Traditional versus developmental measures of weight suppression: Exploring their relationships with bulimic psychopathology

Abstract

Objective Weight suppression (WS) is related to a wide variety of eating disorder characteristics. However, individuals with eating disorders usually reach their highest premorbid weight while still developing physically. Therefore, a more sensitive index of individual differences in highest premorbid weight may be one that compares highest premorbid z‐BMI to current z‐BMI (called developmental weight suppression [DWS] here). Method In this exploratory study, we compared the relationships between traditional weight suppression (TWS) and DWS and a variety of measures related to bulimic psychopathology in 91 females (M age, 25.2; 60.5% White), with clinical or sub‐clinical bulimia nervosa. Results TWS and DWS were correlated (r = 0.40, p < 0.001). TWS was only significantly related to a measure of physical activity whereas DWS was related to 14 outcomes. DWS showed consistent positive relations with behavioural outcomes (e.g., binge eating) but consistent negative relations with cognitive/affective outcomes (e.g., weight concerns). Conclusions Findings indicated much more consistent relationships between the novel DWS measure and bulimic characteristics than with the TWS measure. DWS showed both positive and negative relations with bulimic symptoms, though these findings require replication to confirm their validity. Consistent evidence indicated that the two WS measures served as mutual suppressor variables.

A comparison of traditional and developmental measures of weight suppression in residential patients with bulimia nervosa

“…DWS and TWS showed a similar number of relations with a range of ED-related symptoms (Table 2). Although DWS did not demonstrate a greater number of associations compared with TWS, the present results replicated Lowe et al's (2022) findings that DWS was negatively related to cognitive/affective ED symptoms, but positively related to behavioral ED symptoms (i.e., vomiting).…”

“…However, traditional calculations of WS do not consider the age or height at which one's highest past weight was reached. Lowe et al (2022) found that developmental WS (DWS) was associated with a wider variety of ED-related symptoms compared with traditional WS (TWS). This study replicated and extended these findings in a larger sample of individuals with bulimia nervosa (BN) at a residential ED treatment center.Methods: Participants were 1051 female patients with BN.…”

“…Thus, DWS is calculated using only highest premorbid weight instead of highest past weight (TWS does not distinguish between premorbid or postmorbid highest weight). Lowe et al (2022) compared the associations between TWS and DWS and a range of ED-related symptoms in 91 women with clinical/ subclinical bulimia nervosa (BN) recruited through ED treatment centers and flyers (mean age = 25.2 years, mean length of illness = 9.2 years).…”

A Novel Weight Suppression Score Associates with Distinct Eating Disorder and Ultra- Processed Food Symptoms Compared to the Traditional Weight Suppression Measure Among Adults Seeking Outpatient Nutrition Counseling

“…The authors have referred to this as "developmental weight suppression" since it accounts for the age at which BMIs were reached. Among adult females with BN, this approach indicated more consistent relationships with bulimic characteristics (e.g., bingeing, purging) than the traditional WS calculation [23]. However, while the BMI z-score-based calculation of WS seems useful for individuals before 21 years old, it may be less applicable for those experiencing weight uctuations beyond developmental years.…”