The continuity/discontinuity models of eating disorders: a review of the literature and implications for assessment, treatment, and prevention.
Binge eating looks like a light switch, not a dimmer, so assess and treat it as a separate class.
01Research in Context
What this study did
The authors read 30 years of taxometric studies on eating disorders.
They asked: do eating problems sit on a smooth curve, or do they break into clear groups?
They focused on math tools that spot jumps in data rather than slow slopes.
What they found
Binge eating showed the clearest break.
People who binge looked like a separate group, not just the far end of normal eating.
Other eating problems showed weaker or mixed breaks.
How this fits with other research
Eugenia Gras et al. (2003) watched single cases and saw mood jump up during a binge.
That mood jump fits the idea that binge eating is a separate state, not a gradual shift.
Legenbauer et al. (2011) later found body-image jumps only in obese clients who also binge.
Together the papers line up: binge eating acts like a switch, not a dial.
Burack et al. (2004) list tools that assume eating problems are continuous.
The taxometric work says those tools may miss the real cut-point, so you might under-score severe bingers.
Why it matters
If binge eating is a separate class, your intake should look for clear yes-or-no flags, not just mild-to-severe ratings.
Add a binge-specific screener and watch for sudden mood lifts after food theft or secret eating.
Treat the behavior as a category shift: teach coping plans that kick in the moment urge spikes, not after a slow climb.
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02At a glance
03Original abstract
Are the eating disorders discrete diagnostic entities or do they fall along one or more continua ranging from normal body weight, eating behavior, and weight concerns to severely disturbed patterns? Researchers have debated this question for at least 30 years and have used numerous creative strategies to examine this and related questions. This body of research is reviewed with particular attention to the more recent use of taxometric methods. Although somewhat mixed, much of the earlier research has been interpreted as supporting the continuity model. However, more recent taxometric research suggests the presence of one or more latent discontinuities, particularly with disorders associated with binge eating. These findings have implications for assessment, treatment, and possible prevention of eating disorders, and may ultimately allow us to better predict who will or will not develop an eating disorder in response to dieting, as well as who will or will not respond to particular treatments for an existing eating disorder.
Behavior modification, 2004 · doi:10.1177/0145445503259859