Symposia
Eating Disorders
Elizabeth Lampe, M.S.
Doctoral Student
Drexel University
Philadelphia, Pennsylvania
Stephanie Manasse, PhD
Assistant Research Professor
Drexel University
Philadelphia, Pennsylvania
Binge eating often develops during adolescence and is associated with deleterious psychological and physical consequences. Current treatments for adolescents achieve suboptimal results, likely due to failure to account for the presence of fear. For example, overvaluation of shape and weight (i.e., disproportionate emphasis on shape/weight in self-evaluation) contributes to heightened fear of weight gain among individuals with binge eating. Excessive fear of weight gain, and beliefs about the catastrophic outcomes of weight gain (e.g., social rejection, disgust, and loss of control), may then result in dietary restriction and subsequent binge eating and/or compensatory behaviors. Thus, exposure treatment (the most powerful intervention for fear) may be a promising approach to target fear of weight gain. However, exposure treatment has only minimally tested in adults with binge eating and never tested in adolescents. Thus, the current study was the first to evaluate a 4-session in-vivo exposure module within a 12-session standard cognitive behavioral therapy for adolescents with binge eating (N=5; Mage=16.25, SD=2.06; 80% female). In-session exposures were personalized for each participant and were designed to target fears of weight gain through feared outcome violation (e.g., eating pizza without purging afterwards not resulting in meaningful weight gain). We examined treatment feasibility, acceptability, and preliminary effects on fear of weight gain and eating pathology. Overall, the 4-session exposure module was feasible and acceptable. Further, participants showed large decreases in fear of weight gain across the treatment, and smaller decreases across the in-vivo exposure sessions. However, several participants did not endorse significant fears of weight gain; rather, these participants reported that fears of deprivation or social judgment were more related to their binge eating. Future research should test higher doses of exposure and further examine the role of fear of deprivation/social judgement. Finally, future iterations of this treatment could include more parent involvement or test exposures in combination with treatments other than CBT, such as family-based treatment.