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This study investigates the effects of persistent driven exercise (DEx) in females aged 16-22 with and without an eating disorder (ED). Physical activity (PA) is thought to elevate neurotransmitters associated with both threat and reward systems. We will test exercise-based tasks in order to capture responsivity to PA among women with and without EDs. We will identify variability in risk for and function of exercise among girls and women with eating disorders compared with age-matched healthy controls through multi-modal (behavioral, interview, self-report, physiological) assessment of eating pathology, temperament, and exercise response. Aim 1 of the study is to confirm the feasibility of paradigms evaluating acute response to exercise among outpatient individuals with EDs. Aim 2 is to characterize variability in biobehavioral response to in-lab exercise. Aim 3 is to define preliminary estimates of associations between task-based measures of acute exercise response, self-reported functions of exercise, DEx, and ED severity among the ED group.

POWERED (Phase 1: 2023-) is a pilot study investigating an interview-based assessment and accompanying statistical package and graphical tool for determining individualized target weights and weight ranges in eating disorder (ED) recovery and, more generally, across adolescent development. Treatment for restrictive-spectrum EDs typically includes establishment of an appropriate target weight (also referred to as expected body weight; EBW). Despite its salience in ED treatment, there is no standardized, empirically-validated practice regarding how to optimally set EBW for ED recovery in cases where premorbid BMIz is significantly higher than the population median. This can lead to variability in treatment recommendations across providers and treatment settings and inappropriate target weight recommendations, which can delay recovery. We aim to recruit 15 females (ages 14-20) with mild to moderate restrictive ED pathology to develop and begin initial validation of a tool to define EBW and EBW ranges. We will evaluate participant acceptability of the interview and make refinements prior to Phase 2, during which we will deploy this version of the interview with an additional 50 participants and evaluate clinicians’ user experience of the accompanying graphical tool.

The Body Advocacy Movement (BAM) High Study (Phase 1: 2023) is a pilot study investigating the feasibility, acceptability, and preliminary efficacy of an eating disorder risk reduction intervention within high school students developed by the EMBARK lab in 2022. While existing, dissonance programs (i.e. the Body Project) target reductions in thin-ideal internalization, fears related to fatness and weight gain may be a particularly salient cognitive target among those with current or past eating disorder symptomatology. In an effort to mitigate risk for ED onset and minimize the development of EDs among late adolescents, the current project includes development and initial evaluation of a novel intervention that focuses specifically on fear of fatness and anti-fat bias (the Body Advocacy Movement in High Schools; BAM High). This project aims to recruit 30 high school students (ages 14-18) to all participate in the BAM High intervention. Our objective is to examine the degree to which BAM can reduce fear of fatness and weight gain along with internalized anti-fat bias and reduce risk and development ED symptoms in a late adolescent sample. We will evaluate feasibility and acceptability of BAM and estimate effects of the intervention on self-report and behavioral measures of fear of weight gain and fatness, anti-fat bias, and eating disorder symptoms.

While facets of both anxiety and impulsivity appear central to the development and maintenance of bulimia nervosa (BN), specific BN behaviors may be propagated by differing profiles of risk. The current study examined associations between dimensions of anxiety and impulsivity and BN symptoms (binge eating, vomiting, laxative misuse, driven exercise), both in terms of the presence of such behaviors and their frequency. Two hundred and four women (Mage=25.7years) who met DSM-IV criteria for full or subthreshold BN completed self-report measures of perfectionism (Frost Multidimensional Perfectionism Scale), anxiety (Spielberger Trait Anxiety Inventory), impulsivity (Barratt Impulsiveness Scale-11; Impulsive Behavior Scale), eating disordered behaviors (Eating Disorder Examination - Questionnaire), and associated psychiatric symptoms (Michigan Assessment Screening Test/Alcohol-Drug; Maudsley Obsessive-Compulsive Inventory). Factor analysis revealed multidimensional impulsive and anxiety-related traits (5 anxiety-related factors; 7 impulsivity-related factors). In zero-sensitive regression models, different facets of impulsivity evidenced association with the presence of binge eating (risk taking), laxative misuse (impulsive spending), and fasting (difficulty concentrating), along with the frequency of vomiting (long-term planning difficulties). In contrast, anxiety-related dimensions were only associated with driven exercise (high standards) and fasting (concern over mistakes, high standards, parental expectations). Overall, impulsive and anxiety-related factors and symptoms showed distinct associations with specific eating disorder behaviors, even among those with the same diagnosis.