Preoccupation with shape or weight, fear of weight gain, feeling fat and treatment outcomes in patients with anorexia nervosa: A longitudinal study

Calugi S, El Ghoch M, Conti M, Dalle Grave R (2018) Preoccupation with shape or weight, fear of weight gain, feeling fat and treatment outcomes in patients with anorexia nervosa: A longitudinal study. Behav Res Ther 105:63-68. doi:https://doi.org/10.1016/j.brat.2018.04.001


Highlights

  • Little is known about the role of body-image concern in anorexia nervosa patients.
  • Preoccupation with shape or weight predicted improvement of eating concern.
  • Change in fear of weight gain was associated with improvement in dietary restraint.
  • BMI ≥18.5 at follow-up was predicted by body-image concern components
  • It is important to address body-image concern in patients with anorexia nervosa.

Abstract

Objective

The study aimed to evaluate the trajectories of change over time in body-image concern components in patients with anorexia nervosa treated by means of intensive enhanced cognitive behavioural therapy. Moreover, it aimed to study the role of body-image concern components in changes in eating and general psychopathology as well as work and social functioning.

Method

Sixty-six adult patients with anorexia nervosa were recruited. Body mass index (BMI); Eating Disorder Examination ‘Dietary Restraint’ and ‘Eating Concern’ subscales; Brief Symptom Inventory (BSI); and Work and Social Adjustment Scale (WSAS) scores were recorded at admission, end of treatment, and at 6- and 12-month follow-ups. The trajectories of change of three components of body image concern, namely ‘preoccupation with shape or weight’, ‘fear of weight gain’ and ‘feeling fat’, were assessed.

Results

The treatment was associated with a significant improvement in outcome variables and body-image concern components. Baseline ‘preoccupation with shape or weight’ predicted improvement in Eating Concern, BSI and WSAS scores, while the change in ‘fear of weight gain’ was associated with improvement in dietary restraint. Baseline and end-of-therapy scores for all three measured body-image concern components predicted achievement of BMI ≥18.5 kg/m2 at 6- and 12-month follow-ups.

Discussion

These findings highlight the importance of assessing and addressing body-image concern in the management of patients with anorexia nervosa.

Keywords

  • Body image;
  • Preoccupation with shape or weight;
  • Feeling fat;
  • Fear of weight gain;
  • Inpatient treatment;
  • Cognitive behavioural therapy