Patterns of weight change after treatment for bulimia nervosa

Carter, Frances A.; McIntosh, Virginia V.W.; Joyce, Peter R.; Gendall, Kelly A.; Frampton, Christopher; Bulik, Cynthia M.

doi:10.1002/eat.20021

Cited by 10 publications

(9 citation statements)

References 25 publications

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“…Carter et al (29) reported significant variability in the effect of treatment for BN on weight—with reports of gain, loss, and no change. In a 5-year follow-up study, (29) they observed considerable inter-individual differences in post-treatment weight trajectories with the majority of patients remaining fairly stable, but 30% having lost and 18% having gained 5 kg or more.…”

Section: Weight and Cbt For Bulimia Nervosamentioning

confidence: 99%

“…In a 5-year follow-up study, (29) they observed considerable inter-individual differences in post-treatment weight trajectories with the majority of patients remaining fairly stable, but 30% having lost and 18% having gained 5 kg or more. At 5-year follow-up, 24% of patients fell into the overweight range (25 – 29.9 kg/m 2 ) although mean BMI had been in the healthy range pre-treatment (22.7 kg/m 2 ± 2.7).…”

Section: Weight and Cbt For Bulimia Nervosamentioning

confidence: 99%

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The Changing “Weightscape” of Bulimia Nervosa

Bulik¹,

Marcus²,

Zerwas³

et al. 2012

AJP

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Case Ms. Z, a 35-year-old African-American single woman with a body mass index (BMI) of 37.8 kg/m2 (height 5 feet, 5.5 inches, weight 238 lb.), presents for an evaluation for bulimia nervosa. She was referred to the eating disorders program by her primary care physician who knew about her eating disorder, but was primarily concerned about her weight and blood pressure. Ms. Z has an advanced degree and is employed full time. She has struggled with her eating, weight, and body image since childhood and began binge eating regularly (1–2× week) at age 15. Fasting and self-induced vomiting began in her early twenties, when she achieved her lowest adult BMI of 21.6 kg (weight 130 lb. at age 23). She gained 100 pounds in the past 7 years and currently binges and purges 1–2 times a day. A typical binge consists of a box of cookies, a pint of ice cream, 7 oz. of cheese, two bowls of cereal with 2 cups of milk, and 4 pickles. Ms. Z has seen five therapists to address her eating behaviors and weight concerns and participated in numerous commercial weight loss programs. She states binge eating has always served a self-soothing purpose for her. Ms. Z has a demanding university-related job that absorbs most of her time. She has few friends and has not been in a romantic relationship for the past five years believing that no one would be interested in a woman of her size. She also claimed that food is more reliable than any man because “it’s always there when you need it and you don’t have to take care of it or stoke its ego.” She spends evenings at home working until she is completely exhausted, heads to the kitchen for an all-out binge, vomits everything up, and then cries herself to sleep. She has never smoked and does not drink alcohol. Current medications prescribed by her primary care physician include Fluoxetine (20 mg), Norvasc (5 mg), and Clonazepam (prn). What are Ms. Z’s treatment goals? What are her primary care physician’s? Is her medication for bulimia nervosa adequate? How well would cognitive-behavioral therapy for bulimia nervosa address her personal treatment goals? Her physician’s? What challenges might a therapist face having Ms. Z in group therapy for bulimia?

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Section: Weight and Cbt For Bulimia Nervosamentioning

confidence: 99%

Section: Weight and Cbt For Bulimia Nervosamentioning

confidence: 99%

The Changing “Weightscape” of Bulimia Nervosa

Bulik¹,

Marcus²,

Zerwas³

et al. 2012

AJP

Self Cite

View full text Add to dashboard Cite

show abstract

“…Clinicians may also be concerned about weight change for patients who are underweight or overweight at pre-treatment. Studies examining weight change over time among women seeking treatment for bulimia nervosa have reported mixed results, with significant increases (Fairburn et al, 1991(Fairburn et al, , 1995Keel, Mitchell, Miller, Davis, & Crow, 1999), significant decreases (Fairburn, Jones, & Peveler, 1993) and no significant change (Agras, Schneider, Raeburn, & Telch, 1989;Carter et al, 2004;Gendall et al, 1999) being noted. These studies agree that changes in weight over time are typically not large in absolute terms (e.g.…”

