Skip to main content Accessibility help
×
Home
Hostname: page-component-55597f9d44-mzfmx Total loading time: 0.469 Render date: 2022-08-19T08:00:53.150Z Has data issue: true Feature Flags: { "shouldUseShareProductTool": true, "shouldUseHypothesis": true, "isUnsiloEnabled": true, "useRatesEcommerce": false, "useNewApi": true } hasContentIssue true

Predictive significance of the overvaluation of shape/weight in obese patients with binge eating disorder: findings from a randomized controlled trial with 12-month follow-up

Published online by Cambridge University Press:  12 September 2012

C. M. Grilo*
Affiliation:
Department of Psychiatry, Yale University School of Medicine, New Haven, CT, USA
M. A. White
Affiliation:
Department of Psychiatry, Yale University School of Medicine, New Haven, CT, USA
R. Gueorguieva
Affiliation:
Division of Biostatistics, Yale School of Public Health, Yale University, New Haven, CT, USA
G. T. Wilson
Affiliation:
Graduate School of Applied and Professional Psychology, Rutgers – The State University of New Jersey, Piscataway, NJ, USA
R. M. Masheb
Affiliation:
Department of Psychiatry, Yale University School of Medicine, New Haven, CT, USA
*
*Address for correspondence: C. M. Grilo, Ph.D., Yale School of Medicine, 301 Cedar Street (2nd Floor), New Haven, CT 06519, USA. (Email: carlos.grilo@yale.edu)

Abstract

Background

Undue influence of body shape or weight on self-evaluation – referred to as overvaluation – is considered a core feature across eating disorders, but is not a diagnostic requirement for binge eating disorder (BED). This study examined the concurrent and predictive significance of overvaluation of shape/weight in obese patients with BED participating in a randomized clinical trial testing cognitive behavioral therapy (CBT) and behavioral weight loss (BWL).

Method

A total of 90 participants were randomly assigned to 6-month group treatments of CBT or BWL. Assessments were performed at baseline, throughout- and post-treatment, and at 6- and 12-month follow-ups after completing treatments with reliably administered semi-structured interviews and established measures.

Results

Participants categorized with overvaluation (n = 52, 58%) versus without overvaluation (n = 38, 42%) did not differ significantly in demographic features (age, gender and ethnicity), psychiatric co-morbidity, body mass index or binge eating frequency. The overvaluation group had significantly greater levels of eating disorder psychopathology and poorer psychological functioning (higher depression and lower self-esteem) than the non-overvaluation group. Overvaluation of shape/weight significantly predicted non-remission from binge eating and higher frequency of binge eating at the 12-month follow-up, even after adjusting for group differences in depression and self-esteem levels.

Conclusions

Our findings suggest that overvaluation does not simply reflect concern commensurate with being obese or more frequent binge eating, but also is strongly associated with heightened eating-related psychopathology and psychological distress, and has negative prognostic significance for longer-term treatment outcomes. Overvaluation of shape/weight warrants consideration as a diagnostic specifier for BED as it provides important information about severity and treatment outcome.

