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Psychiatry Res. 2010 May 30;177(3):330-4. doi: 10.1016/j.psychres.2010.03.002. Epub 2010 Apr 15.

Weight suppression predicts weight change over 5 years in bulimia nervosa.

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  • 1Harris Center, Department of Psychiatry, Massachusetts General Hospital, 2 Longfellow Place, Ste 200, Boston, MA 02114, USA.


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.

Copyright 2010 Elsevier Ireland Ltd. All rights reserved.

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