Section: Introductionmentioning

confidence: 99%

“…Studies have identified women who changed in weight over treatment or follow-up and attempted to retrospectively identify predictors of weight loss or gain (e.g. Abraham, 1998;Agras et al, 1989;Carter et al, 2004;Fairburn et al, 1991Fairburn et al, , 1993Gendall et al, 1999;Keel et al, 1999;Maddocks, Kaplan, Woodside, Langdon, & Piran, 1992). However, the relevance of predictors of weight loss or weight gain per se may be difficult to interpret.…”

Section: Introductionmentioning

confidence: 99%

Impact of pre‐treatment weight on weight trajectory in women treated for bulimia nervosa

Carter

McIntosh

Joyce

et al. 2004

Euro Eating Disorders Rev

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Objective: To describe and evaluate changes in weight-related measures over 5-year follow-up for weight status groups identified at pre-treatment. Methods: Participants were 134 non-pregnant women who had participated in a randomized clinical trial for bulimia nervosa. Women were categorized according to their pre-treatment body mass index (BMI; weight in kg/height in m 2 ) into the following groups: low weight (BMI <20), normal weight (BMI 20-25) and overweight (>25). Participants were assessed across treatment and at yearly intervals (or more) over 5-year follow-up. Results: Descriptive data and repeated measures analyses of variance show a trend for patients identified as being overweight at pre-treatment to change (gain) more in weight and BMI over time than low weight or normal weight groups. Conclusion: Weight status groups identified at pre-treatment may have different patterns of weight change over time.

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“…Further understanding these differences is highly relevant for finding the disease genes as well as in view of developing effective treatment programs that may be directed toward specific pathophysiological features of the disease. Indeed, current treatment possibilities only cure a small proportion of the eating disorder patients [for review, see (Fairburn and Harrison 2003;Treasure et al 2010)], and high relapse rates are documented (Herzog et al 1999;Carter et al 2004). Furthermore, genetic studies have, thus far, not revealed many replicated candidate genes for neither anorexia nervosa nor bulimia nervosa [for review, see (Hinney et al 2000;Kas et al 2003b;Klump and Gobrogge 2005;Mazzeo et al 2006;Bulik et al 2007b)], suggesting that either different subgroups within the population may relate to differences in affected genetic pathways or major susceptibility genes have not been found.…”

Section: Why Studying Eating Disorder Traits?mentioning

confidence: 99%

Animal Models of Eating Disorder Traits

Kas

Adan

2010

Behavioral Neurobiology of Eating Disorders

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Eating disorders, such as anorexia and bulimia nervosa, are psychiatric disorders that are likely determined by a complex interaction between genetic variations, developmental processes, and certain life events. Cross-species analysis of traits related to eating disorders may provide a way to functionally and systematically study neurobiological mechanisms underlying these disorders. Interspecies trait genetics may offer opportunities to identify common neurobiological mechanisms underlying eating disorder characteristics relevant to the initiation, progression, and/or maintenance of the disease, such as cognitive rigidity, increased anxiety levels, and behavioral hyperactivity. These can subsequently be tested directly by studying allelic variation in mice and human subjects and by applying methods that can modify gene expression levels in rodent models. Increasing our knowledge about these traits and their underlying neurobiological mechanisms will be relevant to develop new therapies for patients within the heterogeneous eating disorder populations. Novel mouse genetic and phenotyping tools offer a way to study these neurobehavioral traits under controlled environmental and genetic background conditions.

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Patterns of weight change after treatment for bulimia nervosa

Abstract: Five years after treatment for bulimia nervosa, approximately one half of the participants had changed substantially in weight. For those who had changed, weight loss was more common than weight gain.

Cited by 10 publications

References 25 publications

The Changing “Weightscape” of Bulimia Nervosa

The Changing “Weightscape” of Bulimia Nervosa

Impact of pre‐treatment weight on weight trajectory in women treated for bulimia nervosa

Animal Models of Eating Disorder Traits

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