Harris Center, Department of Psychiatry, Massachusetts General Hospital, 2 Longfellow Place, Ste 200, Boston, MA 02114, USA.
Psychiatry Res. 2010 May 30;177(3):330-4. doi: 10.1016/j.psychres.2010.03.002. Epub 2010 Apr 15.
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.
最近的研究表明，体重抑制（WS）定义为当前体重与过去最高体重之间的差异，可预测神经性贪食症（BN）治疗期间的短期体重增加。本研究旨在通过检查 WS 与 BN 长期体重变化之间的关系，对这一初步研究进行扩展。接受治疗的患有 DSM-IV BN 的女性（N=97）参加了进食障碍的自然主义纵向随访研究。在入组时，测量了身高和体重，并评估了过去的最高体重。自我报告的体重每 6 个月收集一次，为期 5 年。分层线性模型（HLM）估计了体重随时间的变化曲线。截距和斜率存在显著的个体间差异（P<0.001），因此两者均被视为随机效应。参与者的体重在研究过程中增加，受基线 WS 的调节（P<0.001），即较高的 WS 预示着体重增加更快。体重变化与进入时的体重、身高或过去的最高体重无关，表明 WS 本身就可以预测体重变化。这些发现补充了 BN 之前的短期研究，表明 WS 可预测 5 年内的体重增加。由于体重增加可能会刺激维持 BN 的激进节食，因此这些结果具有重要的治疗意义。
