Clinical Focus

  • Psychology
  • Adult Eating Disorders

Academic Appointments

  • Clinical Associate Professor, Psychiatry and Behavioral Sciences

Honors & Awards

  • National Research Service Award (T32), NIH (2001-2003)

Professional Education

  • Medical Education:Kent State University (2001) OH
  • Fellowship:Stanford University Medical Center (2003) CA
  • Internship:VA Puget Sound Health Care System (2001) WA


2015-16 Courses


All Publications

  • Do restrained eaters restrict their caloric intake prior to drinking alcohol? EATING BEHAVIORS Luce, K. H., Crowther, J. H., Leahey, T., Buchholz, L. J. 2013; 14 (3): 361-365


    This research used multilevel modeling to investigate the hypothesis that restrained eaters increase dietary restriction when they expect to drink alcohol. Undergraduate women (39 restrained eaters; 40 unrestrained eaters) monitored their food and alcohol intake for ten days. Restrained eaters, on average, consumed fewer calories per day than unrestrained eaters. Although the intent to drink alcohol did not impact the overall caloric intake of restrained eaters prior to drinking, restrained eaters reported significantly fewer eating episodes than unrestrained eaters on days the participants intended to drink. Given that restrained eaters generally consumed fewer calories per day and had fewer eating episodes prior to drinking, one major implication of higher levels of intoxication would be increased risk of negative alcohol-related consequences. Future research should extend this study and evaluate negative alcohol-related consequences that occur with higher levels of intoxication.

    View details for DOI 10.1016/j.eatbeh.2013.06.004

    View details for Web of Science ID 000323586700022

    View details for PubMedID 23910781

  • Psychometric properties of measures of eating disorder risk in latina college women INTERNATIONAL JOURNAL OF EATING DISORDERS Franko, D. L., Jenkins, A., Roehrig, J. P., Luce, K. H., Crowther, J. H., Rodgers, R. F. 2012; 45 (4): 592-596


    Latina college women are at risk for eating disorders (EDs), but assessment is problematic, because the psychometric properties of risk factor measures have not been evaluated with this group.Reliability and validity estimates of the Eating Disorder Examination Questionnaire, Body Esteem Scale, Sociocultural Attitudes Toward Appearance Questionnaire-3, and Body Shape Questionnaire were examined in a sample of 173 female Latina college students.Cronbach ? coefficients (.75-.96) and intraclass coefficients (.65-.96) indicated good reliability. Most measures were significantly correlated, providing evidence for convergent validity. Confirmatory factor analyses resulted in good fit indices.These findings indicate that commonly used measures of ED risk have adequate reliability and validity in Latina college women. Comparison data suggest that ED risk may be similar or even higher in Latina college women relative to Caucasian college women. Prevention efforts with diverse groups are needed.

    View details for DOI 10.1002/eat.20979

    View details for Web of Science ID 000302546500015

    View details for PubMedID 22271562

  • The point prevalence of bulimic disorders from 1990 to 2004 INTERNATIONAL JOURNAL OF EATING DISORDERS Crowther, J. H., Armey, M., Luce, K. H., Dalton, G. R., Leahey, T. 2008; 41 (6): 491-497


    This study investigated the point prevalence of probable cases of bulimia nervosa (BN), eating disorder not otherwise specified (EDNOS), and specific eating disorder symptomatology among 6,844 undergraduate women at a single site, examining changes across five 3-year time periods and on a yearly basis from 1990 to 2004.Participants completed a self-report checklist that assessed the diagnostic criteria for BN (American Psychiatric Association, Diagnostic and Statistical Manual of Mental Disorders, 1994) and the Bulimia Test (Smith and Thelen, J Consult Clin Psychol, 52, 863-872, 1984) (BULIT) or Bulimia Test-Revised (Thelen et al., Psychol Assess, 3, 119-124, 1991) (BULIT-R).Chi-square analyses comparing the percentages of probable cases of BN and EDNOS and the percentages of women who reported frequent binge eating and most compensatory weight control strategies were nonsignificant. Only the percentages of women who endorsed overconcern with weight and shape and diuretic use and excessive exercise as compensatory weight control strategies changed over time.Consistent with Keel et al.'s (Keel et al., Psychol Med, 36, 119-127, 2006) findings regarding the point prevalence rates of BN from 1992 to 2002, results indicated that probable cases of eating disorders remained relatively stable. Methodologically, this research illustrates the importance of examining multiple data points when investigating stability or change in behavior.

