Loss of control eating with and without the undue influence of weight or shape on self-evaluation: evidence from an adolescent population

BACKGROUND The overvaluation of weight and/or shape ("overvaluation"), a diagnostic criterion for anorexia nervosa and bulimia nervosa, is increasingly supported for inclusion in the Diagnostic and Statistical Manual of Mental Disorders 5th Edition (DSM-5) criteria of binge eating disorder (BED). However, current evidence has been largely confined to adult populations. The current study aims to examine the status of overvaluation among adolescents with loss of control (LOC) eating recruited from a large, population-based sample. METHOD Subgroups of female adolescents - LOC eating with overvaluation (n = 30); LOC eating without overvaluation (n = 58); obese no LOC eating ("obese control") (n = 36); and "normal-weight control" (normal-weight, no LOC eating) (n = 439) - recruited from secondary schools within the Australian Capital Territory (ACT) were compared on measures of eating disorder psychopathology, general psychological distress and quality of life. RESULTS Participants in the LOC eating with overvaluation subgroup reported significantly higher levels of eating disorder psychopathology than all other groups, while levels did not differ between participants in the LOC eating without overvaluation and obese control subgroups. On measures of distress and quality of life there were no significant differences between LOC eating with and without overvaluation subgroups. Both reported significantly greater distress and quality of life impairment than normal-weight controls. LOC eating with overvaluation participants had significantly higher levels of distress and quality of life impairment than obese controls, whereas scores on these measures did not differ between LOC eating without overvaluation and obese control subgroups. CONCLUSION The results suggest that the presence of overvaluation among adolescents with LOC eating indicates a more severe disorder in terms of eating disorder psychopathology, however may not indicate distress and disability as clearly as it does among adults with BED.