Abstract
Purpose
Body mass index has been often reported in the normal range in bulimic patients and the literature considering the association between bulimia nervosa (BN) and overweight is scant. The aim of the present study was to compare two groups of normal and overweight BN patients, carefully assessed for several clinical and psychopathological features.
Methods
In the present cross-sectional study, a consecutive series of 124 female BN patients was divided into two groups according to their BMI: normal-weight group (with BMI ≤25; N = 91) and overweight group (with BMI >25; N = 33). The two clinical groups were evaluated and compared, to detect similarities and differences in terms of psychopathological and clinical features. Patients were assessed by means of the Structured Clinical Interview for DSM-IV, the Eating Disorder Examination Questionnaire, the Emotional Eating Scale, the Body Uneasiness Test and the Symptom Checklist 90.
Results
A relevant percentage of BN clinical patients were overweight. Normal-weight and overweight subjects did not differ in terms of eating disorder-specific psychopathology, with the exception of body uneasiness, which was higher in BN overweight patients. Among normal-weight patients, a significant correlation between emotional eating and binge eating frequency was observed, while this correlation was absent in BN overweight patients.
Conclusions
Our results stress the relevance of being overweight in a significant percentage of bulimic subjects and suggest that clinicians should be aware of the relevance of being overweight in these patients.
Similar content being viewed by others
References
American Psychiatric Association (2000). Diagnostic and statistical manual of mental disorders, 4th edn (text rev.). DSM-IV-TR. American Psychiatric Publishing, Inc., USA
Jacobi C, Hayward C, de Zwaan M, Kraemer HC, Agras WS (2004) Coming to terms with risk factors for eating disorders: application of risk terminology and suggestions for a general taxonomy. Psychol Bull 130(1):19–65
Butryn ML, Lowe MR, Safer DL, Agras WS (2006) Weight suppression is a robust predictor of outcome in the cognitive–behavioral treatment of bulimia nervosa. J Abnorm Psychol 115(1):62
Hudson JI, Hiripi E, Pope HG, Kessler RC (2007) The prevalence and correlates of eating disorders in the National Comorbidity Survey Replication. Biol Psychiatry 61(3):348–358
Mitchell JE, Pyle RL, Eckert ED, Hatsukami D, Soll E (1990) Bulimia nervosa in overweight individuals. J Nerv Ment Dis 178(5):324–327
Bulik CM, Marcus MD, Zerwas S, Levine MD, La Via M (2012) The changing “weightscape” of bulimia nervosa. Am J Psychiatry 169(10):1031–1036
First M, Spitzer R, Gibbon M, Williams J (1995) Structured clinical interview for DSM-IV axis I disorders-patient edition (SCIP-I/P, Version 2.0). Biometrics Research Department, New York State Psychiatric Institute, New York
Arnow B, Kenardy J, Agras WS (1995) The Emotional Eating Scale: the development of a measure to assess coping with negative affect by eating. Int J Eat Disord 18(1):79–90
Cuzzolaro M, Vetrone G, Marano G, Garfinkel PE (2006) The Body Uneasiness Test (BUT): development and validation of a new body image assessment scale. Eat Weight Disord 11(1):1–13
Fairburn CG, Beglin SJ (1994) Assessment of eating disorders: interview or self-report questionnaire? Int J Eat Disord 16(4):363–370
Derogatis LR, Lipman RS, Covi L (1973) SCL-90: an outpatient psychiatric rating scale—preliminary report. Psychopharmacol Bull 9(1):13–28
Zachrisson HD, Vedul-Kjelsås E, Götestam KG, Mykletun A (2008) Time trends in obesity and eating disorders. Int J Eat Disord 41(8):673–680
Darby A, Hay P, Mond J, Quirk F, Buttner P, Kennedy L (2009) The rising prevalence of comorbid obesity and eating disorder behaviors from 1995 to 2005. Int J Eat Disord 42(2):104–108
Masheb R, White MA (2012) Bulimia nervosa in overweight and normal-weight women. Compr Psychiatry 53(2):181–186
Garner DM, Fairburn CG (1988) Relationship between anorexia nervosa and bulimia nervosa: Diagnostic implications. In: Garner DM, Garfinkel PE (eds) Diagnostic issues in anorexia nervosa and bulimia nervosa. Brunner/Mazel, New York, pp 56–79
Gendall KA, Bulik CM, Sullivan PF, Joyce PR, Mcintosh VV, Carter FA (1999) Body weight in bulimia nervosa. Eat Weight Disord 4(4):157–164
Abbate-Daga G, Marzola E, Gramaglia C, Brustolin A, Campisi S, De Bacco C, Amianto F, Fassino S (2012) Emotions in eating disorders: changes of anger control after an emotion-focused day hospital treatment. Eur Eat Disord Rev 20(6):496–501
McKisack C, Waller G (1996) Why is attendance variable at groups for women with bulimia nervosa? The role of eating psychopathology and other characteristics. Int J Eat Disord 20(2):205–209
Berkman ND, Bulik CM, Brownley KA, Lohr KN, Sedway JA, Rooks A, Gartlehner G (2006) Management of eating disorders. Evid Rep Technol Assess 135:1–166
Campbell M (2009) Drop-out from treatment for the eating disorders: a problem for clinicians and researchers. Eur Eat Disord Rev 17(4):239–242
Conflict of interest
The authors declare they have no conflict of interests.
Author information
Authors and Affiliations
Corresponding author
Rights and permissions
About this article
Cite this article
Rotella, F., Castellini, G., Montanelli, L. et al. Comparison between normal-weight and overweight bulimic patients. Eat Weight Disord 18, 389–393 (2013). https://doi.org/10.1007/s40519-013-0053-8
Received:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s40519-013-0053-8