    View details for DOI 10.1002/eat.20537

    View details for Web of Science ID 000258608600002

    View details for PubMedID 18433014

  • Do adherence variables predict outcome in an online program for the prevention of eating disorders? JOURNAL OF CONSULTING AND CLINICAL PSYCHOLOGY Manwaring, J. L., Bryson, S. W., Goldschmidt, A. B., Winzelberg, A. J., Luce, K. H., Cunning, D., Wilfley, D. E., Taylor, C. B. 2008; 76 (2): 341-346


    Unlike traditional interventions, Internet interventions allow for objective tracking and examination of the usage of program components. Student Bodies (SB), an online eating disorder (ED) prevention program, significantly reduced ED attitudes/behaviors in college-aged women with high body image concerns, and reduced the development of EDs in some higher risk subgroups. The authors investigated how adherence measures were associated with ED attitudes and behaviors after treatment. Female SB participants (n = 209) completed the Eating Disorders Examination-Questionnaire (EDE-Q; C. G. Fairburn & S. J. Beglin, 1994) at baseline, posttreatment, and 1-year follow-up. Total weeks participation and frequency of utilizing the online Web pages/journals predicted pre- to posttreatment changes in EDE-Q Restraint but not in other ED symptoms. In participants with some compensatory behaviors, discussion board and booster session use were associated with increased weight/shape concerns during follow-up. In overweight participants, higher online Web page/journal use was related to decreased EDE-Q Eating Concern scores during follow-up. This is the first study to investigate the relationship between adherence to specific program components and outcome in a successful Internet-based intervention. Results can be used to inform future development and tailoring of prevention interventions to maximize effectiveness and facilitate dissemination.

    View details for DOI 10.1037/0022-006X.76.2.341

    View details for Web of Science ID 000254539400015

    View details for PubMedID 18377129

  • Eating Disorder Examination Questionnaire (EDE-Q): Norms for undergraduate women INTERNATIONAL JOURNAL OF EATING DISORDERS Luce, K. H., Crowther, J. H., Pole, M. 2008; 41 (3): 273-276


    This research presents normative data on the Eating Disorder Examination Questionnaire (Fairburn and Beglin, Int J Eat Disorder, 16, 363-370, 1994) (EDE-Q) for samples of undergraduate women in the United States.College women (N = 723), ages 18-25, completed the EDE-Q as part of a larger assessment battery.Average scores, standard deviations, and percentile ranks for the raw Restraint, Eating Concern, Shape Concern, and Weight Concern subscales and the Global score are reported. Data on the occurrence of objective and subjective bulimic episodes and compensatory behaviors are presented.These results are helpful for clinicians and researchers in the interpretation of the EDE-Q scores of undergraduate women in the United States. Comparisons are drawn between the results for this sample and those of a United Kingdom sample of young adolescent females, an Australian community sample, and an Australian community age-matched sample.

    View details for DOI 10.1002/eat.20504

    View details for Web of Science ID 000254114400011

    View details for PubMedID 18213686

  • The clinical significance of loss of control over eating in overweight adolescents INTERNATIONAL JOURNAL OF EATING DISORDERS Goldschmidt, A. B., Jones, M., Manwaring, J. L., Luce, K. H., Osborne, M. I., Cunning, D., Taylor, K. L., Doyle, A. C., Wilfley, D. E., Taylor, C. B. 2008; 41 (2): 153-158


