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ObjectiveScaling an online screen that provides referrals may be key in closing the treatment gap for eating disorders (EDs), but we need to understand respondents' help‐seeking intentions and behaviors after receiving screen results. This study reported on these constructs among respondents to the National Eating Disorders Association online screen who screened positive or at high risk for an ED.MethodRespondents completed the screen over 18 months (February 9, 2018–August 28, 2019). Those screening positive or at high risk for an ED (n = 343,072) had the option to provide data on help‐seeking intentions (after screen completion) and behaviors (2‐month follow‐up).ResultsOf eligible respondents, 4.8% (n = 16,396) provided data on help‐seeking intentions, with only 33.7% of those reporting they would seek help. Only 7.6% of eligible respondents opted in to the 2‐month follow‐up, with 10.6% of those completing it (n = 2,765). Overall, 8.9% of respondents to the follow‐up reported being in treatment when they took the screen, 15.5% subsequently initiated treatment, and 75.5% did not initiate/were not already in treatment.DiscussionPreliminary results suggest that among the small minority who provided data, only one‐third expressed help‐seeking intentions and 16% initiated treatment. Online screening should consider ways to increase respondents' motivation for and follow‐through with care.

Heavy episodic drinking (HED) is a serious problem among college women at high-risk for developing eating disorders (EDs). The main objectives of this study are to determine the relationship of the self-rating of the effects of alcohol (SRE) questionnaire and HED over time, and to determine the effects of relationship breakups on HED among college-aged women at high-risk for EDs.Data collected from 163 participants in a randomized controlled trial evaluating the effectiveness of an ED prevention program were used in the analyses. Measures included the SRE, obtained at baseline, and self-reports of the number of HED episodes and relationship breakups each month for the past 12 months.Generalized linear mixed-effect regression models with Poisson distribution were conducted to test the effects of several variables on reported HED episodes over 12 months. Analyses demonstrated that SRE scores and the presence of a breakup predicted increased HED over time.The SRE may be useful in identifying individuals at risk of or with EDs who are at increased risk of HED. Furthermore, relationship breakups predict HED. Findings from the current study could be used to inform clinical interventions for this population.

The prevalence of individuals at high risk or with clinical eating disorders (EDs) on college campuses is high. Often, students are tasked with evaluating the urgency of their needs and knowing when to seek services, which leads to delays in seeking care. Without intervention, symptoms may worsen, resulting in adverse consequences and impaired functioning. As such, early identification and reduced symptom progression for individuals across the risk/clinical continuum of ED psychopathology is urgently needed. However, effective intervention for EDs on the college campus remains a significant challenge. Counseling centers are often understaffed and overburdened, with directors reporting an average student to counselor ratio of 1,900:11. Indeed, less than 20% of students who are screened positive for EDs report receiving treatment.2 The gap in care delivery necessitates research on ways to improve the quality and efficiency of treatment delivery for symptomatic individuals and decrease the number of individuals requiring care. We propose a population-based model, for heuristic purposes, for the identification, prevention, and treatment of EDs, to reduce the incidence and prevalence of EDs on the college campus. A population-based approach allows us to move beyond treating individuals to more broadly intervene with a population, thereby increasing real-world clinical utility of ED interventions and improving the college counseling system of care for EDs.

Objective: To investigate the association between binge features and clinical validators. Method: The Eating Disorder Examination assessed binge features in a sample of 549 college-age women: loss of control (LOC) presence, binge frequency, binge size, indicators of impaired control, and LOC severity. Clinical validators were self-reported clinical impairment and current psychiatric comorbidity, as determined via a semistructured interview. Results: Compared with women without LOC, those with LOC had significantly greater odds of reporting clinical impairment and comorbidity (ps < 0.001). Among women with LOC (n = 252), the indicators of impaired control and LOC severity, but not binge size or frequency, were associated with greater odds of reporting clinical impairment and/or comorbidity (ps < 0.05). Dicussion: Findings confirm that the presence of LOC may be the hallmark feature of binge eating. Further, dimensional ratings about the LOC experience—and possibly the indicators of impaired control—may improve reliable identification of clinically significant binge eating. © 2013 by Wiley Periodicals, Inc. (Int J Eat Disord 2013)

