The relationship between binge eating disorder and non-purging bulimia nervosa.
OBJECTIVE
To further investigate the differentiation between non-purging bulimia nervosa (BN-NP) and binge eating disorder (BED), particularly as concerns weight-shape overconcern affecting self-esteem, a core belief to both anorexia and bulimia nervosa.


METHODS
Twenty-five female subjects with BN-NP and 25 female subjects with BED, consecutively referred to the Eating Disorder Unit of the DPPhNB, were administered the BEDCI, the EDI-2 and the BUT.


RESULTS
BED patients had a higher BMI (35.5 vs. 23.8 kg/m2, p<0.0001) and were slightly older than BN-NP ones. Weight-shape concerns as one of the main/the most important things influencing self-esteem were reported by 68% of BN-NP patients and 62.5% of BED ones. Age at onset of binge-eating, weight-cycling, overall impairment due to the eating behavior, sexual harassment, depressive and substance abuse comorbidity were equally represented in the two groups of patients. BN-NP patients scored higher than BED ones as regards EDI drive for thinness (p<0.05) and BUT weight phobia (p<0.05), with these scores significantly related to differences in BMI (p<0.0005 and p=0.012). Weight-shape overconcern influencing self-esteem was predictive of an earlier onset of binge-eating (p<0.05) and higher scores at the BUT weight phobia, and body image concerns (p<0.05).


CONCLUSIONS
Differences between BED and BN-NP seem to be more of degree than type and there seems little value in the separation between BED and BN-NP based on weight-shape concerns that substantially impair self-esteem. This construct seems core to both disorders and plays a substantial role in triggering and maintaining the binge-eating cycle.
Ramacciotti
C E
CE
Department of Psychiatry, Pharmacology, Neurobiology and Biotechnologies, DPPhNB, Section of Psychiatry, University of Pisa, Italy. carlarama@hotmail.com
Coli
E
E
Paoli
R
R
Gabriellini
G
G
Schulte
F
F
Castrogiovanni
S
S
Dell'Osso
L
L
Garfinkel
P E
PE
D017668:Age of Onset; D001828:Body Image; D015992:Body Mass Index; D052018:Bulimia Nervosa / Q000523:psychology*; D005260:Female; D006801:Humans; D010698:Phobic Disorders / Q000523:psychology*; D012649:Self Concept; D014839:Vomiting / Q000523:psychology*