    Given limited data on the diagnostic validity of binge eating disorder (BED) in adolescents, this study sought to characterize overweight adolescents according to types of overeating episodes.Ninety-six adolescents (ages 13-17 years) with recurrent binge eating (BE), loss of control with or without overeating (subclinical BE; SUB), overeating without loss of control (OE), and no overeating or loss of control episodes (CONTROL) were compared on weight/shape concerns and depressive symptoms using ANCOVA and post-hoc least squares difference tests.BE and SUB adolescents had higher weight/shape concern scores than OEs and CONTROLs (ps < .01). BE and SUB adolescents had higher depression scores than CONTROL adolescents (ps < .05). BE adolescents had greater depression scores than OE (p < .01) but not SUB adolescents.Loss of control over eating signals increased impairment independent of overeating in adolescents. Results support refining BED criteria for youth to reflect this distinction.

    View details for DOI 10.1002/eat.20481

    View details for Web of Science ID 000253226300007

    View details for PubMedID 18095271

  • Randomized, controlled trial of an internet-facilitated intervention for reducing binge eating and overweight in adolescents PEDIATRICS Jones, M., Luce, K. H., Osborne, M. I., Taylor, K., Cunning, D., Doyle, A. C., Wilfley, D. E., Taylor, C. B. 2008; 121 (3): 453-462


    This study examined the efficacy of an Internet-facilitated intervention for weight maintenance and binge eating in adolescents.A total of 105 adolescent male and female high school students at risk for overweight (mean age: 15.1 +/- 1.0 years) were randomly assigned to a 16-week online intervention, StudentBodies2-BED (n = 52), or the wait-list control group (n = 53).Participants in the StudentBodies2-BED group had significantly lower BMI z scores and BMI from baseline assessment to follow-up assessment, compared with the wait-list control group. In addition, significant reductions in objective binge episodes and subjective binge episodes from baseline assessment to posttreatment assessment and from baseline assessment to follow-up assessment were observed among StudentBodies2-BED participants. The StudentBodies2-BED group also reported significantly reduced weight and shape concerns from posttreatment assessment to follow-up assessment and from baseline assessment to follow-up assessment. Participants in the StudentBodies2-BED group who engaged in objective overeating or binge eating episodes at baseline assessment experienced a significantly greater reduction in BMI at follow-up assessment, compared with the wait-list control group.Results suggest that an Internet-facilitated intervention is moderately effective in short-term weight loss and weight maintenance and yields a large reduction in binge eating. This study also demonstrates that weight management and reduction of eating disorder psychopathological features can be achieved simultaneously by using an easily disseminated, Internet-facilitated program.

    View details for Web of Science ID 000253780100001

    View details for PubMedID 18310192

  • Reliability of self-report: paper versus online administration COMPUTERS IN HUMAN BEHAVIOR Luce, K. H., Winzelberg, A. J., Das, S., Osborne, M. I., Bryson, S. W., Taylor, C. B. 2007; 23 (3): 1384-1389
  • Eating disorders and alcohol use: group differences in consumption rates and drinking motives. Eating behaviors Luce, K. H., Engler, P. A., Crowther, J. H. 2007; 8 (2): 177-184


    Alcohol use and drinking motives were investigated among college women divided into four probable eating disorder groups: Bulimia Nervosa, purging subtype (BN n=16) Binge Eating Disorder (BED n=30) Eating Disorder, Not Otherwise Specified (EDNOS n=85) and Non-Eating Disordered Controls (NEDC n=252). Participants completed questionnaires that assessed eating behaviors and attitudes, motives for drinking alcohol, quantity and frequency of alcohol use, and binge drinking. The BED group reported greater weekend alcohol consumption and binge drinking than the EDNOS and NEDC groups. The BN and BED groups were significantly more likely to endorse Coping as a drinking motive than the EDNOS and NEDC groups. The NEDC group was more likely to endorse Mood Enhancement than the EDNOS group. These results offer one explanation for the relationship between eating and alcohol use disorders. Women with eating disorders may use alcohol to cope with negative affect, analogous to findings that women with eating disorders report binge eating to regulate negative affect [Mizes, J. S. (1985). Bulimia: A review of its symptomatology and treatment. Advances in Behavior Research and Therapy, 7, 91-142].

