Binge eating behaviours, depression and weight control strategies

Abstract

The aim of this paper was to explore the relationships between depressive symptoms and weight control strategies in DSM-IV eating disordered patients with binge eating behaviours. We hypothesised that weight control strategies characterised by a loss of control, such as vomiting and purging, may be clinically associated with increased levels of depression. The study population consisted of 402 consecutive outpatients: 27 with binge eating/purging anorexia nervosa (AN-BN), 213 with purging bulimia nervosa (BN-P), 73 with non-purging bulimia nervosa (BN-NP), and 89 with binge eating disorder (BED). The severity of depression was measured using the Beck Depression Inventory (BDI), and binge eating behaviours were investigated using the self-report scale for bulimic behaviours. In the sample as a whole, the severity of depression significantly correlated with the severity of binge eating behaviours, but no significant differences were found in the severity of depression by diagnostic sub-types. In order to avoid the confounding erasing effect of time, a smaller sample of patients with a short history of binge eating behaviours was further explored. Furthermore, because weight control strategies and the eating disorder diagnostic sub-types overlapped imperfectly, the patients were compared on the basis of presence or absence of strategies reflecting an active attempt to master the weight gain due to bingeing behaviours. The patients adopting active control strategies (N = 14) had significantly less severe depressive symptoms than those adopting non-active weight control strategies (N = 39). Finally, the Authors discuss some hypotheses concerning the defensive role of weight control strategies and the impact of illness duration on the clinical expression of depression in eating disordered patients.