Clinical Research Unit, Canterbury District Health Board, Christchurch, New Zealand.
Department of Psychological Medicine, University of Otago, Christchurch, New Zealand.
Int J Eat Disord. 2015 Nov;48(7):912-8. doi: 10.1002/eat.22425. Epub 2015 May 22.
The present study sought to replicate the finding of Wildes and Marcus, Behav Res Ther, 50, 266-274, 2012 that higher levels of weight suppression at pretreatment predict greater total weight gain, faster rate of weight gain, and bulimic symptoms amongst patients admitted with anorexia nervosa.
Participants were 56 women with anorexia nervosa diagnosed by using strict or lenient weight criteria, who were participating in a randomized controlled psychotherapy trial (McIntosh et al., Am J Psychiatry, 162, 741-747, 2005). Thirty-five women completed outpatient treatment and post-treatment assessment. Weight suppression was the discrepancy between highest lifetime weight at adult height and weight at pretreatment assessment. Outcome variables were total weight gain, rate of weight gain, and bulimic symptoms in the month prior to post-treatment assessment [assessed using the Eating Disorders Examination (Fairburn et al., Binge-Eating: Nature, Assessment and Treatment. New York: Guilford, 1993)].
Weight suppression was positively associated with total weight gain and rate of weight gain over treatment. Regression models showed that this association could not be explained by covariates (age at onset of anorexia nervosa and treatment modality). Weight suppression was not significantly associated with bulimic symptoms in the month prior to post-treatment assessment, regardless of whether bulimic symptoms were examined as continuous or dichotomous variables.
The present study reinforces the previous finding that weight suppression predicts total weight gain and rate of weight gain amongst patients being treated for anorexia nervosa. Methodological issues may explain the failure of the present study to find that weight suppression predicts bulimic symptoms. Weight suppression at pretreatment for anorexia nervosa should be assessed routinely and may inform treatment planning.
本研究旨在复制 Wildes 和 Marcus 的研究结果，即治疗前体重抑制水平较高的患者在接受神经性厌食症治疗时，体重增加更多、增重速度更快，并伴有更多的暴食症状。
研究参与者为 56 名符合严格或宽松体重标准的神经性厌食症女性患者，她们正在参加一项随机对照心理治疗试验（McIntosh 等人，《美国精神病学杂志》，162,741-747,2005）。其中 35 名女性完成了门诊治疗和治疗后评估。体重抑制是最高终身体重与治疗前评估体重之间的差异。主要结果变量是治疗期间的体重总增加量、增重速度以及治疗后评估前一个月的暴食症状[采用饮食失调检查（Fairburn 等人，《暴食症：自然、评估和治疗》。纽约：吉尔福德，1993）评估]。
体重抑制与治疗期间的体重总增加量和增重速度呈正相关。回归模型显示，这种相关性不能用协变量（神经性厌食症发病年龄和治疗方式）来解释。无论暴食症状是作为连续变量还是二分类变量进行评估，体重抑制与治疗后评估前一个月的暴食症状均无显著相关性。
本研究再次证实了先前的研究结果，即体重抑制预测了接受神经性厌食症治疗的患者的体重总增加量和增重速度。本研究未能发现体重抑制预测暴食症状的原因可能是方法学问题。治疗前的神经性厌食症患者的体重抑制应常规评估，这可能有助于治疗计划的制定。