    View details for PubMedID 17336788

  • Use of diet pills and other dieting aids in a college population with high weight and shape concerns INTERNATIONAL JOURNAL OF EATING DISORDERS Celio, C. I., Luce, K. H., Bryson, S. W., Winzelberg, A. J., Cunning, D., Rockwell, R., Doyle, A. A., Wilfley, D. E., Taylor, C. B. 2006; 39 (6): 492-497


    The current study examines diet aid use among college women at risk for eating disorders and explores characteristics associated with diet aid use.Participants were 484 college women<30 years from 6 universities in the San Francisco Bay Area (SF) and San Diego who were at risk for developing eating disorders. A checklist assessed diet pill, fat blocker, diuretic, laxative, and other diet aid use over the past 12 months.Thirty-two percent of the college women reported using a diet aid. Diet aid use was double the rate in San Diego (44%) compared with SF (22%) (p=.000). Weight and shape concerns were higher among diet aid users than among nonusers across sites.A significant number of college women at risk for eating disorders are using diet aids. We recommend that clinicians inquire about diet aid use among college-aged patients.

    View details for DOI 10.1002/eat.20254

    View details for Web of Science ID 000239802500008

    View details for PubMedID 16676350

  • Prevention of eating disorders in at-risk college-age women ARCHIVES OF GENERAL PSYCHIATRY Taylor, C. B., Bryson, S., Luce, K. H., Cunning, D., Doyle, A. C., Abascal, L. B., Rockwell, R., Dev, P., Winzelberg, A. J., Wilfley, D. E. 2006; 63 (8): 881-888


    Eating disorders, an important health problem among college-age women, may be preventable, given that modifiable risk factors for eating disorders have been identified and interventions have been evaluated to reduce these risk factors.To determine if an Internet-based psychosocial intervention can prevent the onset of eating disorders (EDs) in young women at risk for developing EDs.San Diego and the San Francisco Bay Area in California.College-age women with high weight and shape concerns were recruited via campus e-mails, posters, and mass media. Six hundred thirty-seven eligible participants were identified, of whom 157 were excluded, for a total sample of 480. Recruitment occurred between November 13, 2000, and October 10, 2003. Intervention A randomized controlled trial of an 8-week, Internet-based cognitive-behavioral intervention (Student Bodies) that included a moderated online discussion group. Participants were studied for up to 3 years.The main outcome measure was time to onset of a subclinical or clinical ED. Secondary measures included change in scores on the Weight Concerns Scale, Global Eating Disorder Examination Questionnaire, and Eating Disorder Inventory drive for thinness and bulimia subscales and depressed mood. Moderators of outcome were examined.There was a significant reduction in Weight Concerns Scale scores in the Student Bodies intervention group compared with the control group at postintervention (P < .001), 1 year (P < .001), and 2 years (P < .001). The slope for reducing Weight Concerns Scale score was significantly greater in the treatment compared with the control group (P = .02). Over the course of follow-up, 43 participants developed subclinical or clinical EDs. While there was no overall significant difference in onset of EDs between the intervention and control groups, the intervention significantly reduced the onset of EDs in 2 subgroups identified through moderator analyses: (1) participants with an elevated body mass index (BMI) (> or =25, calculated as weight in kilograms divided by height in meters squared) at baseline and (2) at 1 site, participants with baseline compensatory behaviors (eg, self-induced vomiting, laxative use, diuretic use, diet pill use, driven exercise). No intervention participant with an elevated baseline BMI developed an ED, while the rates of onset of ED in the comparable BMI control group (based on survival analysis) were 4.7% at 1 year and 11.9% at 2 years. In the subgroup with a BMI of 25 or higher, the cumulative survival incidence was significantly lower at 2 years for the intervention compared with the control group (95% confidence interval, 0% for intervention group; 2.7% to 21.1% for control group). For the San Francisco Bay Area site sample with baseline compensatory behaviors, 4% of participants in the intervention group developed EDs at 1 year and 14.4%, by 2 years. Rates for the comparable control group were 16% and 30.4%, respectively.Among college-age women with high weight and shape concerns, an 8-week, Internet-based cognitive-behavioral intervention can significantly reduce weight and shape concerns for up to 2 years and decrease risk for the onset of EDs, at least in some high-risk groups. To our knowledge, this is the first study to show that EDs can be prevented in high-risk groups.

