Clinical Trial: Bulimia Nervosa: A Biobehavioral Study (The Eating Disorder Study)

Study Status: Recruiting
Recruit Status: Recruiting
Study Type: Observational

Official Title: Weight Suppression, Dieting, and Bulimia Nervosa: A Biobehavioral Study

Brief Summary: The purpose of this study is to examine biological (e.g., energy expenditure, neuroendocrine and appetitive hormones)and behavioral (e.g., binge eating and purging) correlates of weight suppression and current dieting status in women with bulimia nervosa. The investigators have differentiated between a diet-induced long-term energy imbalance (weight suppression, or the difference between one's highest-ever body weight and current weight) and a short-term energy imbalance (current dieting to either lose weight or avoid weight gain). This study will elucidate how two common yet largely unexplored types of dieting influence biological and behavioral variables in patients with bulimia nervosa, which could lead to modifications of prevailing models of bulimia nervosa and new strategies for improving treatment outcome.

Detailed Summary: Bulimia nervosa (BN) is a debilitating psychiatric disorder that primarily affects young women. Empirically supported treatments for BN have been identified but less than half of treated individuals achieve long-term remission from the disorder, possibly because current treatment approaches do not sufficiently account for variables that help maintain the disorder. Psychosocial models of BN emphasize the role of dieting as a proximal cause of binge eating and purging. Dieting has both psychological and biological facets but existing models of BN have overwhelmingly focused on its psychological impact. The investigators have differentiated between a diet-induced long-term energy imbalance (weight suppression (WS), or the difference between one's highest-ever body weight and current weight) and a short-term energy imbalance (current dieting to either lose weight or avoid weight gain). Recent research has shown that WS levels in BN are elevated and that degree of WS predicts the severity of various BN characteristics and its clinical course. Studies of current dieting (CD) to lose weight have found that it is associated with reduced binge eating in BN, a finding that conflicts with prevailing models of the disorder. The proposed research will examine biological (e.g., energy expenditure, neuroendocrine and appetitive hormones) and behavioral (e.g., binge eating and purging) correlates of WS and CD in those with BN. (Relatively few of those with BN report dieting to avoid weight gain but its biological and behavioral correlates will also be examined.) The project will recruit 132 women (66 at Drexel University and 66 at Columbia University) meeting provisional Diagnostic and Statistical Manual-V diagnostic criteria for BN. The investigators will test the hypotheses that 1) CD and elevated WS will be associated with alterations in biological indices of metabolism and appetite, 2) WS will predict greater binge eating and purging, and CD will predict less binge eating, meas
Sponsor: Drexel University

Current Primary Outcome:

  • Purging [ Time Frame: 2 week EMA period ]
    Number of purging episodes recorded over two weeks.
  • Binge Eating [ Time Frame: 2 week EMA period ]
    Number of binge eating episodes over two week period.
  • Hormone levels [ Time Frame: Site Visit 3 (2 weeks) ]
    Hormone levels will be assessed approximately two weeks post-baseline at one time point.
  • Energy intake [ Time Frame: Three weeks ]
    Energy intake (more specifically, energy density) will be assessed as an average of three dietary food recalls approximately three weeks post-baseline.
  • Resting metabolic rate (RMR) [ Time Frame: Two weeks ]
    RMR will be assessed at Site Visit 3, approximately two weeks post-baseline.
  • Total percent body fat [ Time Frame: Two weeks ]
    Total percent body fat will be assessed at Site Visit 3 (approximately 2 weeks post-baseline) using dual energy x-ray absorptiometry.


Original Primary Outcome: Same as current

Current Secondary Outcome:

  • Body weight [ Time Frame: 6 months ]
    Body weight will be assessed at 6-month follow-up.
  • Psychosocial measures [ Time Frame: Site Visit-Baseline ]
    Psychosocial self-report measures will be given at baseline.


Original Secondary Outcome: Same as current

Information By: Drexel University

Dates:
Date Received: March 29, 2013
Date Started: August 2012
Date Completion: May 31, 2018
Last Updated: March 29, 2017
Last Verified: March 2017