Meal patterning in the treatment of bulimia nervosa

• Evening meal consumption influences bulimic behaviors.
• Evening meals influence bulimic behavior, even when controlling for depression.
• Mid-morning snacks and lunch consumption influence purging behaviors.
• Different meals and snacks exert variable influence on bulimic behaviors.

ObjectiveThis study examined the relationship between changes in meal and snack consumption and eating disorder behaviors in a treatment sample of bulimic adults.MethodEighty adults with bulimia nervosa (BN) were randomized to one of two treatments. Meal and snack consumption, binge eating frequency, and purging behavior frequency were assessed at baseline, end-of-treatment, and at four month follow-up using the Eating Disorder Examination (EDE).ResultsGeneralized linear models indicated that increased consumption of evening meals over the course of treatment was related to a significant decrease in the rate of binge eating and purging at four month follow-up; these results remained significant when controlling for changes in depression over the course of treatment.ConclusionsThe findings support the importance of focusing efforts on developing a pattern of regular evening meal consumption among individuals in the treatment of BN.