Weighty decisions: How symptom severity and weight impact perceptions of bulimia nervosa

Galbraith, Katharine; Elmquist, JoAnna; White, Marney A.; Grilo, Carlos M.; Lydecker, Janet A.

doi:10.1002/eat.23125

Cited by 5 publications

(5 citation statements)

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“…The finding that participants given the low weight description were more likely to identify the problem as an eating disorder was consistent with expectations and previous research (Galbraith et al, 2019; Sonneville & Lipson, 2018; Veillette et al, 2018). Similarly, the finding that participants given the low weight description were more likely to recommend specialized eating disorder treatment and medical follow‐up is unsurprising, given evidence that higher weight patients are less likely to receive eating disorder treatment at all, and if they do access treatment, it is at a lower level (Kennedy et al, 2017; MacCaughelty et al, 2016; Sonneville & Lipson, 2018).…”

Section: Discussionsupporting

confidence: 90%

“…Weight bias has been demonstrated to impact therapists' perceptions of patients (Agell & Rothblum, 1991;Hassel et al, 2001), treatment goals (Davis-Coelho et al, 2000), and diagnosis (Davis-Coelho et al, 2000;Hassel et al, 2001). There is also evidence that people judge food and eating behaviors differently based on weight status, which may have contributed to the different ratings of behavioral and cognitive symptoms here (Galbraith et al, 2019;Gotovac, 2017;Schuldt et al, 2016).…”

Section: Discussionmentioning

confidence: 99%

“…Some research has addressed this limitation by using vignette methodology which allows factors like body weight to be manipulated independently and has demonstrated good internal and external validity (Evans et al, 2015). Vignette studies have been used to compare primary care providers' reactions to a patient with AN at two different underweight BMIs (Currin et al, 2007) and to compare community members' reactions to a person with bulimia nervosa (Galbraith et al, 2019). Both studies found differences in responses based on weight status, but neither study directly compared AN and atypical AN.…”

Section: Introductionmentioning

confidence: 99%

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Mental health providers' perceptions of restrictive eating disorders: Relationship with client body weight

Silbiger

2024

Intl J Eating Disorders

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ObjectiveThis study investigated whether mental health providers have different diagnostic impressions and treatment recommendations for patients with restrictive eating disorders, depending on the patient's body weight.MethodParticipants were given one of three versions of a vignette depicting a patient who meets DSM‐5 criteria for anorexia nervosa (AN) or atypical AN with the patient's weight described as either below, within, or above the average range for her age and height. Participants were then asked to respond to a series of questions about diagnosis, symptoms, and treatment recommendations. Results were compared between the three weight conditions with the goal of better understanding how a patient's body weight may influence different aspects of participants' clinical impressions.ResultsParticipants given the low weight version of the vignette were more likely to identify the presenting problem as an eating disorder and to agree that the patient experienced dietary restriction and weight loss, weight gain avoidance, and body image concerns. Participants given the low weight description were also more likely to recommend specialized eating disorder treatment and medical follow‐up.DiscussionFindings suggest that mental health providers were generally more responsive to restrictive eating disorder symptoms when the patient was at a lower body weight. These results are concerning because they suggest patients with atypical AN may be less likely to receive an accurate diagnosis or adequate treatment compared to underweight patients with AN, despite experiencing the same symptoms.Public SignificanceRestrictive eating disorders like AN and atypical AN can cause comparable physical and psychological symptoms in people of any body weight. Despite having the same symptoms, people with a higher body weight are less likely to receive a diagnosis or treatment. This study compared mental health providers' reactions to a description of a patient with an eating disorder at different body weights and found differences in diagnosis, detection of symptoms, and treatment recommendations.

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Section: Discussionsupporting

confidence: 90%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Mental health providers' perceptions of restrictive eating disorders: Relationship with client body weight

Silbiger

2024

Intl J Eating Disorders

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“…Indeed, authors observed that an obese target with BED elicited fewer stereotyping characteristics (i.e., negative personality traits and blame) than an obese target without BED. Conversely, a study has shown that overweight people with BN received more blame and more weight problem attributions (compared to severe psychiatric disorder attributions) than underweight people with BN [ 89 ].…”

Section: Discussionmentioning

confidence: 99%

Stigmatization toward People with Anorexia Nervosa, Bulimia Nervosa, and Binge Eating Disorder: A Scoping Review

