Dissertation
Developmental weight suppression and current z-BMI among individuals with anorexia-spectrum eating disorders: relationships with eating disorder and general psychopathology
Doctor of Philosophy (Ph.D.), Drexel University
May 2026
DOI:
https://doi.org/10.17918/00011499
Abstract
Most individuals with anorexia nervosa lose a substantial amount of weight in the process of developing their ED, leaving them in a state of significant weight suppression (WS). The relatively recent formal recognition of atypical anorexia nervosa has prompted an upsurge in studies comparing AAN with both the restricting and binge-purge subtypes of AN. Past research has found that WS is associated with various psychological and behavioral symptoms of AN-spectrum EDs. Additionally, several studies have found significant interactions between an individual's WS and BMI on eating disorder characteristics. However, these studies have not measured WS using the Developmental Weight Suppression (DWS) measure, a developmentally sensitive, superior operationalization of the original construct of WS. Further, past studies have not explored whether an individual's AN-spectrum diagnosis interacts with WS and current BMI in their associations with psychopathology. Therefore, this study explored how DWS, current z-BMI (BMI z-score), and their interaction relate to measures of ED and general psychopathology in AN-spectrum diagnostic groups. We used an archival dataset of 1,277 female patients with AN-spectrum EDs who presented to a residential ED treatment facility. Of these, 980 patients were eligible for study inclusion. In the final sample, based on diagnostic criteria determined by researchers, 277 participants were diagnosed with AN-R, 83 participants with AN-R in partial remission, 355 participants with AN-BP, 130 participants with AN-BP in partial remission, and 135 participants with AAN. Analyses examined how DWS, current z-BMI, and their two-way interaction relate to psychological measures of ED psychopathology (eating concern, restraint, shape concern, and weight concern), behavioral measures of ED psychopathology (frequency of self-induced vomiting, laxative use, and objective binge episodes), and general psychopathology (depressive and anxiety-related symptoms). While significant interactions between DWS and z-BMI were not found, several positive relationships between these two variables and measures of ED psychopathology emerged. Somewhat surprisingly, these relationships were only found in the AN-R and AN-BP groups, and no significant relationships were found among those with AAN. This finding adds novel nuance to the field's understanding of the relationships between weight-related variables and ED psychopathology, as these relationships may markedly differ between diagnostic groups.
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Details
- Title
- Developmental weight suppression and current z-BMI among individuals with anorexia-spectrum eating disorders
- Creators
- Johanne Ingrid Friedman Singhal
- Contributors
- Michael R. Lowe (Advisor)
- Awarding Institution
- Drexel University
- Degree Awarded
- Doctor of Philosophy (Ph.D.)
- Publisher
- Drexel University
- Number of pages
- viii, 61 pages
- Resource Type
- Dissertation
- Language
- English
- Academic Unit
- Psychological and Brain Sciences (Psychology); College of Arts and Sciences; Drexel University
- Other Identifier
- 991022193297204721