Latinas are at higher risk for obesity and binge eating concerns relative to other ethnic groups. Our objectives were to cultural adapt an evidence-based healthy lifestyle manual with Latinas with overweight/obesity and symptoms of binge eating disorder and identify culturally relevant dissemination strategies. Guided by designing for dissemination and sustainability principles and community-based participatory research methods, we partnered with local community organizations serving Latinas and their families. We then conducted focus groups and interviews to understand their lived experiences with overweight/obesity and binge eating disorder and culturally adapted an evidence-based healthy lifestyle manual. Qualitative data were analyzed by the constant comparative method. Participants (n = 20) were on average 30 years old (SD = 9.87); 68

Rates of type 2 diabetes mellitus continue to rise around the world, largely due to lifestyle factors such as poor diet, overeating, and lack of physical activity. Diet and eating is often the most challenging aspect of management and, when disordered, has been associated with increased risk for diabetes-related complications. Thus, there is a clear need for accessible and evidence-based interventions that address the complex lifestyle behaviors that influence diabetes management. The current study sought to assess the efficacy and acceptability of a pilot lifestyle intervention for women with type 2 diabetes and disordered eating. The intervention followed a cognitive behavioral therapy guided-self-help (CBTgsh) model and included several pillars of lifestyle medicine, including: diet, exercise, stress, and relationships. Ten women completed the 12-week intervention that provided social support, encouraged physical activity, and addressed eating behaviors and cognitions. Results indicate the lifestyle intervention was a feasible treatment for disordered eating behaviors among women with type 2 diabetes and was also associated with improved diabetes-related quality of life. The intervention was also acceptable to participants who reported satisfaction with the program. The current CBTgsh lifestyle intervention is a promising treatment option to reduce disordered eating and improve diabetes management.

Objective: College men may be at risk for binge eating (BE) but are underrepresented in research. This study aimed to examine if body weight/shape concerns, perceived stress, and psychological distress significantly contributed to the likelihood of BE over the past 28 days. Participants: A racially/ethnically diverse sample (N = 873) of college men. Method: An anonymous online survey was administered. Logistic regression analysis was conducted to examine the hypothesized associations for the entire sample, and exploratory analyses were conducted within each racial/ethnic group. Results: The model explained approximately 25% of the variance in BE, with body weight/shape concerns as the only significant predictor in the overall sample and for the White, Black, and Asian subsamples; none of the variables were significant among Latino men. Conclusions: Body weight/shape concerns predict BE among diverse college men. The findings have implications for future research, as well as for prevention and intervention for college men.

Objective: Binge eating disorder (BED) is associated with obesity and psychological distress. Although rates in African American (AA) and White women are similar. AA women report more severity of symptoms and higher frequency of binge eating episodes. However, few AA women seek help due to a lack of acknowledgment of sociocultural influences that shape experiences and behaviors related to BED in currently available interventions. Culturally adapted interventions are an important way to acknowledge these sociocultural factors and produce expected outcomes within a specific group. This qualitative study begins the process of culturally adapting evidence-based treatment for AA women to reduce BED. Method: Sixteen AA women with BED participated in focus groups to determine the need for adaptations to an evidence-based intervention. Thematic content analysis was used to analyze data from focus groups. Results: The unique experiences of AA women including lack of awareness of BED, cultural deviation from the "thin ideal," influence of family on eating practices, social meanings of food, role of religion, binge eating as coping, skepticism about weight standards, and the importance of motivation to change are highlighted. Conclusion: This research adds to the current discourse on the importance of culturally adapting interventions for more targeted use and helps to expand what is known about AA women with BED and associated obesity.

Binge eating disorder (BED) is the most prevalent eating disorder among Latinas. Furthermore, Latinas report more frequent binge eating and higher levels of associated mental health symptoms as compared with non-Latino White women. Research demonstrates that Latinas' eating problems largely go undetected and untreated and that they face numerous barriers to seeking professional help. Cognitive-behavioral therapy (CBT)-based guided self-help (CBTgsh) for binge eating is a more affordable and disseminable intervention than traditional CBT treatment. In this paper, we present the findings from a randomized controlled trial (RCT) of a culturally adapted CBTgsh program in a sample of overweight and obese Latinas with BED, the first RCT of this type with an ethnic minority population. Study participants (N = 40) diagnosed with BED were randomly assigned to the CBTgsh (n = 21) or waitlist (n = 19) condition. Treatment with the CBTgsh program resulted in significant reductions in frequency of binge eating, depression, and psychological distress and 47.6% of the intention-to-treat CBTgsh group were abstinent from binge eating at follow-up. In contrast, no significant changes were found from pre- to 12-week follow-up assessments for the waitlisted group. Results indicate that CBTgsh can be effective in addressing the needs of Latinas who binge eat and can lead to improvements in symptoms. (PsycINFO Database Record (c) 2019 APA, all rights reserved).