Brelet¹,

Flaudias

Désert

et al. 2021

Nutrients

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Research about stigmatization in eating disorders (EDs) has highlighted stereotypes, prejudices, and discrimination against people with EDs, as well as their harmful effects on them, including self-stigma and a difficult recovery process. Whereas a recent review focused on the consequences of ED stigma, our work aimed to provide a broader synthesis of ED stigma, including its consequences, but also its content and distribution. More precisely, we focused on three EDs—namely, anorexia nervosa, bulimia nervosa, and binge eating disorder. Based on a systematic search of four major databases in psychology, the present scoping review includes 46 studies published between 2004 and 2021. We did not conduct any quality assessment of the studies included, because our aim was to provide a wide-ranging overview of these topics instead of an appraisal of evidence answering a precise research question. The review confirmed the existence of a common ED stigma: all individuals affected by EDs reviewed here were perceived as responsible for their situation, and elicited negative emotions and social distance. However, our review also depicted a specific stigma content associated with each ED. In addition, the demographic characteristics of the stigmatizing individuals had a notable influence on the extent of ED stigma: men, young adults, and low-income individuals appeared to be the most stigmatizing toward individuals with EDs. It is important to note that ED stigma had a negative effect on individuals’ eating disorders, psychological wellbeing, and treatment-seeking behavior. There is an urgent need for further research on the adverse effects of ED stigma and its prevention.

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“…Apesar de os pacientes com BN ou TCA reconheçam que têm um problema de saúde (GALBRAITH et al, 2019), acredita-se que a demora pela procura do tratamento pode ser pela preocupação com o julgamento de outras pessoas, medo de perder o controle, negação em perceber a gravidade da doença, estigma e vergonha (ALI et al, 2020;HAY, 2020). Esse fato justifica a idade média mais avançada dos pacientes no início do tratamento, sendo de 20 anos na BN e de 24,5 anos no TCA (UDO; GRILO, 2018).…”

Section: Discussionunclassified

Compulsão alimentar em mulheres: padrão do consumo de bebidas alcoólicas e qualidade da alimentação

Azevedo¹

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Introduction: Bulimia nervosa (BN) and binge eating disorder (BED) present a comorbidity with alcohol consumption disorders due to the similarity between the symptoms of these conditions such as lack of self-control, impulsiveness and increase in self-destructive behavior. The ingestion of alcoholic beverages directly affects the diet because the greater the amount of alcohol consumed, the lower the density and nutritional quality of the diet. Objective: To identify the pattern of alcohol consumption and the quality of diet in women with binge eating disorders. Method: This is a descriptive, cross-sectional, comparative study with a quantitative approach carried out with adult women with diagnoses of BN or BED, monitored in four specialized services in the state of São Paulo. Sociodemographic and anthropometric data was collected (weight and height to calculate the body mass index-BMI; waist circumference-WC), the alcoholic beverage consumption pattern through the Alcohol Use Disorders Identification Test (AUDIT), food compulsion symptoms by the Binge Eating Scale (BES) and food intake by the 24-hour Diet Quality Index calculation -Revised. The data was analyzed in a descriptive way by the SPSS version 21.0 program. To verify the association between the categorical variables, the Pearson's Chi-square tests or Fisher's exact test were used and values of p<0.05 were considered significant. Results: The study was composed of 50 women with binge eating disorders, young adults (35.0±12.0 years), no partner (n=34; 68%), employed (n=31; 60%) and with complete high school (n=29; 58%). They were overweight (BMI: 31.27± 9.70kg/m2) and had very high cardiovascular risk (WC: 91.50±20.5cm). It was evident that 29 participants (38%) presented problematic consumption of alcoholic beverages associated with lower food quality and low vegetable consumption when compared to women who do not drink alcoholic beverages. Conclusion: The problematic consumption of alcoholic beverages in women with binge eating disorders is of concern since they are in mental health treatment and this may impair the quality of their diet. The early detection and treatment of alcoholic beverage consumption in people with eating disorders are fundamental prevention and rehabilitation strategies to minimize the consequences of this practice, favoring the prognosis of these serious diseases.

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Weighty decisions: How symptom severity and weight impact perceptions of bulimia nervosa

Cited by 5 publications

References 36 publications

Mental health providers' perceptions of restrictive eating disorders: Relationship with client body weight

Mental health providers' perceptions of restrictive eating disorders: Relationship with client body weight

Stigmatization toward People with Anorexia Nervosa, Bulimia Nervosa, and Binge Eating Disorder: A Scoping Review

Compulsão alimentar em mulheres: padrão do consumo de bebidas alcoólicas e qualidade da alimentação

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