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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

Published online by Cambridge University Press:  12 September 2012

C. M. Grilo ,
M. A. White ,
R. Gueorguieva ,
G. T. Wilson  and
R. M. Masheb
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: [email protected])
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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.

Keywords

Binge eatingbody imagediagnosiseating disorderobesitytreatment outcome
Type
Original Articles
Information
Psychological Medicine , Volume 43 , Issue 6 , June 2013 , pp. 1335 - 1344
Copyright
Copyright © Cambridge University Press 2012 

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