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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

  • C. M. Grilo (a1), M. A. White (a1), R. Gueorguieva (a2), G. T. Wilson (a3) and R. M. Masheb (a1)...

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.

Copyright

Corresponding author

*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)

References

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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.
APA (1994). Diagnostic and Statistical Manual of Mental Disorders, 4th edn (DSM-IV). American Psychiatric Association: Washington, DC.
Beck, AT, Steer, R (1987). Manual for Revised Beck Depression Inventory. Psychological Corp.: San Antonio, TX.
Beck, AT, Steer, R, Garbin, M (1988). Psychometric properties of the Beck Depression Inventory: 25 years of evaluation. Clinical Psychology Review 8, 77100.
Brownell, KD (2000). The LEARN Program for Weight Management 2000. American Health Publishing Co.: Dallas.
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.
Fairburn, CG, Cooper, Z, Shafran, R (2003). Cognitive behaviour therapy for eating disorders: a “transdiagnostic” theory and treatment. Behaviour Research and Therapy 41, 509528.
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.
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.
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.
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.
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.
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.
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.
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.
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.
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.
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.
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.
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.
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.
Grilo, CM, Masheb, RM, Wilson, GT (2001 c). Subtyping binge eating disorder. Journal of Consulting and Clinical Psychology 69, 10661072.
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.
Grilo, CM, White, MA (2011). A controlled evaluation of the distress criterion for binge eating disorder. Journal of Consulting and Clinical Psychology 79, 509514.
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.
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.
Hrabosky, JI, Masheb, RM, White, MA, Grilo, CM (2007). Overvaluation of shape and weight in BED. Journal of Consulting and Clinical Psychology 75, 175180.
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.
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.
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.
Masheb, RM, Grilo, CM (2000). Binge eating disorder: a need for additional diagnostic criteria. Comprehensive Psychiatry 41, 159162.
Masheb, RM, Grilo, CM (2003). The nature of body image disturbance in patients with binge eating disorder. International Journal of Eating Disorder 33, 333341.
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.
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.
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.
Rosenberg, M (1965). Society and the Adolescent Self-Image. Princeton University: Princeton.
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.
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.
Wilson, GT, Sysko, R (2009). Frequency of binge eating episodes in bulimia nervosa and binge eating disorder. International Journal of Eating Disorders 42, 603610.
Wilson, GT, Grilo, CM, Vitousek, KM (2007). Psychological treatments of eating disorders. American Psychologist 72, 199216.
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Psychological Medicine
  • ISSN: 0033-2917
  • EISSN: 1469-8978
  • URL: /core/journals/psychological-medicine
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