Type
Original Articles
Copyright
Copyright © Cambridge University Press 2012 

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Allison, KC, Grilo, CM, Masheb, RM, Stunkard, AJ (2005). Binge eating disorder and night eating syndrome: a comparative study of disordered eating. Journal of Consulting and Clinical Psychology 73, 11071115.CrossRefGoogle ScholarPubMed
APA (1994). Diagnostic and Statistical Manual of Mental Disorders, 4th edn (DSM-IV). American Psychiatric Association: Washington, DC.Google Scholar
Beck, AT, Steer, R (1987). Manual for Revised Beck Depression Inventory. Psychological Corp.: San Antonio, TX.Google Scholar
Beck, AT, Steer, R, Garbin, M (1988). Psychometric properties of the Beck Depression Inventory: 25 years of evaluation. Clinical Psychology Review 8, 77100.CrossRefGoogle Scholar
Brownell, KD (2000). The LEARN Program for Weight Management 2000. American Health Publishing Co.: Dallas.Google Scholar
Fairburn, CG, Cooper, Z (1993). The Eating Disorder Examination (12th edition). In Binge Eating: Nature, Assessment, and Treatment (ed. Fairburn, C. G. and Wilson, G. T.), pp. 317360. Guilford Press: New York.Google Scholar
Fairburn, CG, Cooper, Z, Shafran, R (2003). Cognitive behaviour therapy for eating disorders: a “transdiagnostic” theory and treatment. Behaviour Research and Therapy 41, 509528.CrossRefGoogle ScholarPubMed
Fairburn, CG, Marcus, MD, Wilson, GT (1993 a). Cognitive–behavioral therapy for binge eating and bulimia nervosa: a comprehensive treatment manual. In Binge Eating: Nature, Assessment, and Treatment (ed. Fairburn, C. G. and Wilson, G. T.), pp. 361404. New York: Guilford Press.Google Scholar
Fairburn, CG, Peveler, RC, Jones, R, Hope, RA, Doll, HA (1993 b). Predictors of 12-month outcome in bulimia nervosa and the influence of attitudes to shape and weight. Journal of Consulting and Clinical Psychology 61, 696698.CrossRefGoogle Scholar
First, MB, Spitzer, RL, Gibbon, M, Williams, JBW (1996). Structured Clinical Interview for DSM-IV Axis I Disorders – Patient Edition (SCID-I/P,Version 2.0). New York State Psychiatric Institute: New York.Google Scholar
Foster, GD, Wyatt, HR, Hill, JO, McGuckin, BG, Brill, C, Mohammed, BS, Szapary, PO, Rader, DJ, Edman, JS, Klein, S (2003). A randomized trial of a low-carbohydrate diet for obesity. New England Journal of Medicine 348, 20822090.CrossRefGoogle ScholarPubMed
Goldschmidt, AB, Hilbert, A, Manwaring, JL, Wilfley, DE, Pike, KM, Fairburn, CG, Dohm, FA, Striegel-Moore, RH (2010). The significance of overvaluation of shape and weight in binge eating disorder. Behaviour Research and Therapy 48, 187193.CrossRefGoogle ScholarPubMed
Griffith, RA, Beumont, EG, Russell, J, Schotte, D, Thornton, C, Touyz, SW, Varano, P (1999). Measuring self-esteem in dieting disordered patients: the validity of the Rosenberg and Coopersmith contrasted. Eating Disorders 25, 227231.Google Scholar
Grilo, CM, Crosby, RD, Masheb, RM, White, MA, Peterson, CB, Wonderlich, SA, Engel, SG, Crow, SJ, Mitchell, JE (2009). Overvaluation of shape and weight in binge eating disorder, bulimia nervosa, and sub-threshold bulimia nervosa. Behaviour Research and Therapy 47, 692696.CrossRefGoogle ScholarPubMed
Grilo, CM, Crosby, RD, Peterson, CB, Masheb, RM, White, MA, Crow, SJ, Wonderlich, S, Mitchell, JE (2010 a). Factor structure of the eating disorder examination interview in patients with binge-eating disorder. Obesity 18, 977981.CrossRefGoogle ScholarPubMed
Grilo, CM, Hrabosky, JI, White, MA, Allison, KC, Stunkard, AJ, Masheb, RM (2008). Overvaluation of shape and weight in binge eating disorder and overweight controls: refinement of a diagnostic construct. Journal of Abnormal Psychology 117, 414419.CrossRefGoogle ScholarPubMed
Grilo, CM, Masheb, RM, Crosby, RD (in press). Predictors and moderators of response to cognitive behavioral therapy and medication for the treatment of binge eating disorder. Journal of Consulting and Clinical Psychology.Google Scholar
Grilo, CM, Masheb, RM, Lozano-Blanco, C, Barry, DT (2004). Reliability of the Eating Disorder Examination in patients with binge eating disorder. International Journal of Eating Disorders 35, 8085.CrossRefGoogle ScholarPubMed
Grilo, CM, Masheb, RM, White, MA (2010 b). Significance of overvaluation of shape and weight in binge-eating disorder: comparative study with overweight and bulimia nervosa. Obesity 18, 499504.CrossRefGoogle ScholarPubMed
Grilo, CM, Masheb, RM, Wilson, GT (2001 a). A comparison of different methods for assessing the features of eating disorders in patients with binge eating disorder. Journal of Consulting and Clinical Psychology 69, 317322.CrossRefGoogle ScholarPubMed
Grilo, CM, Masheb, RM, Wilson, GT (2001 b). Different methods for assessing the features of eating disorders in patients with binge eating disorder. Obesity Research 9, 418422.CrossRefGoogle ScholarPubMed
Grilo, CM, Masheb, RM, Wilson, GT (2001 c). Subtyping binge eating disorder. Journal of Consulting and Clinical Psychology 69, 10661072.CrossRefGoogle ScholarPubMed
Grilo, CM, Masheb, RM, Wilson, GT, Gueorguieva, R, White, MA (2011). Cognitive–behavioral therapy, behavioral weight loss, and sequential treatment for obese patients with binge eating disorder: a randomized controlled trial. Journal of Consulting and Clinical Psychology 79, 317322.CrossRefGoogle ScholarPubMed
Grilo, CM, White, MA (2011). A controlled evaluation of the distress criterion for binge eating disorder. Journal of Consulting and Clinical Psychology 79, 509514.CrossRefGoogle ScholarPubMed
Grilo, CM, White, MA, Masheb, RM (2012). Significance of overvaluation of shape and weight in an ethnically diverse sample of obese patients with binge eating disorder in primary care settings. Behaviour Research and Therapy 50, 298303.CrossRefGoogle Scholar
Hilbert, A, Saelens, B, Stein, R, Mockus, D, Welch, R, Matt, G, Wilfley, DE (2007). Pretreatment and process predictors of outcome in interpersonal and cognitive behavioral psychotherapy for binge eating disorder. Journal of Consulting and Clinical Psychology 75, 645651.CrossRefGoogle ScholarPubMed
Hrabosky, JI, Masheb, RM, White, MA, Grilo, CM (2007). Overvaluation of shape and weight in BED. Journal of Consulting and Clinical Psychology 75, 175180.CrossRefGoogle Scholar
Hrabosky, JI, White, MA, Masheb, RM, Rothschild, BS, Burke-Martindale, CH, Grilo, CM (2008). Psychometric evaluation of the Eating Disorder Examination-Questionnaire for bariatric surgery candidates. Obesity 16, 763769.CrossRefGoogle ScholarPubMed
Hudson, JI, Hiripi, E, Pope, HG, Kessler, RC (2007). The prevalence and correlates of eating disorders in the National Comorbidity Survey Replication. Biological Psychiatry 61, 348358.CrossRefGoogle ScholarPubMed
Keel, PK, Dorer, DJ, Franko, DL, Jackson, SC, Herzog, DB (2005). Postremission predictors of relapse in women with eating disorders. American Journal of Psychiatry 162, 22632268.CrossRefGoogle ScholarPubMed
Masheb, RM, Grilo, CM (2000). Binge eating disorder: a need for additional diagnostic criteria. Comprehensive Psychiatry 41, 159162.CrossRefGoogle ScholarPubMed
Masheb, RM, Grilo, CM (2003). The nature of body image disturbance in patients with binge eating disorder. International Journal of Eating Disorder 33, 333341.CrossRefGoogle ScholarPubMed
Masheb, RM, Grilo, CM (2008). Prognostic significance of two sub-categorization methods for binge eating disorder: negative affect and overvaluation predict, but do not moderate, specific outcomes. Behaviour Research and Therapy 46, 428437.CrossRefGoogle Scholar
Mond, JM, Hay, PJ, Rodgers, B, Owen, C (2007). Recurrent binge eating with and without the “undue influence of weight or shape on self-evaluation”: implications for the diagnosis of binge eating disorder. Behaviour Research and Therapy 45, 929938.CrossRefGoogle Scholar
National Institute for Clinical Excellence (2004). Eating Disorders – Core Interventions in the Treatment and Management of Anorexia Nervosa, Bulimia Nervosa and Related Eating Disorders. NICE: London.Google Scholar
Rosenberg, M (1965). Society and the Adolescent Self-Image. Princeton University: Princeton.CrossRefGoogle Scholar
Sysko, R, Hildebrandt, T, Wilson, GT, Wilfley, DE, Agras, WS (2010). Heterogeneity moderates treatment response among patients with binge eating disorder. Journal of Consulting and Clinical Psychology 78, 681690.CrossRefGoogle ScholarPubMed
Wade, TD, Zhu, G, Martin, NG (2011). Undue influence of weight and shape: is it distinct from body dissatisfaction and concern about weight and shape? Psychological Medicine 41, 819828.CrossRefGoogle ScholarPubMed
Wilson, GT, Sysko, R (2009). Frequency of binge eating episodes in bulimia nervosa and binge eating disorder. International Journal of Eating Disorders 42, 603610.CrossRefGoogle ScholarPubMed
Wilson, GT, Grilo, CM, Vitousek, KM (2007). Psychological treatments of eating disorders. American Psychologist 72, 199216.CrossRefGoogle Scholar
57
Cited by

