BED and Obesity Lessen Quality of Life

Binge eating disorder, or BED, is marked by recurrent episodes of binge eating without the extreme measures of bulimia nervosa, such as purging, to prevent weight gain. Thus, it isn’t surprising that obesity is much more common among persons with BED (65%) than among those with bulimia nervosa (33.5%).

Elizabeth Rieger, PhD, and colleagues found that obese individuals with BED had greater impairment in work, public distress, sexual life, and self-esteem than obese persons without a diagnosis of BED. Thus, they had an overall poorer quality of life (Int J Eat Disord 2005; 37:234).

Defining ‘quality of life’

As the authors point out, quality of life refers to an individual’s overall satisfaction with life. It includes a broad range of elements, including the person’s physical, emotional, social, sexual, and occupational functioning.

Two samples of obese individuals seeking treatment were recruited for the study. Those with BED consisted of individuals from San Diego and Minneapolis who were enrolled in a multisite, randomized, controlled treatment trial assessing the effectiveness of a weight loss medication in the treatment of BED. The non-BED sample included adults from San Diego who were taking part in a randomized, controlled treatment trial intervention testing the effectiveness of various psychological interventions for maintenance of weight loss in children and their parents. In both groups participants had to have a body mass index of at least 30 kg/m2.

The two groups were given various questionnaires, including the Eating Disorder Examination (EDE, 12th Ed.), the Eating Disorder Examination-Questionnaire, the Primary Care Evaluation of Mental Disorders, and the Impact of Weight on the Quality of Life Questionnaire (IWQOL). The IWQOL-Lite is a shorter version of the IWQOL that includes a 31-item, self-report questionnaire that assesses the effect of being overweight on five domains of quality of life, including work, public distress, sexual life, physical function , and self-esteem. For example, it includes choices such as “Because of my weight I don’t get appropriate raises, promotion or recognition at work.”

Results

As the authors had suspected, obese persons with BED had greater impairment in the psychosocial domains of work, public distress, sexual life, and self-esteem. Because the BED and non-BED groups were comparable in terms of BMI, the poorer psychosocial functioning of persons with BED cannot be attributed to elevated obesity among the BED participants. Thus, although research consistently shows that obesity is associated with losses in physical functioning, the current results suggest that BED among obese individuals leads to even greater impairment in terms of decreased psychosocial functioning. Thus, for obese individuals with BED, their quality of life has pervasive deficiencies that affect both the physical and psychosocial functioning.

Some implications of the study

The authors feel their findings have several implications. The pervasive impairment in quality of life among obese persons with BED suggests that this factor should be routinely assessed in treatment outcome research on persons with BED. Finding that BED is associated with losses in quality of life beyond those already resulting from obesity provides additional support for recognizing the severity and distinctiveness of the disorder, according to the authors.