Dieting in bulimia nervosa is associated with increased food restriction and psychopathology but decreased binge eating

• We examine the relation of dieting and binge eating in bulimia nervosa (BN).
• Patients with BN were classified into groups based on dieting status.
• Those dieting to lose weight reported less frequent binge eating than non-dieters.
• Regardless of dieting motivation, dieters had higher EDE-Q scores than non-dieters.
• Implications for current conceptualizations of BN are discussed.

The cognitive behavioral model of bulimia nervosa (BN) suggests that dieting is central to the maintenance of binge eating. However, correlational and experimental studies suggest that additional clarification is needed about the nature of this relationship. Dieting, weight, eating disorder psychopathology, and depression were assessed at admission among 166 patients with BN presenting for residential treatment. As in past research, a significant fraction (43%) of patients with BN reported not currently dieting. A comparison of weight loss dieters and non-dieters found greater food restriction and eating disorder psychopathology among weight loss dieters. However, dieters reported less frequent binge eating. There were no significant group differences in depression. Results suggest that 1) while many individuals with BN are attempting to restrict their food intake, the goal of losing weight fundamentally alters the effect of such restriction on binge eating, and 2) treatment may benefit from helping patients to establish a healthier approach to achieving long-term weight stability.