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An investigation of the joint longitudinal trajectories of low body weight, binge eating, and purging in women with anorexia nervosa and bulimia nervosa

Authors

  • Jason M. Lavender MA,

    1. Department of Psychology, University at Albany, State University of New York, Albany, New York
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    • The first two authors made equal contributions to this manuscript.

  • Kyle P. De Young MA,

    1. Department of Psychology, University at Albany, State University of New York, Albany, New York
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    • The first two authors made equal contributions to this manuscript.

  • Debra L. Franko PhD,

    1. Department of Psychiatry, Massachusetts General Hospital, Boston, Massachusetts
    2. Department of Counseling and Applied Educational Psychology, Northeastern University, Boston, Massachusetts
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  • Kamryn T. Eddy PhD,

    1. Department of Psychiatry, Massachusetts General Hospital, Boston, Massachusetts
    2. Department of Psychiatry, Harvard Medical School, Boston, Massachusetts
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  • Andrea E. Kass BA,

    1. Department of Psychiatry, Massachusetts General Hospital, Boston, Massachusetts
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  • Meredith S. Sears BA,

    1. Department of Psychiatry, Massachusetts General Hospital, Boston, Massachusetts
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  • David B. Herzog MD

    Corresponding author
    1. Department of Psychiatry, Massachusetts General Hospital, Boston, Massachusetts
    2. Department of Psychiatry, Harvard Medical School, Boston, Massachusetts
    • Massachusetts General Hospital, 2 Longfellow Place, Suite 200, Boston, MA 02114
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Abstract

Objectives:

To describe the longitudinal course of three core eating disorder symptoms—low body weight, binge eating, and purging—in women with anorexia nervosa (AN) and bulimia nervosa (BN) using a novel statistical approach.

Method:

Treatment-seeking women with AN (n = 136) or BN (n = 110) completed the Eating Disorders Longitudinal Interval Follow-Up Evaluation interview every 6 months, yielding weekly eating disorder symptom data for a 5-year period. Semiparametric mixture modeling was used to identify longitudinal trajectories for the three core symptoms.

Results:

Four individual trajectories were identified for each eating disorder symptom. The number and general shape of the individual trajectories was similar across symptoms, with each model including trajectories depicting stable absence and stable presence of symptoms as well as one or more trajectories depicting the declining presence of symptoms. Unique trajectories were found for low body weight (fluctuating presence) and purging (increasing presence). Conjunction analyses yielded the following joint trajectories: low body weight and binge eating, low body weight and purging, and binge eating and purging.

Discussion:

The course of individual eating disorder symptoms among patients with AN and BN is highly variable. Future research identifying clinical predictors of trajectory membership may inform treatment and nosological research. © 2010 by Wiley Periodicals, Inc. Int J Eat Disord 2010

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