Patients who manifest both binge eating and purging behaviour are at higher risk of substance use which may have important treatment implications.

Objective: This article examined possible ways of classifying eating disorders not otherwise specified (EDNOS) using latent profile analysis (LPA).Method: Of 687 patients being seen for an evaluation for an eating disorder, 284 were classified as having anorexia nervosa (AN) or bulimia nervosa (BN). LPA was performed on the remaining 403 cases (EDNOS).Results: Five clusters were identified that characterized individuals who appeared to be: (1) subsyndromal restrictor AN patients that denied a great deal of eating disorder (ED) psychopathology; (2) subsyndromal ED patients, some but not all of whom were low weight; (3) subsyndromal BN with higher rates of vomiting than binge-eating; (4) primarily overweight individuals with low levels of ED pathology; or (5) overweight patients who most resembled binge eating disorder (BED).Conclusion: Most EDNOS cases resembled AN, BN, or BED cases and can be conceptualized several ways, one of which is to see them as existing on a continuum with the DSM-IV ED. V V C 2007 by Wiley Periodicals, Inc.

No abstract

Preliminary results are promising and suggest this novel treatment is feasible and acceptable. To establish treatment efficacy, fully-powered randomized controlled trials are necessary.

Anorexia nervosa (AN) tends to be a chronic and deadly disorder with no proven treatments that reverse core symptoms in adults. New insight into neurobiological mechanisms that contribute to symptoms may support development of more effective interventions. We describe the development of a temperament-based treatment for AN on the basis of empirically supported models. It uses a systemized approach and takes into consideration an understanding of how neurobiological mechanisms are expressed through behaviour and personality and contribute to specific AN symptomatology. This model integrates the development of AN-focused constructive coping strategies with carer-focused strategies to manage temperament traits that contribute to AN symptomatology. This intervention is consistent with the recent Novel Interventions for Mental Disorders initiative mandating that treatment trials follow an experimental medicine approach by identifying underlying mechanisms that are directly targeted by the intervention to influence symptoms.

Identified problems with the classification system of eating disorders (EDs), including its imperfect application to clinical samples, challenge its validity and limit its utility. The present study aimed to empirically identify and validate ED phenotypes in a multisite clinical sample using latent profile analysis (LPA). ED symptom data collected from 687 individuals were included in LPA. Identified latent profiles (LPs) were compared on clinical validators. Five LPs were identified: LP1 (n = 178), objective bingeing and multiple purging methods; LP2 (n = 172), objective bingeing without purging; LP3 (n = 130), objective bingeing and vomiting; LP4 (n = 108), low/normal weight and excessive exercise; LP5 (n = 99), low/normal weight and absence of ED symptoms. Validation analyses demonstrated the most extreme psychopathology/medical morbidity in LP1 and the least in LP5. LP1 and LP3 were most likely to report medication treatment for EDs. Identified LPs imperfectly resembled diagnostic and statistical manual of mental disorders-IV-TR EDs. Multiple purging methods and the absence of ED cognitions marked differences in severity across groups, whereas low weight did not. Clinical differences in psychopathology, medical morbidity, and treatment utilization validated groups. Future research should examine longitudinal stability of empirically-derived phenotypes and incremental validity of alternative classification schema to inform DSM-V.

Although normal-weight individuals comprise a substantial minority of the binge eating disorder (BED) population, little is known about their clinical presentation. This study sought to investigate the nature and severity of eating disturbances in normal-weight adults with BED. We compared 281 normal-weight (n = 86) and obese (n = 195) treatment-seeking adults with BED (mean age = 31.0; s.d. = 10.8) on a range of current and past eating disorder symptoms using ANOVA and χ2 analyses. After controlling for age and sex, normal-weight participants reported more frequent use of a range of healthy and unhealthy weight control behaviors compared to their obese peers, including eating fewer meals and snacks per day; exercising and skipping meals more frequently in the past month; and avoiding certain foods for weight control. They also endorsed more frequent attempts at dieting in the past year, and feeling more frequently distressed about their binge eating, at a trend level. There were no group differences in binge eating frequency in the past month, age at onset of binge eating, overvaluation of shape/weight, or likelihood of having used certain weight control behaviors (e.g., vomiting, laxative use) or having sought treatment for an eating disorder in the past. Based on our findings, normal-weight individuals appear to be a behaviorally distinct subset of the BED population with significantly greater usage of both healthy and unhealthy weight control behaviors compared to their obese peers. These results refute the notion that distress and impairment in BED are simply a result of comorbid obesity.

No abstract