Weight concern, including fear of weight gain and sensitivity to weight gain, is indicative of disordered eating in individuals with underweight or healthy weight. It is unknown, however, whether or how these constructs present in individuals with excess weight, particularly among those with binge-eating disorder (BED). This study sought to characterize fear of weight gain and sensitivity to weight gain and examine their relationship with disordered eating and depression symptoms, in individuals seeking weight loss treatment, both with and without BED.
Adults seeking weight loss treatment in an urban primary care clinic (N = 131) completed the Eating Disorder Examination interview and Beck Depression Inventory. Height and weight were collected.
Clinical levels of fear of weight gain and sensitivity to weight gain were present in this sample. Individuals with BED reported experiencing fear of weight gain (48.6%), significantly more than those without BED (20.9%); both groups reported similar and clinically elevated sensitivity to weight gain. Both constructs were related to greater levels of disordered eating and depression symptoms, at times based on BED status. Fear of weight gain was associated with overvaluation of weight and shape for those without BED only. Objective and subjective bulimic episodes were unrelated to fear of weight gain or sensitivity to weight gain, regardless of BED status.
Fear of weight gain and sensitivity to weight gain were common in this sample and may be maladaptive, as evidenced by associations with elevated eating psychopathology. Future studies should examine these variables within larger samples and should employ longitudinal designs.
Level of evidence
Level III: case–control analytic study.
This is a preview of subscription content, log in to check access.
Buy single article
Instant access to the full article PDF.
Price includes VAT for USA
Subscribe to journal
Immediate online access to all issues from 2019. Subscription will auto renew annually.
This is the net price. Taxes to be calculated in checkout.
The datasets generated during and/or analyzed during the current study are available from the senior author on reasonable request.
American Psychological Association (ed) (2013) Diagnostic and statistical manual of mental disorders, 5th edn. American Psychiatric Association, Washington, DC
Attia E (2010) Anorexia nervosa: current status and future directions. Annu Rev Med 61:425–435. https://doi.org/10.1146/annurev.med.050208.200745
Fairburn CG, Cooper Z, Shafran R (2003) Cognitive behaviour therapy for eating disorders: a “transdiagnostic” theory and treatment. Behav Res Ther 41(5):509–528. https://doi.org/10.1016/s0005-7967(02)00088-8
Fairburn CG, Cooper Z (1993) The eating disorder examination. In: Fairburn CG, Wilson GT (eds) Binge eating: nature, assessment, and treatment, 12th edn. Guilford Press, New York, pp 317–360
Berg KC, Peterson CB, Frazier P, Crow SJ (2012) Psychometric evaluation of the eating disorder examination and eating disorder examination-questionnaire: a systematic review of the literature. Int J Eat Disord 45(3):428–438. https://doi.org/10.1002/eat.20931
Grilo CM, Masheb RM, Lozano-Blanco C, Barry DT (2004) Reliability of the eating disorder examination in patients with binge eating disorder. Int J Eat Disord 35(1):80–85. https://doi.org/10.1002/eat.10238
Grilo CM, Masheb RM, Wilson GT (2001) Different methods for assessing the features of eating disorders in patients with binge eating disorder: a replication. Obes Res 9(7):418–422. https://doi.org/10.1038/oby.2001.55
Rodgers RF, DuBois R, Frumkin MR, Robinaugh DJ (2018) A network approach to eating disorder symptomatology: do desire for thinness and fear of gaining weight play unique roles in the network? Body Image 27:1–9. https://doi.org/10.1016/j.bodyim.2018.07.004
Linardon J, Phillipou A, Castle D, Newton R, Harrison P, Cistullo LL, Griffiths S, Hindle A, Brennan L (2018) The relative associations of shape and weight over-evaluation, preoccupation, dissatisfaction, and fear of weight gain with measures of psychopathology: an extension study in individuals with anorexia nervosa. Eat Behav 29:54–58. https://doi.org/10.1016/j.eatbeh.2018.03.002
Levinson CA, Zerwas S, Calebs B, Forbush K, Kordy H, Watson H, Hofmeier S, Levine M, Crosby RD, Peat C, Runfola CD, Bulik CM (2017) The core symptoms of bulimia nervosa, anxiety, and depression: a network analysis. J Abnorm Psychol 126(3):340–354. https://doi.org/10.1037/abn0000254
