Past Weight Loss an Overlooked Factor in Disordered Eating

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Researchers who study anorexia nervosa and other eating disorders commonly focus their attention on psychological aspects of these illnesses, including  one’s thought processes, belief structures and emotional changes. This focus makes sense, since these factors heavily determine the development of disordered eating behaviors. However, according to the results of a study published in August 2013 in the Journal of Abnormal Psychology, anorexia risks are also significantly influenced by an individual’s past history of weight loss. Apparently, people who lose a lot of weight before developing anorexia frequently develop more severe forms of the disorder than people who lose relatively small amounts of weight before their anorexia diagnosis.

Anorexia Basics

Doctors in the U.S. can officially diagnose the presence of anorexia in people who fail to keep their body weight within 85 percent of expected levels, lose the ability to accurately judge their body weight and/or body shape, and have an unreasonable fear of becoming “fat,” even when their weight levels fall perilously low. Current evidence indicates that large numbers of people eventually diagnosed with the disorder first lose their weight/shape perspective and develop weight-related fears when classified as obese or overweight. Anorexia is the deadliest mental health disorder known to humankind. In part, it achieves this notorious distinction because it commonly triggers the onset of starvation and serious malnutrition if not fully addressed. When malnutrition sets in, it can produce death by leading to severe dysfunction in the heart, brain, kidneys or other essential organs. In addition, significant numbers of anorexic individuals die by committing suicide.

Known Risk Factors

Genetic predisposition can boost an individual’s chances of developing anorexia by as much as 900 percent, the National Alliance on Mental Illness reports. Other risk factors known to play a role in the disorder’s onset include being a teenager, being female, having a profession that emphasizes physical appearance or physical prowess, the presence of a perfectionist personality and the presence of personality characteristics normally associated with obsessive-compulsive disorder. Social influences also frequently play a significant role in anorexia risks, including such things as peer pressure, social values that emphasize thinness as a beauty ideal, and images in magazines and other forms of media that equate thinness with success or happiness.

The Influence of Prior Weight Loss

In the study published in the Journal of Abnormal Psychology, researchers from Philadelphia’s Drexel University looked at the issue of “weight suppression” as a factor in the development and severity of anorexia. Doctors use this term to refer to the difference between an individual’s current weight and the amount he or she weighed at his or her lifetime peak. The researchers chose to examine this topic because prior research indicated that weight suppression levels play a significant role in a person’s chances of developing another eating disorder called bulimia nervosa. The weight information used in the study was taken from patients of a nationally recognized eating disorder treatment facility in the Philadelphia area.

After reviewing the gathered data, the researchers found that, generally speaking, people who lose relatively large amounts of weight prior to an anorexia diagnosis have more severe forms of the disorder than people who lose relatively small amounts of weight before becoming anorexic. Specific symptoms found to be worse in individuals with high degrees of weight suppression include eating-fixated thought processes, fixations with body shape, levels of depression, menstrual disruption and participation in periodic episodes of binge eating (a behavior normally associated with bulimia, which also occurs in a substantial minority of anorexic people).


The authors of the study published in the Journal of Abnormal Psychology note that the two main measures of anorexia severity are still body weight and a body fat calculation called the body mass index, or BMI. However, they believe that weight suppression information acts as an important secondary anorexia measurement that can significantly improve the ability to predict the severity of the disorder in any given individual. In addition, the authors note that people who lose a lot of weight before developing anorexia may have increased symptom intensity because their bodies “remember” being much heavier, a situation that requires them to put forth extra effort to stay extremely underweight. Understanding of this situation may give future doctors an improved ability to help their patients find a healthy medium between anorexic weight levels and excessive weight levels.



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