The clinical and public health significance of eating disorders and obesity are well-documented, yet these problems are known to be resistant to treatment. This application is a request for an NIMH mid-career Investigator Award in Patient Oriented Research (K24) in order to relieve me from clinical, administrative, and teaching duties, to ensure 50% protected time for mentoring activities and patient-oriented research in the fields of eating disorders and obesity. This application will focus on an expansion of my research in intervention and prevention of eating disorders and obesity, areas in which I currently have three ongoing NIH-funded studies: """"""""Effectiveness of Psychological treatments for BED"""""""" (R01 MH64153), """"""""Interventions to Reduce Eating Disorder Risk Factors"""""""" (R01 MH60453), and Childhood Obesity: A Maintenance Approach"""""""" (R01 HD36904). These grants focus on, respectively: the long-term effectiveness of three distinct treatments for binge eating disorder (BED); the evaluation of an Internet program designed to reduce risk factors for and incidence of eating disorders; and the efficacy of two family-based treatments intended to improve long-term maintenance of weight loss in children. My overarching goals during the award period and in the long- term are: 1) to continue identifying and developing efficacious treatments for eating disorders and obesity; 2) to apply concepts and methods from basic behavioral science to the study of eating disorders and obesity in order to improve and refine treatments; 3) to clarify the diagnostic status of BED; 4) to investigate the role of familial and social factors in the etiology, prevention, and treatment of eating disorders and obesity; 5) to develop early intervention and prevention strategies aimed at preventing comorbidity, relapse, and disability in eating disorders and obesity; 6) to identify risk and protective factors for co-occurring illnesses, with particular attention to the links between eating disorders and obesity; and 7) to increase my training and mentoring of future clinical scientists, an area where I have already demonstrated strong commitment. I plan to build on my strengths by acquiring expertise in advanced research designs and methods; translational research; eating behavior, development, and psychopathology in children and adolescents; and metabolic processes and precise assessments of energy intake and expenditure. Becoming more knowledgeable in these areas will allow me to perform innovative research and provide enhanced opportunities for clinical researchers under my tutelage. Given the high morbidity and mortality associated with eating disorders and obesity, a continued refinement of treatment approaches and focus on early intervention and prevention is required to augment the rates of successful treatment responders and decrease the incidence of eating disorders and obesity.
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