Journal Article

Predictive significance of the overvaluation of shape/weight in obese patients with binge eating disorder: findings from a randomized controlled trial with 12-month follow-up

White, M. A., Wilson, G. T., Gueorguieva, R., Grilo, C. M., Masheb, R. M.

2013

Overview

Undue influence of body shape or weight on self-evaluation - referred to as overvaluation - is considered a core feature across eating disorders, but is not a diagnostic requirement for binge eating disorder (BED). This study examined the concurrent and predictive significance of overvaluation of shape/weight in obese patients with BED participating in a randomized clinical trial testing cognitive behavioral therapy (CBT) and behavioral weight loss (BWL). Method A total of 90 participants were randomly assigned to 6-month group treatments of CBT or BWL. Assessments were performed at baseline, throughout- and post-treatment, and at 6- and 12-month follow-ups after completing treatments with reliably administered semi-structured interviews and established measures. Participants categorized with overvaluation (n = 52, 58%) versus without overvaluation (n = 38, 42%) did not differ significantly in demographic features (age, gender and ethnicity), psychiatric co-morbidity, body mass index or binge eating frequency. The overvaluation group had significantly greater levels of eating disorder psychopathology and poorer psychological functioning (higher depression and lower self-esteem) than the non-overvaluation group. Overvaluation of shape/weight significantly predicted non-remission from binge eating and higher frequency of binge eating at the 12-month follow-up, even after adjusting for group differences in depression and self-esteem levels. Our findings suggest that overvaluation does not simply reflect concern commensurate with being obese or more frequent binge eating, but also is strongly associated with heightened eating-related psychopathology and psychological distress, and has negative prognostic significance for longer-term treatment outcomes. Overvaluation of shape/weight warrants consideration as a diagnostic specifier for BED as it provides important information about severity and treatment outcome.

• Publisher: Cambridge University Press
• Subject: Adult / Adult and adolescent clinical studies / Age / Binge eating / Binge-Eating Disorder - psychology / Binge-Eating Disorder - therapy / Biological and medical sciences / Body Image - psychology / Body mass index / Body shape / Body weight / Clinical outcomes / Clinical research / Clinical trials / Cognitive behavioral therapy / Cognitive behaviour therapy / Cognitive Therapy / Cognitive-behavioral factors / Disorders / Eating behavior disorders / Eating disorders / Ethnicity / Female / Groups / Humans / Male / Medical sciences / Mental depression / Metabolic diseases / Middle Aged / Miscellaneous / Morbidity / Obese people / Obesity / Obesity - psychology / Original Articles / Patients / Prognosis / Psychological distress / Psychological functioning / Psychology. Psychoanalysis. Psychiatry / Psychopathology / Psychopathology. Psychiatry / Psychotherapy / Remission (Medicine) / Self Concept / Self esteem / Self evaluation / Self image / Self-Assessment / Selfesteem / Treatment methods / Treatment Outcome / Treatment outcomes / Weight loss / Weight Reduction Programs