Cognitive Distortions Scale (BCDS), the Eating Disorders Inventory (EDI), and the Bulimic Symptoms Checklist (BSCL). The latter three scales were readministered on completion of the 10‐week group. Symptom improvement was assessed by examining percentage reduction in binge frequency, purge frequency, and summed scores for the EDI subscales Bulimia, Drive for Thinness, and Body Dissatisfaction. The only significant predictor of improvement in binge frequency and bulimic cognitions was family environment. Conflicted, controlling, and overorganized family environments appear to impede both reductions in binge frequency and changes in bulimic cognitions. Reduction in vomit frequency was associated with weight history and with laxative or diuretic use. The implications for planning psychotherapeutic interventions in bulimia nervosa are discussed. © 1994 bylohn Wiley & Sons, Inc.