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Overvaluation of body shape/weight and engagement in non-compensatory weight-control behaviors in eating disorders: is there a reciprocal relationship?

Published online by Cambridge University Press:  21 May 2015

N. Tabri
Affiliation:
Department of Psychiatry, Massachusetts General Hospital Eating Disorders Clinical and Research Program, Boston, MA, USA Department of Psychiatry, Harvard Medical School, Boston, MA, USA
H. B. Murray
Affiliation:
Department of Psychiatry, Massachusetts General Hospital Eating Disorders Clinical and Research Program, Boston, MA, USA
J. J. Thomas
Affiliation:
Department of Psychiatry, Massachusetts General Hospital Eating Disorders Clinical and Research Program, Boston, MA, USA Department of Psychiatry, Harvard Medical School, Boston, MA, USA
D. L. Franko
Affiliation:
Department of Psychiatry, Massachusetts General Hospital Eating Disorders Clinical and Research Program, Boston, MA, USA Northeastern University, Boston, MA, USA
D. B. Herzog
Affiliation:
Department of Psychiatry, Harvard Medical School, Boston, MA, USA
K. T. Eddy*
Affiliation:
Department of Psychiatry, Massachusetts General Hospital Eating Disorders Clinical and Research Program, Boston, MA, USA Department of Psychiatry, Harvard Medical School, Boston, MA, USA
*
*Address for correspondence: Dr K. T. Eddy, Eating Disorders Clinical and Research Program, Department of Psychiatry, Massachusetts General Hospital and Harvard Medical School, 2 Longfellow Place, suite 200, Boston, MA 02114, USA. (Email: keddy@mgh.harvard.edu)

Abstract

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.

Type
Original Articles
Copyright
Copyright © Cambridge University Press 2015 

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