Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Review
. 2019 Sep 1:208:112565.
doi: 10.1016/j.physbeh.2019.112565. Epub 2019 May 30.

Examining weight suppression as a transdiagnostic factor influencing illness trajectory in bulimic eating disorders

Pamela K Keel  1 , Lindsay P Bodell  2 , K Jean Forney  3 , Jonathan Appelbaum  4 , Diana Williams  5
Affiliations
Review

Examining weight suppression as a transdiagnostic factor influencing illness trajectory in bulimic eating disorders

Pamela K Keel et al. Physiol Behav. .

Abstract

Recent research indicates that weight suppression (WS: defined as the difference between highest lifetime and current weight) prospectively predicts illness trajectory across eating disorders characterized by binge eating, including AN binge-purge subtype (ANbp), bulimia nervosa (BN), and binge eating disorder (BED), collectively referred to as bulimic eating disorders. Through a series of studies, we have developed a model to explain the link between WS and illness trajectory in bulimic eating disorders. Our model posits that WS contributes to reduced circulating leptin, which leads to reduced postprandial glucagon-like peptide 1 (GLP-1) response. Diminished leptin and GLP-1 function contribute to alterations in two reward-related constructs in the Research Domain Criteria (RDoC): reward value/effort and reward satiation. Respectively, these changes increase drive/motivation to consume food and decrease ability for food consumption to lead to a state of satiation/satisfaction. Combined, these alterations increase risk for experiencing large, out-of-control binge-eating episodes. The following review presents evidence that contributed to the development of this model as well as preliminary findings from an on-going project funded to test this model.

PubMed Disclaimer

Figures

Figure 1.
Figure 1.
Explanatory Model for Association between WS and Bulimic Eating Disorder Maintenance
See this image and copyright information in PMC

References

    1. Lowe MR. The effects of dieting on eating behavior: a three-factor model. Psychol Bull. July 1993;114(1):100–121. - PubMed
    1. Lowe MR, Piers AD, Benson L. Weight Suppression in Eating Disorders: a Research and Conceptual Update. Curr Psychiatry Rep. August 28 2018;20(10):80. - PubMed
    1. National Institute of Mental Health. Definitions of the RDoC Domains and Constructs. 2018; https://www.nimh.nih.gov/research-priorities/rdoc/definitions-of-the-rdo.... Accessed November 11, 2018.
    1. American Psychiatric Association. Diagnostic and Statistical Manual of Mental Disorders, 5th Edition (DSM-5) Washington, DC: American Psychiatric Publishing, Incorporated; 2013.
    1. Keel PK, Brown TA, Holland LA, Bodell LP. Empirical classification of eating disorders. Annu Rev Clin Psychol. 2012;8:381–404. - PubMed

Publication types