The long term objectives of this study are to explore the utility of defining binge-eating episodes in bulimia nervosa by the amount of food consumed and to reveal factors that contribute to the development or maintenance of bulimic symptoms. An additional objective is to improve the recognition of an alternative symptom cluster that resembles bulimia nervosa-purging subtype, except that perceived binge episodes do not involve objectively large amounts of food. Recent research indicates that a substantial number of young women suffer from this alternative symptom cluster (subjective bulimia nervosa-SBN) suggesting that SBN represents a significant public health concern.
One specific aim of this study is to test the hypothesis that, like women with DSM-IV bulimia nervosa, women with SBN demonstrate clinically significant levels of distress and impairment.
A second aim i s to demonstrate that SBN is distinct from DSM-IV bulimia nervosa and thus should not be combined with this syndrome within one diagnostic category. The study proposes to extend preliminary data suggesting that women with bulimia nervosa have higher levels of impulsiveness compared to women with SBN. In addition, this study proposes a novel examination of whether, compared to women with SBN, women with bulimia nervosa demonstrate lower levels of satiety and blunted cholecystokin (CCK) release following a rest meal. The study will include 30 women with DSM-IV bulimia nervosa-purging subtype, 30 women with SBNm and 30 non-eating disordered control females. Subjects will complete psychological assessments including structured clinical interviews and standardized questionnaire assessments of depression, anxiety, impulsiveness, and social and occupational functioning. Subjects will also participate in assessments of post-prandial satiety and CCK release. This study will test a model of bulimia nervosa in which deficient satiety signals fail to decrease the impulse to eat which, combined with poor impulse control, increases the liability to experience objectively large binge-eating episodes by the amount of food consumed and reveal etiologic or maintaining factors for objectively large bing episodes in bulimia nervosa. Further, this study has the potential to identify a new subtype of eating disorder that is worthy of study, treatment, and inclusion in nosological schemes.

Agency
National Institute of Health (NIH)
Institute
National Institute of Mental Health (NIMH)
Type
Research Project (R01)
Project #
1R01MH061836-01A1
Application #
6325492
Study Section
Special Emphasis Panel (ZRG1-BBBP-5 (01))
Program Officer
Dolan-Sewell, Regina
Project Start
2001-04-01
Project End
2004-03-31
Budget Start
2001-04-01
Budget End
2002-03-31
Support Year
1
Fiscal Year
2001
Total Cost
$238,000
Indirect Cost
Name
Harvard University
Department
Psychology
Type
Schools of Arts and Sciences
DUNS #
071723621
City
Cambridge
State
MA
Country
United States
Zip Code
02138
Keel, Pamela K; Eckel, Lisa A; Hildebrandt, Britny A et al. (2018) Disturbance of gut satiety peptide in purging disorder. Int J Eat Disord 51:53-61
Keel, Pamela K; Haedt-Matt, Alissa A; Hildebrandt, Britny et al. (2018) Satiation deficits and binge eating: Probing differences between bulimia nervosa and purging disorder using an ad lib test meal. Appetite 127:119-125
Keel, Pamela K; Bodell, Lindsay P; Haedt-Matt, Alissa A et al. (2017) Weight suppression and bulimic syndrome maintenance: Preliminary findings for the mediating role of leptin. Int J Eat Disord 50:1432-1436
Forney, K Jean; Bodell, Lindsay P; Haedt-Matt, Alissa A et al. (2016) Incremental validity of the episode size criterion in binge-eating definitions: An examination in women with purging syndromes. Int J Eat Disord 49:651-62
Dossat, Amanda M; Bodell, Lindsay P; Williams, Diana L et al. (2015) Preliminary examination of glucagon-like peptide-1 levels in women with purging disorder and bulimia nervosa. Int J Eat Disord 48:199-205
Haedt-Matt, Alissa A; Keel, Pamela K (2015) Affect regulation and purging: An ecological momentary assessment study in purging disorder. J Abnorm Psychol 124:399-411
Forney, K Jean; Haedt-Matt, Alissa A; Keel, Pamela K (2014) The role of loss of control eating in purging disorder. Int J Eat Disord 47:244-51
Davis, Heather A; Holland, Lauren A; Keel, Pamela K (2014) A preliminary examination of a nonpurging compensatory eating disorder. Int J Eat Disord 47:239-43
Keel, Pamela K; Crosby, Ross D; Hildebrandt, Thomas B et al. (2013) Evaluating new severity dimensions in the DSM-5 for bulimic syndromes using mixture modeling. Int J Eat Disord 46:108-18
Keel, Pamela K (2013) Commentary on Empirical Examinations of the Association between Anxiety and Eating Disorders. Cognit Ther Res 37:

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