Little is known about personality disorders (PD) and comorbidities among Latinas with eating disorders (ED). The dysregulation and chronicity of PDs can complicate and augment the symptomatology of EDs. This set of analyses provides a preliminary examination of PD and psychopathology in a sample of Latina women with ED. Participants (N = 34) were administered the Structured Clinical Interview for the Diagnostic and Statistical Manual, Eating Disorders Examination, and Millon Clinical Multiaxial Inventory-III to assess personality pathology, and questionnaires (Beck Depression Inventory-II and Brief Symptom Inventory) to assess psychological functioning. Results indicated the most common clinically significant trait in the sample was depressive personality (50% of the sample had a score of 75 or higher on this trait). For Bulimia Nervosa (BN) and Binge Eating Disorder (BED), avoidant (41%) and depressive (65%) personalities, respectively, were the most common clinically significant traits. Anxiety disorders were the most common psychiatric diagnoses, and 52.9% of the sample reported both clinically significant PD traits and other major psychopathology. There were no significant differences between the BED and BN groups on prevalence of PD traits and psychopathology. This pilot study highlights the need for further examination of PD and psychopathology in Latinas with ED. Unlike previous research with White women, we found no differences on PD and psychopathology between BED and BN, and the most prevalent PDs among Latinas were different than White women. Personality and psychological functioning should be assessed in all patients with ED, with ongoing research focused on identifying patterns in understudied groups such as Latinas, a practice that may improve treatment for this underserved population.

AbstractThe objective of this study is to provide a comprehensive review of empirical research exploring barriers to and facilitators of initial treatment seeking (“first contact”) from professional health care providers by adults and young adults with eating disorders (EDs). A search of databases PsycINFO and MEDLINE using the terms “treatment” and “eating disorder*” yielded 9,468 peer‐reviewed articles published from January 1945 to June 2016. Screening identified 31 articles meeting the following criteria: (1) participants were 16 or older and presented with a self‐reported or clinically diagnosed ED; (2) studies focused on (a) initial treatment seeking (b) for an ED (c) from professional health care providers; (3) articles were empirical, and (4) peer reviewed. Quantitative studies revealed few consistent correlates of treatment seeking, perhaps because most variables were examined in only one or two investigations. Variables with some degree of predictive utility (i.e., produced significant results in multiple studies) were age (older), ethnicity (nonethnic minority), ED type (anorexia, purging BN), specific ED‐related behaviors (i.e., purging), and time spent on a treatment waitlist following referral (less). Although BMI was one of the most investigated variables, it did not predict treatment seeking. Qualitative studies revealed the following perceived barriers: (1) personal feelings of shame/fear, (2) ED‐related beliefs/perceptions, (3) lack of access/availability, and (4) aspects of the treatment process. Perceived facilitators included (1) health‐related concerns, (2) emotional distress, and (3) social support. Implications for clinical practice and areas for further research are discussed. Results highlight the need for shared definitions and methodologies across studies of treatment seeking.

Establishing a regular pattern of eating is a core element of treatment for binge eating, yet no research to date has examined meal patterns of Latina women.OBJECTIVE:Compare eating patterns of Latinas who binge eat and those who do not, and examine associations between meal patterns and binge episodes, associated distress and concerns, and body mass index (BMI).METHOD:One-hundred fifty-five Latinas [65 Binge Eating Disorder (BED), 22 Bulimia Nervosa (BN), 68 with no eating disorder] were assessed with the Eating Disorder Examination.RESULTS:There were no significant differences in eating patterns between groups. Breakfast was the least and dinner the most consumed meal. For the BED group: greater frequency of lunch consumption was associated with higher BMI while more frequent evening snacking was associated with lower BMI and with less weight importance; more frequent breakfast consumption, mid-morning snack consumption and total meals were associated with greater distress regarding binge eating. For the BN group, evening snack frequency was associated with less dietary restriction and more weight and shape concern; total snack frequency was associated with more weight concern. Regular meal eaters reported more episodes of binge eating than those who did not eat meals regularly.DISCUSSION:Associations with meal patterns differed by eating disorder diagnosis. Study findings mostly are not consistent with results from prior research on primarily White women. CBT treatments may need to be tailored to address the association between binge eating and regular meal consumption for Latinas. Culturally, appropriate modifications that address traditional eating patterns should be considered. © 2016 Wiley Periodicals, Inc. (Int J Eat Disord 2017; 50:32-39).

The prevalence of bulimia nervosa (BN) and binge eating disorder (BED) among Latinas is comparable to those of the general population; however, few interventions and treatment trial research have focused on this group. Cognitive-behavioral therapy (CBT) is the treatment of choice for binge eating related disorders. CBT-based guided self-help (CBTgsh)-a low-cost minimal intervention-has also been shown effective in improving binge eating related symptom, but the effectiveness of the CBTgsh among ethnic minority women is not well understood. Cultural adaptation of evidence-based treatments can be an important step for promoting treatment accessibility and engagement among underserved groups. This qualitative study was part of a larger investigation that examined the feasibility and efficacy of a culturally adapted CBTgsh program among Mexican American women with binge eating disorders. Posttreatment focus groups were conducted with 12 Mexican American women with BN or BED who participated in the intervention. Data were analyzed with the grounded theory methodology (Corbin & Strauss, 2008). Three themes emerged from the data: (a) eating behavior and body ideals are socially and culturally constructed, (b) multifaceted support system is crucial to Mexican American women's treatment engagement and success, and (c) the culturally adapted CBTgsh program is feasible and relevant to Mexican American women's experience, but it can be strengthened with increased family and peer involvement. The findings provide suggestions for further adaptation and refinement of the CBTgsh, and implications for future research as well as early intervention for disordered eating in organized care settings.