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Is past weight loss overlooked in eating disorders?


Weight-loss researchers have long asserted that the more weight a person loses, the harder it is to keep it off.

Yet the focus of eating disorder treatment tends to overlook past weight as an influence on outcomes, report researchers from Drexel University.

"The focus of eating disorder research has very much been on the state of patients' thoughts, beliefs, emotions and personalities," said Michael Lowe, a professor of psychology at Drexel. "And while these mental influences are undoubtedly part of the problem, historically there has been very little focus on how their current and past body weights contribute to their eating disorder."

Weight and eating disorder perpetuation

Lowe's work over the past several years has been largely focused on bulimia, and his studies reveal that having an elevated body weight in the past – as well as having a body weight well below the highest past weight – may cause disordered eating.

His most recent study is the first to address this idea in anorexia, and he says the study "fundamentally changes the assumption that the problem is primarily psychological or emotional."

The research

Using data collected at the Renfrew Center for eating disorders in Philadelphia, the team found that anorexia treatment outcomes depended on how much weight patients had lost from their previous highest weight – a term called "weight suppression" – and how much they currently weigh.

Patients with greater weight suppression were shown to have more severe anorexia symptoms than patients who maintained a weight closer to their highest weight.

Lowe said the research reveals that many anorexic patients actually weighed more than their peers before developing the eating disorder. The findings also suggest that treatment specialists who use weight and BMI when measuring the severity of an eating disorder should also take weight suppression into account.

"The standards for treating anorexia nervosa are all about 'how much weight do they need to gain to meet a minimally healthy body weight for their height,'" Lowe said. "What we've rarely asked, is 'What is this patient's weight history?'"

Source: Drexel University