Shared psychopathology in obese subjects with and without binge-eating disorder.
OBJECTIVE
To investigate obese people with/without binge-eating Disorder (BED) in terms of shared psychopathological features pertaining to spectrum of eating disorders.


METHODS
One-hundred obese adult patients with a BMI > 30 kg/m(2) referred to an Eating Disorder Unit and/or hospital weight-loss programs were administered the BED Clinical Interview, the Eating Disorder Inventory, and the Structured Clinical Interview for Anorexic-Bulimic Spectrum, Self-Report.


RESULTS
Twenty-seven subjects satisfied DSM-IV research criteria for current BED; compared to nonbingeing obese subjects, BED ones were characterized by greater weight-shape concerns influencing self-esteem (p = .05), overall impairment due to the overweight condition (p < .005), psychological distress leading to professional help (p < .001), dichotomous reasoning (p = .01) and secondary social phobia due to the overweight condition (p < .005). Compared to the other group, BED obese subjects scored higher at the following EDI subscales: bulimia (p < .0001), ineffectiveness (p < .01), interoceptive awareness and social insecurity (p < .05).


CONCLUSIONS
The results of this study highlight the role of cognitive mechanisms such as dichotomous reasoning and weight-shape concerns unduly influencing self-esteem as a hallmark of BED in obese patients, and the importance of investigating eating disorder psychopathology by adopting a dimensional perspective, rather than strictly focusing on categories when dealing with obese patients.
Department of Psychiatry, Pharmacology, Neurobiology and Biotechnologies, Section of Psychiatry, University of Pisa, Italy. carlarama2001@hotmail.com
Carla E
CE
Ramacciotti
Elisabetta
E
Coli
Emi
E
Bondi
Annalisa
A
Burgalassi
Gabriele
G
Massimetti
Liliana
L
Dell'osso
D000328:Adult; D001290:Attitude; D001526:Behavioral Symptoms; D001828:Body Image; D052018:Bulimia Nervosa / Q000175:diagnosis / Q000523:psychology*; D003071:Cognition; D003430:Cross-Sectional Studies; D039721:Diagnostic and Statistical Manual of Mental Disorders; D005260:Female; D006801:Humans; D007558:Italy; D008297:Male; D008960:Models, Psychological; D009765:Obesity / Q000175:diagnosis / Q000523:psychology*; D012649:Self Concept; D013315:Stress, Psychological / Q000523:psychology