Discussion
weight gain, anorexia nervosa, disordered eating
The current study was the first to our knowledge to examine fear of weight gain during CBT-E for the treatment of binge-spectrum EDs. Notably, we found that fear of weight gain decreased over the course of CBT-E, both in session-by-session ratings and from pre- to post-treatment assessment. These findings are encouraging, as CBT-E does not explicitly target this fear even though it is posited to be a maintaining factor of disordered eating [Despite decreases in fear of weight gain, fear remained somewhat elevated at the end of treatment (in particular, for those with BN-spectrum EDs) compared to scores reported in prior research with non-ED samples [Both those with BN-spectrum EDs and BED started treatment with elevated levels of fear of weight gain compared to non-ED samples in prior research [Those with a higher fear of weight gain experienced more LOC episodes in the following week. Fear of weight gain appears to be a maintaining factor for LOC eating, even during treatment, such that individuals who are experiencing a higher level of fear are more at risk for a LOC episode shortly thereafter. This may occur through a pathway of restrictive or restrained eating. On the other hand, experiencing less intense fear of weight gain may be somewhat protective in that it puts individuals at lower risk for LOC episodes. This corroborates the theory suggesting that fears of weight gain are a core maintaining factor in EDs, and that targeting the fear may reduce symptoms [Interestingly, we found that BMI was not associated with fear of weight gain at pre-treatment, which adds to previous findings from a sample with anorexia nervosa [