Weight suppression as a predictor of weight gain and response to intensive behavioral treatment in patients with anorexia nervosa

Previous studies have documented that weight suppression (a person’s highest adult weight minus current weight) predicts weight gain and disordered eating symptoms during treatment of bulimia spectrum disorders, but no research has examined weight suppression in individuals with anorexia nervosa (AN). Thus, this study sought to characterize weight suppression in a large sample of patients with AN (N = 185), and to evaluate whether weight suppression at admission for intensive behavioral treatment predicts weight gain and clinical outcomes at discharge. Weight suppression varied from 0 kg to78 kg (M [SD] = 17.1 [10.8] kg) in AN patients. Higher levels of weight suppression predicted greater total weight gain, a faster rate of weight gain, and bulimic symptoms during intensive treatment even after controlling for body mass index on admission, length and type of intensive treatment received, restricting versus binge-eating/purging AN subtype, and other predictors of study outcomes. These findings converge with previous research documenting the clinical significance of weight suppression in the treatment of eating disorders. Future work is needed to replicate the current findings, and examine whether weight suppression predicts the course of AN following discharge from intensive treatment.

► We examined the effects of weight suppression on treatment of anorexia nervosa.
► There was considerable variation in weight suppression in anorexia nervosa patients.
► Weight suppression predicted larger and faster weight gains and bulimic symptoms.
► Effects remained after controlling for admission BMI and other covariates.
► Weight suppression may have clinical utility in anorexia as well as bulimia nervosa.