Save article to Kindle

To save this article to your Kindle, first ensure coreplatform@cambridge.org is added to your Approved Personal Document E-mail List under your Personal Document Settings on the Manage Your Content and Devices page of your Amazon account. Then enter the ‘name’ part of your Kindle email address below. Find out more about saving to your Kindle.

Note you can select to save to either the @free.kindle.com or @kindle.com variations. ‘@free.kindle.com’ emails are free but can only be saved to your device when it is connected to wi-fi. ‘@kindle.com’ emails can be delivered even when you are not connected to wi-fi, but note that service fees apply.

Find out more about the Kindle Personal Document Service.

Predictive significance of the overvaluation of shape/weight in obese patients with binge eating disorder: findings from a randomized controlled trial with 12-month follow-up
Available formats
×

Save article to Dropbox

To save this article to your Dropbox account, please select one or more formats and confirm that you agree to abide by our usage policies. If this is the first time you used this feature, you will be asked to authorise Cambridge Core to connect with your Dropbox account. Find out more about saving content to Dropbox.

Predictive significance of the overvaluation of shape/weight in obese patients with binge eating disorder: findings from a randomized controlled trial with 12-month follow-up
Available formats
×

Save article to Google Drive

To save this article to your Google Drive account, please select one or more formats and confirm that you agree to abide by our usage policies. If this is the first time you used this feature, you will be asked to authorise Cambridge Core to connect with your Google Drive account. Find out more about saving content to Google Drive.

Predictive significance of the overvaluation of shape/weight in obese patients with binge eating disorder: findings from a randomized controlled trial with 12-month follow-up
Available formats
×
×

Reply to: Submit a response

Please enter your response.

Your details

Please enter a valid email address.

Conflicting interests

Do you have any conflicting interests? *