Impulsivity, dietary control and the urge to binge in bulimic syndromes

Objective: Naturalistic studies on sufferers of bulimic syndromes suggest t hat binge episodes are often precipitated by episodes of dietary restraint. However, evidence also implies that binge eating may, in certain psychopat hological contexts, have less direct connection with dietary control factor s. Applying an 8- to 22-day experience-sampling procedure in individuals wi th bulimic syndromes, we explored possible moderating effects of trait impu lsivity upon the ongoing association between cognitive dietary control and binge eating. Method: Fifty-one women with bulimia spectrum eating disorder s provided periodic daily observations on cognitive control over eating, ur ges to binge, and binge episodes. impulsivity was assessed by self-report q uestionnaire. Hierarchical linear modeling techniques were used to assess r elationships of interest. Results: Urge to Binge was higher (on average) pr ior to eating binges than at comparable times on binge-free days, and thus seemed to signal the potential for binge eating. More importantly, scores o n Urge to Binge and Dietary Control covaried systematically over time in mo st participants, but were desynchronous in highly impulsive individuals. Co nclusions: Binge eating is closely linked to dietary control in most bulimi c individuals, but this may be less typical of individuals showing marked i mpulsivity. We discuss factors that may explain the disconnection between D ietary Control and Urge to Binge in impulsive binge eaters as well as the i mplications of such factors for the management of bulimic patients with mar ked impulsivity. (C) 1999 by John Wiley & Sons, Inc.