Objective A bogus pipeline paradigm was utilized to assess whether food intake underreporting by unsuccessful dieters is intentional. Method: Twenty‐eight subjects completed 1‐week food diaries. Then, 17 subjects in the experimental condition kept 2‐week food diaries while being told the researcher was verifying their report. Eleven subjects in the control group were asked merely to self‐monitor for two more weeks. Results: Results indicate that subjects in the experimental group reported significantly greater intake than control subjects, when controlling for reported intake during the screening phase and weight change. Discussion: Thus, the belief that the researcher could verify their report improved the accuracy of patients' self‐report. However, all subjects continued to underreport their dietary intake. In summary, underreporting may be an intentional attempt to manage presentation to others in a society that is increasingly critical of overweight persons. © 1998 by John Wiley & Sons, Inc. Int J Eat Disord 24: 259–266, 1998.

Objective: This study used mixed methods to evaluate caregiver perspectives on recovery from an eating disorder.Method: Caregivers (N = 387) completed an online survey about their child's weight history, treatment history, illness trajectory, and recovery. Results:Children were predominantly females with adolescent onset anorexia nervosa and currently 18.4 years old on average. Qualitative analysis of caregivers' open-ended definitions of recovery revealed seven distinct recovery domains, including 1) weight (45%); 2) body image, eating disorder cognitions, and related emotions (54%); 3) eating behavior (71%); 4) independence and responsibility in eating disorder management (28%); 5) physical health (21%); 6) psychological well-being (31%); and 7) life worth living (27%). Most (72%) reported that their child had achieved partial or full recovery at some point in their lifetime. Only 20% reported that their child had ever achieved full recovery, but 93% of those had sustained recovery over time (i.e., no relapses since achieving recovery). Physical recovery occurred on average 2.7 years after eating disorder onset, followed shortly by social and emotional recovery (2.9 years), and finally behavioral (3.4 years) and cognitive (3.9 years) recovery, which occurred at weights 6 to 7 pounds higher than those at which physical recovery was achieved. Conclusion:Findings suggest that caregivers hold a multi-faceted view of recovery that includes not only weight restoration and symptom reduction, but also full engagement in social and occupational activities, establishment of a meaningful life, cognitive flexibility, and emotional well-being. These data support clinical observations that physical and behavioral recovery precede cognitive recovery.

Patients with anorexia nervosa, bulimia nervosa, and binge-eating disorder are at risk for premature death. These complex psychological disorders with potentially devastating physical consequences usually require that treatment professionals have specialized knowledge and skills that are often outside the scope of basic therapist training. Without a well-known and psychotherapeutic field-wide accepted definition of what constitutes minimum eating disorder treatment competence, psychotherapists are often left to decide for themselves. This article proposes a suggested standard body of initial knowledge and considerations for clinicians striving to obtain a level of competence—between generalist and specialist skillsets—in treating eating disorders in the outpatient setting. Suggested competency domains include: assessment and diagnosis, medical factors, nutrition and malnutrition, treatment strategies, and multidisciplinary collaboration and levels of care.

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