Overvaluation of shape and weight in binge eating disorder, bulimia nervosa, and sub-threshold bulimia nervosa☆
Section snippets
Participants
Participants were 436 women evaluated for treatment studies at the department of psychiatry at Yale University and the Neuropsychiatric Research Institute at the University of North Dakota (NRI/UND). These advertisements specifically targeted patients with BED (Yale University) or BN (NRI/UND). Study inclusion criteria required meeting DSM-IV full research criteria for BED, full criteria for BN, or sub-threshold criteria for BN. Sub-threshold BN was defined as either full BN criteria except
Results
Of the 324 participants with BED, 60% (n = 195) had clinical overvaluation and 40% (n = 129) with subclinical overvaluation. As expected, per the DSM-IV criteria determined using the SCID-I/P, the BED, BN, and sub-threshold BN groups differed significantly in the proportion of participants meeting overvaluation thresholds on the EDE (χ2 (2, N = 436)) = 37.56, (p < .001). Clinical overvaluation was nearly universal in the BN patients: 95% (58 of 61) participants with BN and 86% (44 of 51)
Discussion
This study examined the significance of overvaluation of shape/weight for the diagnosis of BED by comparing BED patients who overvalue their shape/weight, BED patients with subclinical levels of overvaluation, BN patients, and sub-threshold BN patients. Whereas clinical overvaluation is nearly universal in patients with BN and even among those with sub-threshold BN, only 60% of BED patients met research convention criteria for clinical overvaluation. When overvaluation of shape/weight was
References (25)
- et al.
Eating disorder NOS (EDNOS): an example of the troublesome “not otherwise specified” (NOS) category in DSM-IV
Behaviour Research and Therapy
(2005) - et al.
The severity and status of eating disorder NOS: implications for DSM-V
Behaviour Research and Therapy
(2007) - et al.
The prevalence and correlates of eating disorders in the NCS Replication
Biological Psychiatry
(2007) - et al.
Binge eating disorder: a need for additional diagnostic criteria
Comprehensive Psychiatry
(2000) - et al.
Prognostic significance of two sub-categorization methods for binge eating disorder: negative affect and overvaluation predict, but do not moderate, specific outcomes
Behaviour Research and Therapy
(2008) - et al.
Recurrent binge eating with and without the “undue influence of weight or shape on self-evaluation”: implications for the diagnosis of binge eating disorder
Behaviour Research and Therapy
(2007) Diagnostic and statistical manual of mental disorders
(1994)- et al.
Dimensional versus categorical classification of mental disorders in the 5th edition of the diagnostic and statistical manual of mental disorders and beyond: comment on special series
Journal of Abnormal Psychology
(2005) - et al.
Assessment of eating disorders: interview or self-report questionnaire?
International Journal of Eating Disorders
(1994) - et al.
The eating disorder examination
Bias and bulimia nervosa: how typical or clinic cases?
American Journal of Psychiatry
Structured clinical interview for DSM-IV Axis I disorders patient-version (SCID-I/P)
Cited by (103)
An inflexible adherence to food rules mediates the longitudinal association between shape/weight overvaluation and binge eating
2024, Journal of Psychiatric ResearchMicrobiota-gut-brain axis drives overeating disorders
2023, Cell MetabolismA model of self-criticism as a transdiagnostic mechanism of eating disorder comorbidity: A review
2022, New Ideas in Psychology
- ☆
Supported by the National Institutes of Health (DK056735, DK49587, DK071646, DK070052, MHDK058820, and MH65919).