Fisher Sarah M, Friedman J Ingrid, Lowe Michael R
Department of Psychological and Brain Sciences, Drexel University, 3201 Chestnut St., Room 119, Philadelphia, PA, 19104, USA.
Osher Center for Integrative Medicine, University of California San Francisco, San Francisco, USA.
J Eat Disord. 2025 Jun 5;13(1):105. doi: 10.1186/s40337-025-01301-2.
Weight suppression (WS) is associated with many problematic characteristics in individuals with bulimia nervosa (BN). It is theorized that WS contributes to eating disorder (ED) characteristics through the initiation of metabolic and appetitive responses that contribute to dysregulated food intake and weight gain. However, some individuals with BN exhibit little or no WS, and we investigated two possible explanations for this: that low-WS individuals were once weight-suppressed but regained most of the weight they previously lost, or that low-WS individuals never underwent the large weight losses that some of those with BN have shown.
Participants were 453 female patients with BN. We used mixed-model ANOVAs to compare individuals with low and high WS on four weight variables (i.e., premorbid high, postmorbid high, postmorbid low, and current z-BMI). We conducted these analyses using a new, developmentally sensitive measure called developmental weight suppression (DWS).
Our results revealed strikingly different weight histories between low and high WS groups. The high WS groups displayed dramatic weight losses (and only partial weight regain), but the low WS groups demonstrated only modest weight losses and an overall pattern of weight gain over time.
Individuals with BN and low WS do not show the same large and rapid z-BMI losses that are characteristic of most individuals with BN; rather, they show patterns of weight gain that are more characteristic of individuals with BED. Therefore, it may not be appropriate to include individuals who never lost significant weight in studies of WS in BN, as weight suppression would not be relevant to their presentation. Thus, there may be two groups of individuals with BN: those for whom weight suppression is a maintaining factor of binge eating, and those for whom it is not.
体重抑制（WS）与神经性贪食症（BN）患者的许多问题特征相关。理论认为，WS通过引发代谢和食欲反应导致饮食失调（ED）特征，进而导致食物摄入失调和体重增加。然而，一些BN患者几乎没有或完全没有体重抑制现象，我们研究了对此的两种可能解释：低体重抑制个体曾经历体重抑制但已恢复了大部分先前减轻的体重，或者低体重抑制个体从未经历过一些BN患者所表现出的大幅体重减轻。
参与者为453名女性BN患者。我们使用混合模型方差分析，比较低体重抑制和高体重抑制个体在四个体重变量（即病前高体重、病后高体重、病后低体重和当前z - 体重指数）上的差异。我们使用一种新的、对发育敏感的测量方法，即发育性体重抑制（DWS）进行这些分析。
我们的结果显示，低体重抑制组和高体重抑制组的体重史存在显著差异。高体重抑制组表现出显著的体重减轻（且只有部分体重恢复），但低体重抑制组仅表现出适度的体重减轻以及随时间推移总体的体重增加模式。
BN且体重抑制低的个体并未表现出大多数BN个体所特有的大幅且快速的z - 体重指数下降；相反，他们表现出的体重增加模式更像是暴食障碍（BED）个体的特征。因此，在BN的体重抑制研究中纳入从未大幅减重的个体可能不合适，因为体重抑制与他们的表现无关。因此，可能存在两类BN个体：一类体重抑制是暴饮暴食的维持因素，另一类则不是。
