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Eating disorder symptoms, psychiatric correlates and self-image in normal, overweight and obese eating disorder patients

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Abstract

The impression from Swedish eating disorder (ED) units is that there has been an increase in the number of overweight or obese patients. There is, however, no research studying whether these patients differ from normal-weight ED patients in other aspects than weight. Differences between normal-weight and overweight or obese ED patients could indicate that these groups of patients need different treatment approaches. The aim of this study was to investigate possible differences between normal-weight and overweight or obese ED patients in psychiatric and psychological pre-treatment variables. The study was based on data from a Swedish quality assurance system for ED care. In total, data from 3,798 adult patients with body mass index ≥ 18.5 were used. The sample included all normal-weight ED diagnoses. Significant differences between normal-weight, overweight and obese patients were found for five of eight self-image variables, for all eating disorder examination questionnaire subscales and for most key diagnostic symptoms. However, effect sizes were mostly small or very small. Overweight or obese patients did not display greater levels of psychiatric psychopathology than normal-weight patients. They did, however, show a tendency towards more negative self-image and more severe ED symptoms than normal-weight patients. Overweight and obesity in ED patients are thus not only associated with physical health problems, but also with mental health issues. Further studies are required to investigate the clinical relevance of these findings.

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References

  1. World Health Organization (2013) Obesity and overweight. http://who.int/mediacentre/factsheets/fs311/en/index.html. Accessed 20 sept 2013

  2. American Psychiatric Association (1994) Diagnostic and statistical manual of mental disorders, 4th edn. American Psychiatric Press, Washington DC

    Google Scholar 

  3. Dingemans AE, van Furth EF (2012) Binge eating disorder psychopathology in normal-weight and obese individuals. Int J Eat Disord 45:135–138

    Article  PubMed  Google Scholar 

  4. Niego SH, Kofman MD, Weiss JJ et al (2007) Binge eating in the bariatric surgery population: a review of the literature. Int J Eat Disord 40:349–359

    Article  PubMed  Google Scholar 

  5. Fichter MM, Quadflieg N, Hedlund S (2008) Long-term course of binge eating disorder and bulimia nervosa: relevance for nosology and diagnostic criteria. Int J Eat Disord 41:577–586

    Article  PubMed  Google Scholar 

  6. de Man Lapidoth J, Ghaderi A, Norring C (2006) Eating disorders and disordered eating among patients seeking non-surgical weight-loss treatment in Sweden. Eat Behav 7:15–26

    Article  Google Scholar 

  7. Sjöström L (2008) Bariatric surgery and reduction in morbidity and mortality: experiences from the SOS study. Int J Obes 32(Suppl 7):93–97

    Article  Google Scholar 

  8. Greenberg I, Perna F, Kaplan M et al (2005) Behavioural and psychological factors in the assessment and treatment of obesity surgery patients. Obes Res 13:244–249

    Article  PubMed  Google Scholar 

  9. Barry DT, Grilo CM, Masheb RM (2003) Comparison of patients with bulimia nervosa, obese patients with binge eating disorder, and nonobese patients with binge eating disorder. J Nerv Ment Dis 191:589–594

    Article  PubMed  Google Scholar 

  10. Villarejo C, Fernández-Aranda F, Jiménez-Murcia S et al (2012) Lifetime obesity in patients with eating disorders: increasing prevalence, clinical and personality correlates. Eur Eat Disord Rev 20:250–254

    Article  PubMed Central  PubMed  Google Scholar 

  11. Striegel-Moore RH, Cachelin FM, Dohm FA et al (2001) Comparison of binge eating disorder and bulimia nervosa in a community sample. Int J Eat Disord 29:157–165

    Article  CAS  PubMed  Google Scholar 

  12. Goldschmidt AB, LeGrange D, Powers P et al (2011) Eating disorder symptomatology in normal-weight vs. obese individuals with binge eating disorders. Obesity 19:1515–1518

    Article  PubMed  Google Scholar 

  13. Carrard I, Van der Linden M, Golay A (2012) Comparison of obese and nonobese individuals with binge eating disorder: delicate boundary between binge eating disorder and non-purging bulimia nervosa. Eur Eat Disord Rev 20:350–354

    Article  PubMed  Google Scholar 

  14. Wilfley DE, Schwartz MB, Spurell EB et al (2000) Using the eating disorder examination to identify the specific psychopathology of binge eating disorder. Int J Eat Disord 27:259–269

    Article  CAS  PubMed  Google Scholar 

  15. Birgegård A, Björck C, Clinton D (2010) Quality assurance of specialised treatment of eating disorders using large-scale internet-based collection systems: methods, results and lessons learned from designing the Stepwise database. Eur Eat Disord Rev 18:251–259

    Article  PubMed  Google Scholar 

  16. Blinder BJ, Cumella EJ, Sanathara VA (2006) Psychiatric comorbidities of female inpatients with eating disorders. Psychosom Med 68:454–462

    Article  PubMed  Google Scholar 

  17. Björck C, Clinton D, Sohlberg S et al (2007) Negative self-image and outcome in eating disorders: results at 3-year follow-up. Eat Behav 8:398–406

    Article  PubMed  Google Scholar 

  18. Dingemans AE, Bruna MJ, van Furth EF (2002) Binge eating disorder: a review. Int J Obes Relat Metab Disord 26:299–307

