Lifetime Weight Course as a Phenotypic Marker of Severity and Therapeutic Response in Patients with Eating Disorders

• Main Authors: Zaida Agüera, Cristina Vintró-Alcaraz, Isabel Baenas, Roser Granero, Isabel Sánchez, Jéssica Sánchez-González, José M. Menchón, Susana Jiménez-Murcia, Janet Treasure, Fernando Fernández-Aranda
• Format: Article
• Language: English
• Published: MDPI AG 2021-06-01
• Series: Nutrients
• Subjects: body mass index (BMI) profiles; eating disorders; obesity; treatment outcome
• Online Access: https://www.mdpi.com/2072-6643/13/6/2034

The association between lifetime weight fluctuations and clinical characteristics has been widely studied in populations with eating disorders (ED). However, there is a lack of literature examining the potential role of weight course as a transdiagnostic factor in ED so far. Therefore, the aim of this study is to compare ED severity and treatment outcomes among four specific BMI profiles based on BMI-trajectories across the lifespan: (a) persistent obesity (OB-OB; (<i>n</i> = 74)), (b) obesity in the past but currently in a normal weight range (OB-NW; <i>n</i> = 156), (c) normal weight throughout the lifespan (NW-NW; <i>n</i> = 756), and (d) current obesity but previously at normal weight (NW-OB; <i>n</i> = 314). Lifetime obesity is associated with greater general psychopathology and personality traits such as low persistence and self-directedness, and high reward dependence. Additionally, greater extreme weight changes (NW-OB and OB-NW) were associated with higher psychopathology but not with greater ED severity. Higher dropout rates were found in the OB-OB group. These results shed new light on the BMI trajectory as a transdiagnostic feature playing a pivotal role in the severity and treatment outcome in patients with ED.