    View details for Web of Science ID 000239573200006

    View details for PubMedID 16894064

  • The adverse effect of negative comments about weight and shape from family and siblings on women at high risk for eating disorders PEDIATRICS Taylor, C. B., Bryson, S., Doyle, A. A., Luce, K. H., Cunning, D., Abascal, L. B., Rockwell, R., Field, A. E., Striegel-Moore, R., Winzelberg, A. J., Wilfley, D. E. 2006; 118 (2): 731-738


    Our purpose with this work was to examine the relationship between negative comments about weight, shape, and eating and social adjustment, social support, self-esteem, and perceived childhood abuse and neglect.A retrospective study was conducted with 455 college women with high weight and shape concerns, who participated in an Internet-based eating disorder prevention program. Baseline assessments included: perceived family negative comments about weight, shape, and eating; social adjustment; social support; self-esteem; and childhood abuse and neglect. Participants identified 1 of 7 figures representing their maximum body size before age 18 and parental maximum body size.More than 80% of the sample reported some parental or sibling negative comments about their weight and shape or eating. Parental and sibling negative comments were positively associated with maximum childhood body size, larger reported paternal body size, and minority status. On subscales of emotional abuse and neglect, most participants scored above the median, and nearly one third scored above the 90th percentile. In a multivariate analysis, greater parental negative comments were directly related to higher reported emotional abuse and neglect. Maximum body size was also related to emotional neglect. Parental negative comments were associated with lower reported social support by family and lower self-esteem.In college women with high weight and shape concerns, retrospective reports of negative comments about weight, shape, and eating were associated with higher scores on subscales of emotional abuse and neglect. This study provides additional evidence that family criticism results in long-lasting, negative effects.

    View details for DOI 10.1542/peds.2005-1806

    View details for Web of Science ID 000239440600038

    View details for PubMedID 16882830

  • Application of an algorithm-driven protocol to simultaneously provide universal and targeted prevention programs INTERNATIONAL JOURNAL OF EATING DISORDERS Luce, K. H., Osborne, M. I., Winzelberg, A. J., Das, S., Abascal, L. B., Celio, A. A., Wilfley, D. E., Stevenson, D., Dev, P., Taylor, C. B. 2005; 37 (3): 220-226


    Our objective was to develop a model to simultaneously prevent eating disorders and weight gain among female high school students.Of 188 female 10th graders enrolled in health classes, 174 elected to participate in the current study. They were assessed on-line and decided to participate in one of four interventions appropriate to their risk.The algorithm identified 111 no-risk (NR), 36 eating disorder risk (EDR), 16 overweight risk (OR), and 5 both risks. Fifty-six percent of the EDR and 50% of the OR groups elected to receive the recommended targeted curricula. Significant improvements in weight and shape concerns were observed in all groups.An Internet-delivered program can be used to assess risk and provide simultaneous universal and targeted interventions in classroom settings.

    View details for DOI 10.1002/eat.20089

    View details for Web of Science ID 000228875900005

    View details for PubMedID 15822091

  • Internet-delivered psychological interventions for body image dissatisfaction and disordered eating PSYCHOTHERAPY Luce, K. H., Winzelberg, A. J., Zabinski, M. F., Osborne, M. I. 2003; 40 (1-2): 148-154
  • Computer- and Internet-based psychotherapy interventions CURRENT DIRECTIONS IN PSYCHOLOGICAL SCIENCE Taylor, C. B., Luce, K. H. 2003; 12 (1): 18-22

Stanford Medicine Resources: