Traditional versus developmental measures of weight suppression: Exploring their relationships with bulimic psychopathology

2021 ◽  
Author(s):  
Michael R Lowe ◽  
Simar Singh ◽  
Danielle Apple ◽  
Laurel Mayer ◽  
Michael Rosenbaum ◽  
...  

Objective: Weight suppression (WS) is related to a wide variety of eating disorder characteristics. However, individuals with eating disorders usually reach their highest premorbid weight while still developing physically. Therefore, a more sensitive index of individual differences in highest premorbid weight may be one that compares highest premorbid z-BMI to current z-BMI (called developmental weight suppression (DWS) here). Method: We compared the relationships between traditional weight suppression (TWS) and DWS and a wide variety of measures related to bulimic psychopathology in 91 females (M age, 25.2; 60.5% White), with clinical or sub-clinical bulimia nervosa. Results: TWS and DWS were correlated (r = .40). TWS was significantly related to only one of 23 outcome variables whereas DWS showed significant or near-significant relationships to 14 outcomes. DWS showed consistent positive relations with behavioral outcomes (e.g., binge eating) but consistent negative relations with cognitive/affective outcomes (e.g., weight concerns). Conclusions: Findings indicated a much more consistent relationship between the novel DWS measure and bulimic characteristics than with the traditional weight suppression measure. DWS showed both positive and negative relations with bulimic symptoms, though these findings require replication to confirm their validity. Consistent evidence indicated that the two WS measures served as mutual suppressor variables.

2020 ◽  
Vol 112 (4) ◽  
pp. 941-947 ◽  
Author(s):  
Eric Stice ◽  
Paul Rohde ◽  
Heather Shaw ◽  
Chris Desjardins

ABSTRACT Background Eating disorders affect 13% of females and contribute to functional impairment and mortality, but few studies have identified risk factors that prospectively correlate with future onset of anorexia nervosa (AN), bulimia nervosa (BN), binge eating disorder (BED), and purging disorder (PD). Identifying risk factors specific to each eating disorder is critical for advancing etiologic knowledge and designing effective prevention programs. Objectives This study examined whether weight suppression (the difference between a person's highest past weight at their adult height and their current weight) correlates with future onset of AN, BN, BED, and PD. Methods Data from 1165 young women with body image concerns (mean ± SD age: 21.9 ± 6.4 y) who completed annual diagnostic interviews over a 3-y follow-up period were examined. Logistic regression models evaluated the relation of baseline weight suppression to onset risk of each eating disorder controlling for age, dietary restraint, and intervention condition. Results Elevated weight suppression predicted future onset of AN (OR: 1.36; 95% CI: 1.03, 1.80), BN (OR: 1.34; 95% CI: 1.11, 1.62), PD (OR: 1.46; 95% CI: 1.23, 1.74), and any eating disorder (OR: 1.32; 95% CI: 1.12, 1.56), but not BED (OR: 1.10; 95% CI: 0.89, 1.37). Highest past weight correlated with future onset of BN and PD but not onset of AN, BED, or any eating disorder, and baseline current weight was inversely related to future AN onset only, implying that women with the largest difference between their highest past weight and current weight are at greatest risk of eating disorders. Conclusions The results provide novel evidence that weight suppression correlates with future onset of eating disorders characterized by dietary restriction or compensatory weight control behaviors and suggest weight-suppressed women constitute an important risk group to target with selective prevention programs. These trials were registered at clinicaltrials.gov as NCT01126918 and NCT01949649.


2021 ◽  
Vol 10 (17) ◽  
pp. 3976
Author(s):  
Mia Beck Lichtenstein ◽  
Lauge Haastrup ◽  
Karen Krogh Johansen ◽  
Jacob B. Bindzus ◽  
Pia Veldt Larsen ◽  
...  

The Eating Disorder Examination Questionnaire (EDE-Q) is a gold standard questionnaire to identify eating disorder symptoms but has not yet been validated in Danish. The scale consists of four theoretical constructs of disordered eating: Restraint eating, Eating concerns, Shape concerns and Weight concerns. However, the four-factor structure has been difficult to replicate across cultures. This study aimed to examine the factor structure and psychometric properties of the EDE-Q in Danish. The study consisted of four samples (aged 15–70): Patients with anorexia, bulimia and unspecified eating disorders (n = 101), patients with symptoms of binge-eating disorder (n = 300), recreational athletes (n = 404), and elite athletes (n = 526). Depending on the analysis performed, participants had to complete the EDE-Q, the SCOFF questionnaire for eating disorders or the Binge Eating Disorders Questionnaire. In accordance with international research, we found no evidence for a four-factor structure in the EDE-Q among patients or among athletes. But our results showed significant, positive associations between EDE-Q and SCOFF, BED-Q and MDI in all samples. We conclude that the internal structure of EDE-Q is low, while construct validity is high, making EDE-Q useful as an instrument to identify individuals with eating disorder symptoms, including recreational, and elite athletes.


