The relation of weight suppression and BMI to bulimic symptoms

Abstract

Objective High levels of weight suppression have been associated with greater binge eating and weight gain as well as poorer treatment outcome in bulimia nervosa. This study examined the relationship between weight suppression and bulimia nervosa symptoms and explored how weight suppression might interact with body mass index (BMI) in accounting for level of symptomatology at presentation for treatment. Method Participants were 64 women with threshold or sub-threshold bulimia nervosa. A clinical interview assessed binge eating and purging. Results Weight suppression and the interaction between BMI and weight suppression predicted frequency of binge eating such that participants with low BMI and high weight suppression engaged in the most binge eating. High levels of weight suppression also predicted more frequent purging. Discussion Additional research is warranted to examine mediators of these relationships.

Weight suppression as a predictor of weight gain and response to intensive behavioral treatment in patients with anorexia nervosa

“…First, we calculated indices of weight fluctuation that have been used in previous reports including participants’ highest and lowest self-reported BMIs at their current height (Butryn et al, 2011), and the difference between lowest weight (at current height) and current weight (Butryn et al, 2011; Butryn et al, 2006; Carter et al, 2008). We did not consider the difference between highest and lowest weight at current height, although this has been used in previous studies (Butryn et al, 2011; Carter et al, 2008), because highest weight at current height minus lowest weight at current height was virtually equivalent to weight suppression in the present sample, r (183) = 0.94, p < .001. Finally, we determined whether participants had a history of overweight or obesity based on BMI (for weights that occurred when participants were ≥ 20 years old) or BMI ≥ 85 th percentile for age and sex (weights that occurred between the ages of 12 and 19).…”

“…Cross-sectional studies have found positive associations between weight suppression and frequency of binge eating and purging in patients seeking treatment for bulimia spectrum disorders (Butryn, Juarascio, & Lowe, 2011; Lowe, Thomas, Safer, & Butryn, 2007). Moreover, longitudinal research has found that weight suppression predicts the onset and maintenance of bulimic syndromes (i.e., threshold and subthreshold bulimia nervosa [BN], binge eating spectrum disorders, purging disorder; Keel & Heatherton, 2010; Lowe et al, 2011).…”

“…B. Herzog, et al, 2010). In contrast, other measures of weight history, such as highest or lowest body mass index (BMI) at current height and the difference between lowest weight and current weight, have failed to demonstrate consistent associations with disordered eating symptoms or weight gain (Butryn et al, 2011; Butryn, Lowe, Safer, & Agras, 2006; Carter et al, 2008), suggesting that weight suppression may be particularly salient to the presentation and course of eating disorders.…”

Weight suppression predicts bulimic symptoms at 20-year follow-up: The mediating role of drive for thinness.

“…Several cross-sectional studies have reported significant associations between higher WS and greater frequency of binge eating and purging in individuals with BN (Bodell & Keel, 2015; Butryn, Juarascio, & Lowe, 2011; Lowe, Thomas, Safer, & Buytryn, 2007). Furthermore, longitudinal studies support the role of WS in the maintenance of BN (Butryn, Lowe, Safer, & Agras, 2006; Keel & Heatherton, 2010; Lowe et al, 2011).…”

The relation of weight suppression and body mass index to symptomatology and treatment response in anorexia nervosa.

“…Initial results in individuals with BN spectrum disorders support consideration of a joint influence of weight suppression and low BMI on eating disorder symptomatology in AN. BMI was found to moderate the relation between weight suppression and binge eating frequency in full and sub-threshold BN, with individuals highest in weight suppression and lowest in objective weight status reporting the highest binge eating frequencies (Butryn, Juarascio, & Lowe, 2011). Similarly, in addition to previously reported main effects of weight suppression in AN, the same degree of weight suppression may have a more dramatic impact on an individual depending on the severity of the resulting low BMI level, particularly because such weight loss may activate varying degrees of physiological starvation responses.…”