Weight Suppression But Not Symptom Improvement Predicts Weight Gain During Inpatient Treatment for Bulimia Nervosa

Heßler, Johannes Baltasar; Diedrich, Alice; Greetfeld, Martin; Schlegl, Sandra; Schwartz, Caroline; Voderholzer, Ulrich

doi:10.1002/erv.2573

Cited by 11 publications

(16 citation statements)

References 20 publications

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“…As regards the role of WS in determining weight gain, this article is consistent with several valuable pieces of research clearly showing that WS predicts weight gain during and after treatment (Berner et al, 2013;Bodell, Racine, & Wildes, 2016;Carter et al, 2015;Wildes & Marcus, 2012) in AN (and restricting AN) and in BN (Brewerton et al, 2000;Herzog et al, 2010;Hessler et al, 2018;Lowe et al, 2006), which may be only partially because of lower energy expenditure and resting metabolic rate in the presence of high WS (Stice, Durant, Burger, & Schoeller, 2011), or to leptin (Bodell & Keel, 2015;Keel, Bodell, Haedt-Matt, Williams, & Appelbaum, 2017). Moreover consistently with the present study, several studies have shown that WS may not be associated with treatment outcome such as binge/purge abstinence, response, remission, in patients with BN (Carter et al, 2008;Dawkins et al, 2013;Zunker et al, 2011), nor with treatment compliance or drop-out rates (Carter et al, 2008).…”

Section: Discussionsupporting

confidence: 84%

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The impact of weight suppression and weight loss speed on baseline clinical characteristics and response to treatment

Solmi

Gallicchio

Collantoni

et al. 2018

Intl J Eating Disorders

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Section: Discussionsupporting

confidence: 84%

“…Moreover, WS also has been studied as a potential moderator of eating disorder treatment outcome (Hessler et al, 2018). Specifically WS has been found to predict weight gain after multidisciplinary treatment in patients with AN (Berner, Shaw, Witt, & Lowe, 2013;Wildes & Marcus, 2012), and at long-term follow-up (Brewerton et al, 2000).…”

mentioning

confidence: 99%

The impact of weight suppression and weight loss speed on baseline clinical characteristics and response to treatment

Solmi

Gallicchio

Collantoni

et al. 2018

Intl J Eating Disorders

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show abstract

“…= 8) ranged from 2–5 (see Table ). In all studies, WS was the primary variable of interest and comprised analysis of either an existing randomized study (Butryn et al., ; Carter et al., , ; Zunker et al., ) or routinely collected clinic data (Berner, Shaw, Witt, & Lower, ; Dawkins et al., ; Hessler et al., ; Lowe, Davis, Lucks, Annunziato, & Butryn, ; Seetharaman et al., ; Wildes & Marcus, ). All but one study used DSM criteria to define groups (Hessler et al.…”

Section: Resultsmentioning

confidence: 99%

“…All studies used regression analyses to determine the predictive effect(s) of WS, except for Hessler et al. () who grouped a sample of female inpatients with BN by degree of WS (0–4, 4–9, 9–15.7, and 15.8 kg+) and compared groups via analysis of variance (ANOVA).…”

Section: Resultsmentioning

confidence: 99%

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Weight suppression as a predictor variable in the treatment of eating disorders: A systematic review

Jenkins

Lebow

Rienecke

2018

Psychiatric Ment Health Nurs

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WHAT IS KNOWN ON THE SUBJECT?: Weight suppression (WS) has been suggested to predict outcome following psychological treatment for an eating disorder (ED). Some findings are contradictory and have not been considered systematically. WHAT THE PAPER ADDS TO EXISTING KNOWLEDGE?: The review suggests that weight gain at post-treatment is reliably predicted by pretreatment WS, but findings regarding other outcomes (e.g., treatment dropout) are less consistent. Approximate effect sizes for observed relationships are identified, alongside support for biobehavioural theories of metabolic adaptation to weight loss. WHAT ARE THE IMPLICATIONS FOR PRACTICE?: Degree of WS at pretreatment is associated with weight gain and is important for clinicians to consider before offering treatment to patients with EDs. Patients high in WS might benefit from further support (e.g., psychoeducation) prior to beginning treatment. ABSTRACT: Introduction Weight suppression (WS-the difference between highest body weight and current body weight) has been proposed as a predictor of treatment outcome within eating disorders (EDs), although this hypothesis has not been consistently supported. Aim/Question Review the association between pretreatment WS and outcome following psychological treatment for EDs. Method A comprehensive electronic database search for published and unpublished literature from 1979 to 2017. Reference lists were also inspected. Eligibility criteria were determined according to relevant guidelines and a quality appraisal was conducted. Results Twelve studies met inclusion criteria (one was subsequently excluded based on insufficient data). Greater WS was generally associated with weight gain at post-treatment although not with other treatment outcomes. Discussion The existing evidence, with data from 1,566 participants, is summarized according to three main post-treatment outcomes: weight change; treatment completion; and symptom abstinence. Patients with disordered eating and greater WS may need to gain more weight than others during treatment to achieve good outcomes. Recommendations for future studies are provided. Implications for practice Evidence-based treatments for EDs may benefit from considering WS when planning treatment, such as further psychoeducation on weight changes. Societal interventions regarding promotion of healthy eating may also draw on these findings.

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

Lowe

Singh

Apple

et al. 2022

Euro Eating Disorders Rev

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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.

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Weight Suppression But Not Symptom Improvement Predicts Weight Gain During Inpatient Treatment for Bulimia Nervosa

Abstract: Bulimia nervosa can be successfully treated without causing excessive weight gain. Patients with higher WS might expect somewhat more weight gain. Copyright © 2017 John Wiley & Sons, Ltd and Eating Disorders Association.

Cited by 11 publications

References 20 publications

The impact of weight suppression and weight loss speed on baseline clinical characteristics and response to treatment

The impact of weight suppression and weight loss speed on baseline clinical characteristics and response to treatment

Weight suppression as a predictor variable in the treatment of eating disorders: A systematic review

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

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