Binge status as a predictor of weight loss treatment outcome

OBJECTIVE: A widely held clinical belief is that individuals with binge eat ing problems fare poorly in weight loss programs. The empirical evidence re garding the prognostic significance of binge eating, however, is mixed. The goals of this study were to examine psychological and behavioral character istics associated with binge eating and the prognostic significance of bing e eating for short- and long-term weight loss in a large sample of women tr eated for obesity. DESIGN: The dataset used in the current study was a combined sample of wome n (n = 444) who participated in one of three behavioral weight loss researc h studies. MATERIALS AND METHOD: Measures of dieting and weight history were obtained at baseline. Body weight, the Binge Eating Scale (BES), a measure of percei ved barriers to weight loss, the Beck Depression Inventory, the Block Food Frequency Questionnaire, and the Paffenbarger Physical Activity Questionnai re were assessed at baseline, 6 months and 18 months. Regression analyses e xamined cross-sectional associations between the BES and the other variable s at baseline, prospective associations between baseline BES and changes in weight and the psychological and behavioral variables over time, and tempo ral covariations between BES and the other variables over time. RESULTS: Cross-sectional analyses showed baseline binge eating status to be strongly associated with dieting history, weight cycling, depressive sympt omatology and perceived barriers to weight loss. Women with binge eating pr oblems were also more likely to drop out of treatment. Baseline binge statu s was not associated with 6-month weight loss, but was weakly predictive of less weight loss success at 18 months. Binge status at baseline did not pr edict changes in dietary intake, physical activity, perceived barriers to w eight loss or depressive symptomatology at either 6 months or 18 months. In time-dependent covariance analyses, changes in BES scores were significant ly associated with changes in body weight, independent of changes in dietar y intake and physical activity. However, when depression scores are include d in the analysis, the association between binge score and body weight was no longer statistically significant. CONCLUSION: These findings suggest that baseline binge status was a weak pr ognostic indicator of success in women who are moderately obese and are see king treatment for weight loss. Although assessments of binge status covary with weight loss and regain, the relationship appears to be mediated by ps ychological dysphoria.