    Article  CAS  PubMed  Google Scholar 

  19. Wilfley DE, Wilson GT, Agras WS (2003) The clinical significance of binge eating disorder. Int J Eat Disord 34:S96–S106

    Article  PubMed  Google Scholar 

  20. American Psychiatric Association (2013) Diagnostic and statistical manual of mental disorders, 5th edn. American Psychiatric Publishing, Arlington

    Google Scholar 

  21. First MB, Spitzer RL, Gibbon M, Williams JR (2002) Structured clinical interview for DSM-IV-TR axis I disorders, research version, non-patient edition (SCID-I/NP). New York State Psychiatric Institute, New York

    Google Scholar 

  22. Lobbestael J, Leurgans M, Arntz A (2010) Inter-rater reliability of the structured clinical interview for DSM-IV axis I disorders (SCID I) and axis II disorders (SCID II). Clin Psychol Psychother 18(1):75–79

    Article  Google Scholar 

  23. Steiner JL, Tebes JK, Sledge WH et al (1995) A comparison of the structured clinical interview for DSM-III-R and clinical diagnoses. J Nerv Ment Dis 183:365–369

    Article  CAS  PubMed  Google Scholar 

  24. Endicott J, Spitzer RL, Fleiss JL, Cohen J (1976) The global assessment scale: a procedure for measuring overall severity of psychiatric disturbance. Arch Gen Psychiatry 3:766–771

    Article  Google Scholar 

  25. Fairburn CG, Beglin SJ (1992) Evaluation of a new instrument for the detection of eating disorders in community samples. Psychiatry Res 3:191–201

    Google Scholar 

  26. Binford RB, Le Grange D, Jellar CC (1995) Eating disorders examination versus eating disorders examination-questionnaire in adolescents with full and partial-syndrome bulimia nervosa and anorexia nervosa. Int J Eat Disord 37:44–49

    Article  Google Scholar 

  27. Luce KH, Crowther JH (1999) The reliability of the eating disorder examination-self-report questionnaire version (EDE-Q). Int J Eat Disord 25:349–351

    Article  CAS  PubMed  Google Scholar 

  28. Benjamin LS (1974) Structural analysis of social behavior. Psychol Rev 81:92–425

    Article  Google Scholar 

  29. Benjamin LS (2000) SASB Intrex user’s manual. University of Utah, Utah

    Google Scholar 

  30. von der Lippe AL, Monsen JT, Rønnestad MH et al (2008) Treatment failure in psychotherapy: the pull of hostility. Psychother Res 18:420–432

    Article  PubMed  Google Scholar 

  31. Birgegård A, Björck C, Norring C et al (2009) Anorexic self-control and bulimic self hate: differential outcome prediction from initial self-image. Int J Eat Disord 42:522–530

    Article  PubMed  Google Scholar 

  32. Åsberg M, Montgomery SA, Perris C et al (1978) A comprehensive psychopathological rating scale. Acta Psychiatr Scand 271:5–27

    Article  Google Scholar 

  33. Mattila-Evenden M, Svanborg P, Gustavsson P et al (1996) Determinants of self-rating and expert rating concordance in psychiatric out-patients, using the affective subscales of the CPRS. Acta Psychiatr Scand 94:386–396

    Article  CAS  PubMed  Google Scholar 

  34. World Health Organization (2000) Obesity: preventing and managing the global epidemic. Report of a WHO consultation of obesity. WHO, Geneva

    Google Scholar 

  35. Van Dorsten B, Lindley EM (2011) Cognitive and behavioral approaches in the treatment of obesity. Med Clin N Am 95:971–988

    Article  PubMed  Google Scholar 

  36. Welch E, Birgegård A, Parling T et al (2011) Eating disorder examination questionnaire and clinical impairment assessment questionnaire: general population and clinical norms for young adult women in Sweden. Behav Res Ther 4:85–91

    Article  Google Scholar 

  37. Mond JM, Hay PJ, Rodgers B et al (2004) Validity of the eating disorder examination questionnaire (EDE-Q) in screening for eating disorders in community samples. Behav Res Ther 42:551–567

    Article  CAS  PubMed  Google Scholar 

  38. Watson HJ, Fursland A, Bulik CM et al (2013) Subjective binge eating with compensatory behaviors: a variant presentation of bulimia nervosa. Int J Eat Disord 46:119–126

    Article  PubMed  Google Scholar 

  39. Lewis S, Thomas SL, Blood RW et al (2011) How do obese individuals perceive and respond to the different types of obesity stigma that they encounter in their daily lives? A qualitative study. Soc Sci Med 73:1349–1356

    Article  PubMed  Google Scholar 

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The authors declare that they have no conflict of interest.

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Authors and Affiliations

  1. Stockholm Centre for Eating Disorders and Karolinska Institutet, Wollmar Yxkullsgatan 25, 2 tr, 11850, Stockholm, Sweden

    Joakim de Man Lapidoth & Yvonne von Hausswolff-Juhlin

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  1. Joakim de Man Lapidoth
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  2. Yvonne von Hausswolff-Juhlin
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Correspondence to Joakim de Man Lapidoth.

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de Man Lapidoth, J., von Hausswolff-Juhlin, Y. Eating disorder symptoms, psychiatric correlates and self-image in normal, overweight and obese eating disorder patients. Eat Weight Disord 19, 233–240 (2014). https://doi.org/10.1007/s40519-014-0112-9

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  • DOI: https://doi.org/10.1007/s40519-014-0112-9

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