Strengths and limits
weight gain, SD
REMISSION
Examining fear of weight gain at each session allowed us to predict the following week LOC episodes to establish a temporal association between fear of weight gain and LOC. Limitations include a somewhat narrow sample, as participants were ineligible to participate if they had high inhibitory control due to the intention to test inhibitory control training in the broader RCT. Additionally, although it would have been optimal to calculate clinically significant change in fear of weight gain, we were unable to do so given lack of norms for the GFFS and high variability in GFFS scores at pre-treatment (SD = 7.5, ranging 10–40). It will be critical to examine whether the changes in fear of weight gain during CBT-E are clinically significant, or whether additional methods of targeting fear of weight gain during treatment (i.e., exposure therapy; [CBT-E appears to implicitly target fear of weight gain during treatment of binge-spectrum EDs likely through regularizing eating patterns, reducing compensatory behaviors, and breaking dietary rules. We also observed that fear of weight gain predicted more frequent LOC episodes, suggesting that fear of weight gain is a worthy target for future interventions for BN and BED. Clinicians may find it helpful to explicitly discuss fear of weight gain with patients and to make reducing this fear a direct aim of treatment, especially for those experiencing more intense fear. Additional research is needed to understand whether fear of weight gain predicts use of compensatory behaviors in those with BN. Furthermore, future research should investigate whether an intervention explicitly designed to target fear of weight gain (e.g., exposure therapy) would produce even greater changes in fear than CBT-E, and whether reductions in fear result in decreases in LOC episodes and compensatory behaviors. Finally, longitudinal studies must examine whether decreases in fear of weight gain during treatment have an effect on long-term remission from EDs.