A comparison of onset of binge eating versus dieting in the development of bulimia nervosa.
OBJECTIVE
This study further investigates the hypothesis that dieting is the precursor to the development of binge eating.


METHODS
The temporal relationship of onset of binge eating and dieting is examined from retrospective self-reports collected at baseline from women participating in two bulimia nervosa (BN) treatment studies (N = 221). Twenty women were identified who reported binge eating prior to the onset of dieting ("binged first," BF). For comparison, 20 similar age individuals reporting dieting onset preceding that of binge eating ("dieted first," DF) were selected.


RESULTS
A subset of women (8.8%) seeking treatment for BN endorsed the development of binge eating prior to dieting onset. The BF pattern of BN development was associated with earlier age of onset of binge eating, later onset of purging, increased desired weight, and increased actual weight. Binge eating prior to dieting onset was also associated with improved response to group cognitive-behavioral treatment at 6-month follow-up.


CONCLUSIONS
This study provides support for the hypothesis that dieting is a risk factor, but not necessarily a precursor, to the development of binge eating in BN. Implications for treatment and future research are discussed.
Pederson Mussell
M
M
Department of Psychiatry, University of Minnesota, Minneapolis, USA.
Mitchell
J E
JE
Fenna
C J
CJ
Crosby
R D
RD
Miller
J P
JP
Hoberman
H M
HM
D000328:Adult; D002032:Bulimia / Q000209:etiology / Q000523:psychology*; D004038:Diet, Reducing / Q000523:psychology*; D005247:Feeding Behavior / Q000523:psychology*; D005260:Female; D006801:Humans; D012307:Risk Factors; D015431:Weight Loss