2021 ◽  
Vol 9 (1) ◽  
Author(s):  
Jocelyn Lebow ◽  
Angela Mattke ◽  
Cassandra Narr ◽  
Paige Partain ◽  
Renee Breland ◽  
...  

Abstract Background Family-Based Treatment (FBT) is considered the first-line intervention for adolescent anorexia nervosa. However, access to this treatment is limited. Treatment programs for other pediatric mental health conditions have successfully overcome barriers to accessing evidence-based intervention by integrating mental health services into primary care. This study evaluated the proof-of-concept of a novel modification of FBT, Family-Based Treatment for Primary Care (FBT-PC) for adolescent restrictive eating disorders designed for delivery by primary care providers in their practices. Methods This retrospective clinical cohort study evaluated 15 adolescents with restrictive eating disorders receiving FBT-PC and 15 adolescents receiving standard FBT. We examined improvement in BMI percentile, reduction in weight suppression, and clinical benchmarks of eating disorder recovery including weight restoration to > 95% of expected body weight (EBW) and resolution of DSM-5 criteria for eating disorders. Results In both groups, effect sizes for increased BMI percentile exceeded Cohen’s convention for a large effect (FBT-PC: d = .94; standard FBT: d = 1.15) as did effect sizes for reduction in weight suppression (FBT-PC: d = 1.83; standard FBT: d = 1.21). At the end of treatment, 80% of the FBT-PC cohort and 87% in the standard FBT group achieved > 95%EBW and 67% in the FBT-PC group and 60% in the standard FBT group no longer met DSM-5 criteria for an eating disorder. There were no cohort differences in the number of treatment drop-outs or referrals to a more intensive level of eating disorder treatment. Conclusions Findings suggest that primary care providers have potential to improve weight and clinical status in adolescents with restrictive eating disorders. Based on these results, more rigorous testing of the FBT-PC model is warranted.


Assessment ◽  
2021 ◽  
pp. 107319112110208
Author(s):  
Martin Sellbom ◽  
Kelsie T. Forbush ◽  
Sara R. Gould ◽  
Kristian E. Markon ◽  
David Watson ◽  
...  

We report on Phase 1 efforts of the Hierarchical Taxonomy of Psychopathology (HiTOP) measurement subgroup tasked with developing provisional scales for the somatoform spectrum and eating disorders. In Study 1, items were written to assess five somatoform spectrum constructs (bodily distress symptoms, conversion symptoms, health anxiety, disease conviction, and somatic preoccupation). Scale development analyses were conducted on 550 university students. The conversion symptom items were too infrequently endorsed and were set aside for Phase 2. Analyses of the other items yielded four scales corresponding closely to their hypothesized structure. In Study 2, we delineated 15 specific feeding and eating disorder constructs. A sample of 400 university students were administered candidate items and several eating disorder questionnaires for criterion validity. Analyses yielded six scales capturing previously described constructs, tapping content related to body image and weight concerns, restricting and purging, cognitive restraint, binging, excessive exercise, and muscle building. Two scales representing additional constructs deemed to be of high clinical import—negative attitude towards obesity and avoidant/restrictive food intake disorder—were retained for Phase 2, for a total of eight scales. Overall, we concluded that Phase 1 had been successful at generating a comprehensive set of provisional scales for inclusion in Phase 2.


2015 ◽  
Vol 45 (14) ◽  
pp. 2951-2958 ◽  
Author(s):  
N. Tabri ◽  
H. B. Murray ◽  
J. J. Thomas ◽  
D. L. Franko ◽  
D. B. Herzog ◽  
...  

