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Weight History May Be Vital to Bulimia Treatment

In a new study, researchers discovered a majority of women with bulimia nervosa reach their highest-ever body weight after developing their eating disorder — even though bulimia is characterized overall by significant weight loss.

The study concludes that exploring a woman’s weight history and the course of the eating disorder will improve productive discussion of weight and weight history, and thus improve treatments.

“Most patients lose a lot of weight as part of developing this disorder, and all dedicate significant effort, including the use of extreme behaviors, to prevent weight gain,” said doctoral student Jena Shaw, lead author of the study.

“In spite of this, we found that most women also regain a lot of weight while they have bulimia. We want to find out why that is.”

Shaw and her colleagues examined data from two study populations of women with bulimia. One group of 78 women were studied over two years, the other group of 110 women were interviewed at six-month intervals for eight years.

“Most of the women we studied reached their highest weight ever after developing bulimia and before remission,” Shaw said.

A total of 59 percent of women in the two-year study population, and 71.6 percent of women in the eight-year study population, showed this weight history pattern. These weights were even higher than their weights before developing bulimia, despite the fact that their pre-bulimia weights were overall already higher than average.

Investigators also studied why some women reach their highest weight after onset of bulimia, while others obtain their highest weight before development of the eating disorder.

In the course of the study, researchers discovered women who reached a new highest weight during bulimia had generally developed the disorder at an earlier age, and struggled with it for a longer period of time.

Investigators believe these findings demonstrate the importance of weight and weight history in the outcomes and treatment of bulimia.

“Bulimia nervosa was first medically described in 1979 among patients whose body weight generally appeared ‘normal,’ but who, in most cases, had weighed substantially more in the past,” said researcher Michael Lowe, Ph.D. “Yet relatively few studies have considered weight history or the fear of becoming overweight again as a possible perpetuating factor for the disorder.”

Researchers are learning that another personal variable can influence the development of eating disorders.

Dr. Michael Lowe believes “weight suppression” — the difference between a person’s past highest weight and her current weight — is an important indicator for bulimia as most people with bulimia have higher weight suppression values than their peers without bulimia.

Studies have shown correlations between higher weight suppression in bulimic women and undesired outcomes including greater likelihood of dropping out of treatment, less likelihood of abstaining from binge/purge behaviors, greater weight gain and longer time to remission.

The new study, by Drexel University researchers is published online in the International Journal of Eating Disorders.

Source: Drexel University

Weight History May Be Vital to Bulimia Treatment

Rick Nauert PhD

Rick Nauert, PhDDr. Rick Nauert has over 25 years experience in clinical, administrative and academic healthcare. He is currently an associate professor for Rocky Mountain University of Health Professionals doctoral program in health promotion and wellness. Dr. Nauert began his career as a clinical physical therapist and served as a regional manager for a publicly traded multidisciplinary rehabilitation agency for 12 years. He has masters degrees in health-fitness management and healthcare administration and a doctoral degree from The University of Texas at Austin focused on health care informatics, health administration, health education and health policy. His research efforts included the area of telehealth with a specialty in disease management.

APA Reference
Nauert PhD, R. (2018). Weight History May Be Vital to Bulimia Treatment. Psych Central. Retrieved on December 3, 2020, from
Scientifically Reviewed
Last updated: 8 Aug 2018 (Originally: 1 Mar 2012)
Last reviewed: By a member of our scientific advisory board on 8 Aug 2018
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