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Dissertation
Within-subject variability in weight: characterization and clinical correlates in residential patients with an eating disorder
Doctor of Philosophy (Ph.D.), Drexel University
Sep 2021
DOI:
https://doi.org/10.17918/00000832
Abstract
Although eating disorders (EDs) have long been considered biopsychosocial disorders, the field has typically treated biological and weight-related complications as unfortunate consequences of the psychopathology of EDs. However, a growing body of research shows that weight-related variables may have an influence the development and maintenance of EDs independently of cognitive and affective dysfunctions. A yet-unexplored aspect of weight and weight trajectories in this population is within-subject weight variability (WV; i.e., the magnitude of the fluctuations in weight around the trend line of weight change over time). The current study aimed to explore the construct of WV in a transdiagnostic sample of individuals with EDs receiving treatment for their disorder. Importantly, body weights assessed in the study were collected during a residential stay, where patients are provided with all the food they consume, and both dieting and binge eating are proscribed. We aimed to characterize treatment WV in this sample, and examine how it related to ED pathology and weight trajectory over time (i.e., both during treatment and six months after discharge) in Anorexia Nervosa-spectrum (AN-spectrum) and Bulimia Nervosa-spectrum (BN-spectrum) patients. We calculated WV in two ways: "early treatment WV," using data only from patients' first 16 days in treatment, and "full treatment WV," using weights from the entire length of stay, to test whether the method of calculating WV would impact our results. In both diagnostic subsamples (n = 311 women with AN-spectrum disorders and n = 165 women with BN-spectrum disorders), full treatment WV was greater than early treatment WV (i.e., WV increased over the course of treatment). WV values were similar between diagnostic subgroups. Only full treatment WV was significantly related to pre-treatment ED symptoms, including global ED pathology, purging frequency, and weight suppression in both diagnostic subsamples, and eating concerns and restraint in the AN-spectrum subsample. In the AN-spectrum subsample, higher full treatment WV predicted more weight gain in treatment and at six-month follow up. There were no effects of WV on change in ED symptoms during treatment. As the first investigation into WV in a sample of individuals with EDs, results from this project have important implications for the growing field investigating weight and biological variables on the symptoms and maintenance of EDs. We posit that weight trajectories, including those calculated over a short period of time as in the current study, should be integrated into the understanding of the role of weight regulation in EDs. Results also highlight important methodological considerations for calculating WV and other weight-related variables in ongoing research.
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Details
- Title
- Within-subject variability in weight
- Creators
- Amani D. Piers
- Contributors
- Michael R. Lowe (Advisor)
- Awarding Institution
- Drexel University
- Degree Awarded
- Doctor of Philosophy (Ph.D.)
- Publisher
- Drexel University; Philadelphia, Pennsylvania
- Number of pages
- 86 pages
- Resource Type
- Dissertation
- Language
- English
- Academic Unit
- Psychological and Brain Sciences (Psychology); College of Arts and Sciences; Drexel University
- Other Identifier
- 991015241382104721