Role of Loss of Control (LOC) Eating in Purging Disorder

Purging Disorder (PD), a proposed Eating Disorder Not Elsewhere Classified (American Psychiatric Association, 2010), is characterized by recurrent purging in the absence of binge eating. Though objectively large binge episodes are not present, some individuals with PD experience a loss of control (LOC) while eating a normal or even small amount of food. The present study sought to examine the role of LOC eating in PD using archival data from 101 women with PD. Participants completed diagnostic interviews and self-report questionnaires. Analyses examined the relationship between LOC eating and eating disorder features, psychopathology, personality traits, and impairment, controlling for purging frequency, age, and body mass index. More frequent LOC eating was associated with greater disinhibition around food, greater hunger, greater body image disturbance and greater eating disorder severity, but LOC eating was not associated with restraint. LOC eating was associated with depressive symptoms, but not anxiety symptoms. More frequent LOC eating was associated with a greater likelihood of lifetime substance use disorders and impulse control disorders, but LOC eating was not associated with lifetime mood and anxiety disorders. LOC eating was positively associated with negative urgency, but not with other aspects of impulsivity. Those with more frequent LOC eating were significantly more impaired and reported more distress. LOC eating is a clinically significant feature of PD and should be considered in future definitions of PD. Future research should examine the relationship between LOC eating and the course of PD.