{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,11]],"date-time":"2026-09-11T12:28:19Z","timestamp":1789129699305,"version":"build-2803163510"},"reference-count":50,"publisher":"Wiley","issue":"3","license":[{"start":{"date-parts":[[2023,1,10]],"date-time":"2023-01-10T00:00:00Z","timestamp":1673308800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/100006108","name":"National Center for Advancing Translational Sciences","doi-asserted-by":"publisher","award":["UL1 TR002014"],"award-info":[{"award-number":["UL1 TR002014"]}],"id":[{"id":"10.13039\/100006108","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Intl J Eating Disorders"],"published-print":{"date-parts":[[2023,3]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Objective<\/jats:title><jats:p>Exposure therapy is a promising treatment for eating disorders (EDs). However, questions remain about the effectiveness of exposure to feared foods during the weight restoration phase of treatment, and the importance of between\u2010session and within\u2010session habituation.<\/jats:p><\/jats:sec><jats:sec><jats:title>Method<\/jats:title><jats:p>We recruited 54 adolescents from a partial hospitalization program (PHP) for EDs which included daily food exposure. Throughout treatment, participants provided subjective units of distress (SUDS) ratings before and after eating a feared food, and completed measures of ED symptomatology.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Multilevel models found that pre\u2010exposure SUDS decreased over time, providing some evidence that between\u2010session habituation occurred. In contrast, the difference between pre\u2010exposure and post\u2010exposure SUDS did not decrease over time, indicating that within\u2010session habituation did not occur. Weight gain predicted greater between\u2010session habituation to feared foods, but did not predict within\u2010session habituation. Between\u2010session habituation, but not within\u2010session habituation, predicted favorable treatment outcomes, including weight gain and improvements on the Children's Eating Attitudes Test and Fear of Food Measure.<\/jats:p><\/jats:sec><jats:sec><jats:title>Discussion<\/jats:title><jats:p>Partial hospitalization programs that include daily exposure to feared foods may be effective at decreasing anxiety about foods for adolescents with EDs who are experiencing weight restoration. Further research is warranted to replicate our findings challenging the importance of within\u2010session habituation, and to better understand between\u2010session habituation and inhibitory learning as mechanisms of change when conducting food exposure for EDs.<\/jats:p><\/jats:sec><jats:sec><jats:title>Public Significance<\/jats:title><jats:p>This study provides some evidence that PHPs that include food exposure may be useful for adolescents with EDs who are experiencing weight restoration. Between\u2010session habituation, but not within\u2010session habituation, predicted favorable treatment outcomes. Further research is needed to determine whether clinicians can disregard within\u2010session habituation when conducting food exposure for EDs, and understand the importance of between\u2010session habituation as a potential mechanism of food exposure.<\/jats:p><\/jats:sec>","DOI":"10.1002\/eat.23894","type":"journal-article","created":{"date-parts":[[2023,1,10]],"date-time":"2023-01-10T17:57:48Z","timestamp":1673373468000},"page":"637-645","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":10,"title":["The impact of between\u2010session habituation, within\u2010session habituation, and weight gain on response to food exposure for adolescents with eating disorders"],"prefix":"10.1002","volume":"56","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-7743-3707","authenticated-orcid":false,"given":"Jamal H.","family":"Essayli","sequence":"first","affiliation":[{"name":"Department of Pediatrics Pennsylvania State University College of Medicine  Hershey Pennsylvania USA"},{"name":"Department of Psychiatry and Behavioral Health Pennsylvania State University College of Medicine  Hershey Pennsylvania USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1481-5078","authenticated-orcid":false,"given":"Lauren N.","family":"Forrest","sequence":"additional","affiliation":[{"name":"Department of Psychiatry and Behavioral Health Pennsylvania State University College of Medicine  Hershey Pennsylvania USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9228-0139","authenticated-orcid":false,"given":"Hana F.","family":"Zickgraf","sequence":"additional","affiliation":[{"name":"Department of Psychiatry and Behavioral Sciences Emory University School of Medicine  Atlanta Georgia USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Emily C.","family":"Stefano","sequence":"additional","affiliation":[{"name":"Bariatric and Weight Management Center Wake Forest University School of Medicine  Winston\u2010Salem North Carolina USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kathleen L.","family":"Keller","sequence":"additional","affiliation":[{"name":"Department of Nutritional Sciences Pennsylvania State University  Pennsylvania USA"},{"name":"Department of Food Science Pennsylvania State University  Pennsylvania USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Susan E.","family":"Lane\u2010Loney","sequence":"additional","affiliation":[{"name":"Department of Pediatrics Pennsylvania State University College of Medicine  Hershey Pennsylvania USA"},{"name":"Department of Psychiatry and Behavioral Health Pennsylvania State University College of Medicine  Hershey Pennsylvania USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2023,1,10]]},"reference":[{"key":"e_1_2_9_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.beth.2013.03.003"},{"key":"e_1_2_9_3_1","doi-asserted-by":"publisher","DOI":"10.1037\/met0000195"},{"key":"e_1_2_9_4_1","doi-asserted-by":"publisher","DOI":"10.18637\/jss.v067.i01"},{"key":"e_1_2_9_5_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0005-7916(97)00041-4"},{"key":"e_1_2_9_6_1","doi-asserted-by":"publisher","DOI":"10.1002\/eat.22853"},{"key":"e_1_2_9_7_1","doi-asserted-by":"publisher","DOI":"10.1176\/appi.ajp.2012.12010147"},{"key":"e_1_2_9_8_1","doi-asserted-by":"publisher","DOI":"10.1002\/eat.22376"},{"key":"e_1_2_9_9_1","doi-asserted-by":"publisher","DOI":"10.1002\/erv.2639"},{"key":"e_1_2_9_10_1","doi-asserted-by":"publisher","DOI":"10.1016\/0146-6402(94)90003-5"},{"key":"e_1_2_9_11_1","doi-asserted-by":"publisher","DOI":"10.1002\/eat.10041"},{"key":"e_1_2_9_12_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.brat.2007.10.003"},{"key":"e_1_2_9_13_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.brat.2013.06.006"},{"key":"e_1_2_9_14_1","doi-asserted-by":"publisher","DOI":"10.1007\/978-1-0716-0700-8_9"},{"key":"e_1_2_9_15_1","volume-title":"Cognitive behavior therapy and eating disorders","author":"Fairburn C. 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