Background.Overvaluation of body shape/weight is thought to be the core psychopathology underlying eating disorders, which propels engagement in non-compensatory weight-control behaviors. In turn, these behaviors lead to binge eating and/or maintenance of low weight thereby reinforcing overvaluation. The present study investigated the reciprocal relationship between overvaluation and engagement in non-compensatory weight-control behaviors (defined in two ways: restrictive eating and compulsive exercise) among women diagnosed with anorexia nervosa or bulimia nervosa (N = 237).Method.Participants completed clinical interviews in which weekly eating disorder symptoms and behaviors were assessed over 2 years.Results.Overvaluation on a given week was associated with greater engagement in non-compensatory weight-control behaviors during the following week. Further, engagement in non-compensatory weight-control behaviors on a given week was associated with greater overvaluation during the following week. These findings held true regardless of participants’ shape/weight concerns (feelings of fatness and fat phobia), and eating disorder diagnosis.Conclusions.Our data provide empirical support for key aspects of the transdiagnostic cognitive-behavioral model of eating disorders and suggest that targeting non-compensatory weight-control behaviors in treatment may help alleviate overvaluation and shape/weight concerns.


2012 ◽  
Vol 28 (1) ◽  
pp. 25-31 ◽  
Author(s):  
Paula Elosua ◽  
Alicia López-Jáuregui

In this study the Eating Disorder Inventory-3 was adapted to Spanish and analyzed the internal psychometric properties of the test in a clinical sample of females with eating disorders. The results showed a high internal consistency of the scores as well as high temporal stability. The factor structure of the scale composites was analyzed using confirmatory factor analysis. The results supported the existence of a second-order structure beyond the psychological composites. The second-order factor showed high correlation with the factor related to eating disorders. Overall, the Spanish version of the EDI-3 showed good psychometric qualities in terms of internal consistency, temporal stability and internal structure.


Author(s):  
Susan McElroy ◽  
Anna I. Guerdjikova ◽  
Nicole Mori ◽  
Paul E. Keck

This chapter addresses the pharmacotherapy of the eating disorders (EDs). Many persons with EDs receive pharmacotherapy, but pharmacotherapy research for EDs has lagged behind that for other major mental disorders. This chapter first provides a brief rationale for using medications in the treatment of EDs. It then reviews the data supporting the effectiveness of specific medications or medication classes in treating patients with anorexia nervosa (AN), bulimia nervosa (BN), binge eating disorder (BED), and other potentially important EDs, such as night eating syndrome (NES). It concludes by summarizing these data and suggesting future areas for research in the pharmacotherapy of EDs.


Author(s):  
Pamela Keel

The epidemiology of eating disorders holds important clues for understanding factors that may contribute to their etiology. In addition, epidemiological findings speak to the public health significance of these deleterious syndromes. Information on course and outcome are important for clinicians to understand the prognosis associated with different disorders of eating and for treatment planning. This chapter reviews information on the epidemiology and course of anorexia nervosa, bulimia nervosa, and two forms of eating disorder not otherwise specified, binge eating disorder and purging disorder.


Author(s):  
Kathryn H. Gordon ◽  
Jill M. Holm-Denoma ◽  
Ross D. Crosby ◽  
Stephen A. Wonderlich

The purpose of the chapter is to elucidate the key issues regarding the classification of eating disorders. To this end, a review of nosological research in the area of eating disorders is presented, with a particular focus on empirically based techniques such as taxometric and latent class analysis. This is followed by a section outlining areas of overlap between the current Diagnostic and Statistical Manual of Mental Disorders – Fourth Edition, Text Revision (DSM-IV-TR; American Psychiatric Association, 2000) eating disorder categories and their symptoms. Next, eating disorder classification models that are alternatives to the DSM-IV-TR are described and critically examined in light of available empirical data. Finally, areas of controversy and considerations for change in next version of the DSM (i.e., the applicability of DSM criteria to minority groups, children, males; the question of whether clinical categories should be differentiated from research categories) are discussed.


Author(s):  
Susan L. McElroy ◽  
Anna I. Guerdjikova ◽  
Anne M. O’Melia ◽  
Nicole Mori ◽  
Paul E. Keck

Many persons with eating disorders (EDs) receive pharmacotherapy, but pharmacotherapy research for EDs has lagged behind that for other major mental disorders. In this chapter, we first provide a brief rationale for using medications in the treatment of EDs. We then review the data supporting the effectiveness of specific medications or medication classes in treating patients with anorexia nervosa (AN), bulimia nervosa, binge eating disorder (BED), and other potentially important EDs, such as night eating syndrome (NES) and sleep-related eating disorder (SRED). We conclude by summarizing these data and suggesting future areas for research in the pharmacotherapy of EDs.


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