Objective: Given limited data on the diagnostic validity of binge eating disorder (BED) in adolescents, this study sought to characterize overweight adolescents according to types of overeating episodes. Method: Ninety-six adolescents (ages 13–17 years) with recurrent binge eating (BE), loss of control with or without overeating (subclinical BE; SUB), overeating without loss of control (OE), and no overeating or loss of control episodes (CONTROL) were compared on weight/shape concerns and depressive symptoms using ANCOVA and post-hoc least squares difference tests. Results: BE and SUB adolescents had higher weight/shape concern scores than OEs and CONTROLs (ps < .01). BE and SUB adolescents had higher depression scores than CONTROL adolescents (ps < .05). BE adolescents had greater depression scores than OE (p < .01) but not SUB adolescents. Conclusion: Loss of control over eating signals increased impairment independent of overeating in adolescents. Results support refining BED criteria for youth to reflect this distinction. © 2007 by Wiley Periodicals, Inc. Int J Eat Disord, 2008

Objective The current study examines diet aid use among college women at risk for eating disorders and explores characteristics associated with diet aid use. Method Participants were 484 college women

Objective Our objective was to develop a model to simultaneously prevent eating disorders and weight gain among female high school students. Method Of 188 female 10th graders enrolled in health classes, 174 elected to participate in the current study. They were assessed on-line and decided to participate in one of four interventions appropriate to their risk. Results The algorithm identified 111 no-risk (NR), 36 eating disorder risk (EDR), 16 overweight risk (OR), and 5 both risks. Fifty-six percent of the EDR and 50% of the OR groups elected to receive the recommended targeted curricula. Significant improvements in weight and shape concerns were observed in all groups. Discussion An Internet-delivered program can be used to assess risk and provide simultaneous universal and targeted interventions in classroom settings. © 2005 by Wiley Periodicals, Inc.

Objective The current study reviews the state of eating disorder screens. Methods Screens were classified by their purported screening function: identification of cases with (a) anorexia nervosa only; (b) bulimia nervosa only; (c) eating disorders in general; (d) partial syndrome, eating disorder not otherwise specified (EDNOS), or subclinical; (e) not a–d but at high risk. Information is presented on development, psychometric properties, and external validation (e.g., sensitivity, specificity, positive predictive values, and negative predictive values). Results Screens differ widely with regard to objective, psychometric properties and the validation methodology used. Most screens that identify cases are not appropriate for the identification of at-risk behaviors. Little data on the external validity of screens are available. Discussion Screens should be used with caution. A sequential procedure, in which subjects identified as being at risk during the first stage is followed by more specific diagnostic tests during the second stage, might overcome some of the limitations of the one-stage screening approach. © 2004 by Wiley Periodicals, Inc. Int J Eat Disord 36: 280–295, 2004.

Nine hundred thirty-nine 6th and 7th grade girls participated in the baseline phase of a prospective study designed to examine a set of potential risk factors for the development of eating disorders. Of the 939,839 girls (89%) completed the bulimia nervosa section of the Structured Clinical Interview for DSM-III-R disorders. One girl received the diagnosis of bulimia nervosa, another 35 were classified as a symptomatic group. Using analysis of covariance (ANCOVA), controlling for age and stage of sexual maturation, symptomatic and asymptomatic groups were compared on the following measures: Eating Disorders Inventory (EDI), BMI, triceps skinfold thickness, waist-to-hip ratio, depression symptoms (CES-D and DSRS), Restraint Scale, and a measure of family adaptability and cohesion (FACES). Symptomatic girls were more developmentally mature, significantly heavier, reported greater fear of weight gain, experienced greater dysphoria, indicated increased body dissatisfaction, and reported greater feelings of inadequacy and personal worthlessness. Their status on these dimensions may indicate potential vulnerability to eating disorders and, ultimately, suggest the choice of targets for intervention. Our future goal is to conduct the prospective analyses needed to confirm the hypothesized linkages.