Department of Psychiatry, UCSF Weill Institute for Neurosciences, University of California, San Francisco, 3333 California Street, LH Suite 245, Box 0503, San Francisco, CA 94143 USA.
Department of Psychiatry and Behavioral Sciences, University of Miami Miller School of Medicine, Miami, FL USA ; Department of Psychiatry and Psychology, Mayo Clinic School of Medicine, Rochester, MN USA.
J Eat Disord. 2016 Jul 27;4:21. doi: 10.1186/s40337-016-0111-5. eCollection 2016.
Weight suppression (WS), which is the difference between a patient's highest and current weight, has been associated with bulimic symptom severity in adults with bulimia nervosa (BN). However, the impact of WS on eating disorder psychopathology in youth with BN is unknown.
Participants included 85 youth with DSM-5 BN who presented for outpatient treatment. Current WS was calculated as the difference between highest and current body mass index z-score (BMIz), while greatest WS was the difference between highest and lowest BMIz, both assessed at participants' current height. Separate multivariable linear regressions were conducted to determine if current or greatest WS was significantly associated with frequency of binge eating, compensatory behaviors, or dietary restraint. A secondary analysis was conducted on youth ages 16 and older, given the limitation of assessing WS at current height in younger participants with greater height instability.
Youth with higher levels of greatest WS (but not current WS) were older, had a longer duration of illness, and reported greater weight and shape concern. When adjusting for BMIz, neither current nor greatest WS was significantly associated with bulimic behaviors or dietary restraint in the full sample. However, in the subset of youth ages 16 and older, current WS moderated the effect of BMIz on binge eating and compensatory behaviors. For youth with high WS, those with a high current BMIz engaged in more frequent binge eating than those with low current BMIz, and the negative impact of BMIz on compensatory behaviors became weaker.
Our findings suggest that WS is clinically relevant in the presentation of youth with BN, and that it may need to be addressed as one important factor in BN psychopathology. Future studies using growth charts to determine historically highest and lowest BMIz may help to further elucidate the link (or lack thereof) between WS and BN psychopathology in youth.
体重抑制（WS）是指患者的最高体重与当前体重之间的差异，与神经性贪食症（BN）成年患者的暴食症状严重程度有关。然而，WS 对 BN 青少年患者饮食障碍心理病理的影响尚不清楚。
参与者包括 85 名符合 DSM-5 标准的 BN 青少年，他们因门诊治疗而就诊。当前 WS 计算为最高和当前体质指数 z 分数（BMIz）之间的差异，而最大 WS 则为最高和最低 BMIz 之间的差异，均在参与者当前身高下评估。分别进行多元线性回归，以确定当前或最大 WS 是否与暴食频率、补偿行为或饮食限制显著相关。由于在身高变化较大的年轻参与者中，只能在当前身高下评估 WS，因此对年龄在 16 岁及以上的青少年进行了二次分析。
最大 WS 水平较高的青少年年龄较大、患病时间较长，并且报告的体重和体型担忧更严重。在调整 BMIz 后，当前和最大 WS 均与整个样本中的暴食行为或饮食限制无显著相关性。然而，在年龄在 16 岁及以上的青少年亚组中，当前 WS 调节了 BMIz 对暴食和补偿行为的影响。对于 WS 较高的青少年来说，那些当前 BMIz 较高的青少年比那些当前 BMIz 较低的青少年更频繁地发生暴食行为，而 BMIz 对补偿行为的负面影响变得较弱。
我们的研究结果表明，WS 在 BN 青少年患者的表现中具有临床相关性，它可能需要作为 BN 心理病理的一个重要因素加以解决。未来使用生长图表来确定历史上最高和最低 BMIz 的研究可能有助于进一步阐明 WS 与 BN 青少年心理病理之间的联系（或缺乏联系）。
