Psychopathology associated with bulimia, binge eating, and obesity

Abstract

Bulimic binge‐purgers, bulimic binge‐eaters, nonbulimic obese presenting for treatment for obesity, obese not in treatment, and normal control subjects were compared using the Minnesota Multiphasic Personality Inventory (MMPI), Symptom Checklist‐90‐Revised (SCL‐90‐R), and Beck Depression Inventory (BDI). Results suggested a continuum of severity, with the binge‐purger group showing the highest levels of psychopathology, and the binge‐eaters and clinical obese showing significantly more distress than the two control groups. Analysis of the frequency of clinically elevated scores on each scale of the MMPI and SCL‐90R as well as the BDI as a function of group indicated that the clinical groups evidenced significantly greater psychopathology compared with their appropriate control groups. These results clarify some of the conflicting results of previous investigations of obesity which did not differentiate obese patients and nonpatients. The implications of these findings for treatment research on obesity are that perhaps a more broadspectrum form of treatment may be required in order to address the psychological problems of the chronically obese.

Are Obese Adolescents and Young Adults at Higher Risk for Mental Disorders? A Community Survey

“…Parallel findings were reported from controlled studies with obese control subjects (8,45) or with non-obese patients presenting for general medical treatment (46). Again, in contrast to these findings, most population-based studies found only weak or inconsistent associations between general psychopathology and categorical or continuous (e.g., BMI) measures of obesity (47).…”

“…Depending on differences in sampling, diagnostic criteria, diagnostic coverage, age composition, and culture, numerous clinical studies demonstrate almost consistently up to 4.8 times higher prevalence rates of mental disorders (5,6) as well as an elevated general psychopathology (7,8) in obese patients compared with non-obese nonpatients. A major problem of studies with obese patients is the uncertainty of whether obesity or other factors contribute to a higher degree to the increased psychopathology (9).…”

A test of the continuity perspective across bulimic and binge eating pathology

“…Dykens and Gerrard's (1986) study of 424 undergraduate women, bulimics, repeat dieters, and controls differed on body esteem, supporting the continuity perspective. In contrast, Prather and Williamson (1988) found that depression levels did not differentiate 16 bulimic binge-purgers, 16 bulimic binge-eaters, 16 nonbulimic obese presenting for obesity treatment, 16 obese not in treatment, and 16 female undergraduate controls. Most work in this area has been conducted with female student populations (Dykens & Gerrard, 1986;Ruderman & Besbeas, 1992;Stice et al, 1998) and has focused predominantly on bulimia and various comparison groups, including (1) dieters and nonsymptomatic individuals (Ruderman & Besbeas, 1992); (2) current dieters, restrained dieters, and unrestrained nondieters (Lowe et al, 1996); (3) severe binge eaters, moderate binge eaters, mild binge eaters, and nonbinge eaters (Vanderheyden & Boland, 1987); and (4) binge/purgers, binge eaters, and controls (Prather & Williamson, 1988).…”

“…Stice and colleagues (1998) suggested that future research should attempt to include larger samples of bulimic women to have increased statistical power and reliability of effects. In addition, in contrast to most research in this area that has included primarily high school and college age women (Dykens & Gerrard, 1986;Prather & Williamson, 1988), this study included women ranging from 27-41 years old.…”

“…In addition, the subthreshold categories used do not always meet criteria defined by the DSM-IV (American Psychological Association, 1994;Dykens & Gerrard, 1986;Ruderman & Besbeas, 1992;Vanderheyden & Boland, 1987). Moreover, because nontreatment-seeking high school and undergraduate populations have often been used (Dykens & Gerrard, 1986;Prather & Williamson, 1988), the control groups have been large, but the number of individuals meeting the criteria for subthreshold and full syndrome forms of the disorder have been small (Dykens & Gerrard, 1986;Lowe et al, 1996;Ruderman & Besbeas, 1992;Stice et al, 1998;Vanderheyden & Boland, 1987). By using a treatment-seeking sample, there are sufficient numbers in both full syndrome and subthreshold groups.…”