title: Weight suppression predicts weight change over 5 years in bulimia nervosa.
abstract: Recent studies suggest that weight suppression (WS), defined as the discrepancy between current and highest past weight, predicts short-term weight gain in bulimia nervosa (BN) during treatment. The current study was designed to build on this preliminary work by examining the relation between WS and long-term weight change in BN. Treatment-seeking women (N=97) with DSM-IV BN participated in a naturalistic longitudinal follow-up study of eating disorders. At intake, height and weight were measured and highest past weight was assessed. Self-reported weights were collected every 6 months for 5 years. Hierarchical Linear Modeling (HLM) estimated growth curves for weight change over time. Significant inter-person variability was detected for intercepts and slopes (P<0.001) so both were treated as random effects. Participants' weights increased over the study course, moderated by baseline WS (P<0.001), such that higher WS predicted more rapid weight gain. Weight change was not associated with entry weight, height, or highest-ever weight, suggesting that WS per se predicted weight change. These findings complement previous short-term studies in BN by demonstrating that WS predicts weight gain over 5 years. Because weight gain could spur radical dieting that maintains BN, these results have important treatment implications.
authors.affiliation: Harris Center, Department of Psychiatry, Massachusetts General Hospital, 2 Longfellow Place, Ste 200, Boston, MA 02114, USA.
authors.forename: David B
authors.initials: DB
authors.lastname: Herzog
authors.forename: J Graham
authors.initials: JG
authors.lastname: Thomas
authors.forename: Andrea E
authors.initials: AE
authors.lastname: Kass
authors.forename: Kamryn T
authors.initials: KT
authors.lastname: Eddy
authors.forename: Debra L
authors.initials: DL
authors.lastname: Franko
authors.forename: Michael R
authors.initials: MR
authors.lastname: Lowe
mesh_terms: D000293:Adolescent; D000328:Adult; D015992:Body Mass Index; D001835:Body Weight / Q000502:physiology*; D052018:Bulimia Nervosa / Q000503:physiopathology* / Q000523:psychology*; D005260:Female; D006801:Humans; D016014:Linear Models; D008137:Longitudinal Studies; D015233:Models, Statistical; D011237:Predictive Value of Tests; D012189:Retrospective Studies; D018709:Statistics, Nonparametric; D011795:Surveys and Questionnaires; D013997:Time Factors; D015431:Weight Loss / Q000502:physiology; D055815:Young Adult
references.citation: Int J Obes Relat Metab Disord. 2003 Feb;27(2):247-52
references.pmid: 12587006
references.citation: J Abnorm Psychol. 1998 May;107(2):263-71
references.pmid: 9604555
references.citation: Arch Gen Psychiatry. 1995 Apr;52(4):304-12
references.pmid: 7702447
references.citation: Arch Gen Psychiatry. 1997 Jun;54(6):509-17
references.pmid: 9193191
references.citation: J Am Acad Child Adolesc Psychiatry. 1999 Jul;38(7):829-37
references.pmid: 10405500
references.citation: Psychol Bull. 1993 Jul;114(1):100-21
references.pmid: 8346324
references.citation: J Abnorm Psychol. 2006 Feb;115(1):62-7
references.pmid: 16492096
references.citation: Annu Rev Nutr. 2001;21:323-41
references.pmid: 11375440
references.citation: Am J Clin Nutr. 2008 Oct;88(4):906-12
references.pmid: 18842775
references.citation: Arch Gen Psychiatry. 1993 Jun;50(6):419-28
references.pmid: 8498876
references.citation: Psychol Med. 1979 Aug;9(3):429-48
references.pmid: 482466
references.citation: Physiol Behav. 2006 Mar 30;87(3):487-92
references.pmid: 16442572
references.citation: Arch Gen Psychiatry. 1981 Apr;38(4):381-9
references.pmid: 6260053
references.citation: J Am Acad Child Adolesc Psychiatry. 1992 Sep;31(5):810-8
references.pmid: 1400111
references.citation: Arch Gen Psychiatry. 1987 Jun;44(6):540-8
references.pmid: 3579500
references.citation: Am J Psychiatry. 2005 Dec;162(12):2263-8
references.pmid: 16330589
references.citation: Int J Eat Disord. 2007 Nov;40(7):640-4
references.pmid: 17607698
references.citation: J Abnorm Psychol. 2008 Nov;117(4):936-40
references.pmid: 19025238
references.citation: Appetite. 2006 Jan;46(1):16-21
references.pmid: 16171898
references.citation: Obes Res. 1998 Sep;6 Suppl 2:51S-209S
references.pmid: 9813653