Overvaluation of shape and weight in binge eating disorder and overweight controls: Refinement of a diagnostic construct.

Abstract

Debate continues regarding the nosological status of binge eating disorder (BED) as a diagnosis as opposed to simply reflecting a useful marker for psychopathology. Contention also exists regarding the specific criteria for the BED diagnosis, including whether, like anorexia nervosa and bulimia nervosa, it should be characterized by overvaluation of shape/weight. The authors compared features of eating disorders, psychological distress, and weight among overweight BED participants who overvalue their shape/weight (n = 92), BED participants with subclinical levels of overvaluation (n = 73), and participants in an overweight comparison group without BED (n = 45). BED participants categorized with clinical overvaluation reported greater eating-related psychopathology and depression levels than those with subclinical overvaluation. Both BED groups reported greater overall eating pathology and depression levels than the overweight comparison group. Group differences existed despite similar levels of overweight across the 3 groups, as well as when controlling for group differences in depression levels. These findings provide further support for the research diagnostic construct and make a case for the importance of shape/weight overvaluation as a diagnostic specifier. Keywordsovervaluation; binge eating disorder; obesity; body image; diagnosis Binge eating disorder (BED), a research category in the Diagnostic and Statistical Manual of Mental Disorders (4th ed.; DSM-IV; American Psychiatric Association, 1994), is characterized by recurrent binge eating without extreme compensatory weight-control behaviors. The BED research diagnosis is more common than the two formal eating disorder et al., 2006) that is associated with heightened psychiatric comorbidity, psychosocial impairment, and medical problems (Hudson et al., 2007) and is a distinct familial phenotype in obese persons (Hudson et al., 2006).As we move toward the development of the DSM-V (Brown & Barlow, 2005), a pressing question regarding the BED research diagnosis is whether revisions or additions to its criteria would improve the construct (Masheb & Grilo, 2000. Included in the DSM-IV criteria for AN and BN, but not for BED, is the presence of overvaluation of shape and weight, or the "undue influence of body weight or shape on self-evaluation" (American Psychiatric Association, 1994, p. 545). Although patients with BED appear to have similar levels of overvaluation of shape and weight as those with BN and AN (Wilfley, Schwartz, Spurrell, & Fairburn, 2000), little empirical attention has been given to the potential utility of such a body-image related cognitive criterion or specifier for this research diagnostic construct.Two recent studies have specifically examined the significance of shape/weight overvaluation in BED. Hrabosky, Masheb, White, and Grilo (2007) assessed 399 patients with BED using the investigator-based Eating Disorder Examination (EDE; Fairburn & Cooper, 1993) and found that overvaluation significantly predicted degree of eating-...

Relations of dietary restraint and depressive symptomatology to loss of control over eating in overweight youngsters

“…, but in line with recent research in adults [34,35], depressive symptoms were also significantly correlated with the over-evaluation of eating, weight and shape.…”

“…In line with recent studies among adult samples of patients with binge eating disorder [34,35], this finding indicates that being over-concerned is not simply a characteristic of overweight individuals, but is also indicative of more severe ED pathology thereby emphasizing the importance of assessing the occurrence of this 'core pathology' among overweight youth.…”

“…These results provide preliminary support for the importance of this over-evaluating system among overweight youth and indicate that, in line with adult research [34,35], being over-concerned about ones eating, weight and shape may not simply reflect concerns commensurate with being overweight but seems to be an important clinical variable associated with both eating pathology and depression. Nevertheless among overweight youngsters, the questions still remains whether this over-evaluating system is related to LC through the restriction of one's food intake, as it was proposed by the…”

Uma revisão dos estudos latino-americanos sobre o transtorno da compulsão alimentar periódica

“…1 The other system is the Diagnostic and Statistical [51][52][53] Three studies comparing samples with and without BED 22,26,54 and one comparing full and partial BED, BN, and healthy volunteers 17 showed an important association between BED and psychiatric comorbidities, especially mood and anxiety disorders.…”

Guided Self-Help Treatment for Recurrent Binge Eating: Replication and Extension

“…The latter interventions are well suited for use in everyday practice settings (16,17). Nevertheless, only a minority of individuals who might benefit from such interventions receive them (18,19) or any other mental health treatments specifically targeting eating disorders (13,20–22). In a previous trial (23) we investigated the effectiveness of a brief CBT-GSH treatment for binge eating that augmented usual care.…”