Weight Suppression: Predicting Lasting Bulimic Behavior

A factor that can predict
long-term weight changes.

Reprinted from Eating Disorders Review
November/December 2010 Volume 21, Number 6
©2010 Gürze Books

Two recent studies have taken a long-term look at the effects of weight suppression on the maintenance and onset of bulimic syndromes.

Weight suppression helps predict changes in weight among inpatients with bulimia nervosa (BN) for as long as 5 years, according to results of a study by Dr. David Herzog and colleagues at Massachusetts General Hospital, Boston (Psychiatry Res 2010; 177:330).

Earlier short-term studies among patients with BN suggested that weight suppression itself could be used to predict weight changes. In the recent study, 97 women with DSM-IV BN participated in a longitudinal follow-up study. At intake, height and weight were measured and the highest past weight was assessed. Self-reported weights were collected every 6 months for 5 years. Then, multilevel analysis estimated growth curve for weight change over time.

Significant inter-person variability was detected for intercepts and slopes (P< 0.001); thus, greater weight suppression predicted more rapid weight gain. Weight change was not associated with weight at the beginning of treatment, or height, or highest-ever weight, suggesting that weight suppression per se predicted weight gain over 5 years.

The authors note that these findings have important implications for treatment planning because weight gain could spur radical dieting that maintains BN.

A 10-year study

Drs. Pauline K. Keel and T. F. Heatherton at Florida State University, Tallahassee, found the same pattern in a study that followed patients with BN for 10 years (J Abnorm Psychol 2010; 119:268). The researchers wanted to know if the degree of weight suppression would predict bulimic syndrome maintenance and onset in a group of college–aged men (369) and women (968) 10 years later. Among those who had a bulimic syndrome at baseline, greater weight suppression predicted onset of a bulimic syndrome at 10-year follow-up. Drs. Keel and Heatherton suggest that future research address mechanisms that could account for the effects of weight suppression over a long period of follow-up.

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