Goldschmidt AB, Aspen VP, Sinton MM, Tanofsky-Kraff M, Wilfley DE (2008) Disordered eating attitudes and behaviors in overweight youth. Obesity (Silver Spring) 16(2):257–264. https://doi.org/10.1038/oby.2007.48
Killen JD, Taylor CB, Hayward C, Haydel KF, Wilson DM, Hammer L, Kraemer H, Blair-Greiner A, Strachowski D (1996) Weight concerns influence the development of eating disorders: a 4-year prospective study. J Consult Clin Psychol 64(5):936–940. https://doi.org/10.1037/0022-006x.64.5.936
Taylor CB, Altman T (1997) Priorities in prevention research for eating disorders. Psychopharmacol Bull 33(3):413–417
Hudson JI, Hiripi E, Pope HG Jr, Kessler RC (2007) The prevalence and correlates of eating disorders in the National Comorbidity Survey Replication. Biol Psychiatry 61(3):348–358. https://doi.org/10.1016/j.biopsych.2006.03.040
Grilo CM (2013) Why no cognitive body image feature such as overvaluation of shape/weight in the binge eating disorder diagnosis? Int J Eat Disord 46(3):208–211. https://doi.org/10.1002/eat.22082
Grilo CM, Hrabosky JI, White MA, Allison KC, Stunkard AJ, Masheb RM (2008) Overvaluation of shape and weight in binge eating disorder and overweight controls: refinement of a diagnostic construct. J Abnorm Psychol 117(2):414–419. https://doi.org/10.1037/0021-843x.117.2.414
Grilo CM, White MA, Gueorguieva R, Wilson GT, Masheb RM (2013) Predictive significance of the overvaluation of shape/weight in obese patients with binge eating disorder: findings from a randomized controlled trial with 12-month follow-up. Psychol Med 43(6):1335–1344. https://doi.org/10.1017/s0033291712002097
Linardon J (2017) Correlates of the over-evaluation of weight and shape in binge eating disorder and mixed eating disorder samples: a meta-analytic review. Eat Disord 25(3):183–198. https://doi.org/10.1080/10640266.2016.1260374
Thomas JJ, Vartanian LR, Brownell KD (2009) The relationship between eating disorder not otherwise specified (EDNOS) and officially recognized eating disorders: meta-analysis and implications for DSM. Psychol Bull 135(3):407–433. https://doi.org/10.1037/a0015326
Heinberg L, Haythornthwaite J, Rosofsky W, McCarron P, Clarke A (2000) Body image and weight loss maintenance in elderly African American hypertensives. Am J Health Behav 24(3):163–173. https://doi.org/10.5993/AJHB.24.3.1
Wilkinson L, Pacanowski CR, Levitsky D (2017) Three-year follow-up of participants from a self-weighing randomized controlled trial. J Obes 2017:4956326. https://doi.org/10.1155/2017/4956326
Butryn ML, Phelan S, Hill JO, Wing RR (2007) Consistent self-monitoring of weight: a key component of successful weight loss maintenance. Obesity (Silver Spring) 15(12):3091–3096. https://doi.org/10.1038/oby.2007.368
Zheng Y, Klem ML, Sereika SM, Danford CA, Ewing LJ, Burke LE (2015) Self-weighing in weight management: a systematic literature review. Obesity (Silver Spring) 23(2):256–265. https://doi.org/10.1002/oby.20946
Goldschmidt AB, Hilbert A, Manwaring JL, Wilfley DE, Pike KM, Fairburn CG, Striegel-Moore RH (2010) The significance of overvaluation of shape and weight in binge eating disorder. Behav Res Ther 48(3):187–193. https://doi.org/10.1016/j.brat.2009.10.008
Beck AT, Steer RA, Brown GK (1987) Manual for revised beck depression inventory. Psychological Corporation, New York
Beck AT, Steer R, Garbin MG (1988) Psychometric properties of the Beck Depression Inventory 25 years of evaluation. Clin Psychol Rev 8:77–100. https://doi.org/10.1016/0272-7358(88)90050-5
Barnes RD, Ivezaj V, Martino S, Pittman BP, Paris M, Grilo CM (2018) Examining motivational interviewing plus nutrition psychoeducation for weight loss in primary care. J Psychosom Res 104:101–107. https://doi.org/10.1016/j.jpsychores.2017.11.013
Barnes RD, White MA, Martino S, Grilo CM (2014) A randomized controlled trial comparing scalable weight loss treatments in primary care. Obesity (Silver Spring) 22(12):2508–2516. https://doi.org/10.1002/oby.20889
Field AP (ed) (2013) Discovering statistics using IBM SPSS statistics: and sex and drugs and rock ‘n’ roll, 4th edn. Sage, Los Angeles
Sauer B, Brookhart MA, Roy JA et al (2013) Covariate Selection, in Developing a Protocol for Observational Comparative Effectiveness Research: A User’s Guide, Velentgas P et al (ed), Rockville (MD)
Grilo CM, Masheb RM, Crosby RD (2012) Predictors and moderators of response to cognitive behavioral therapy and medication for the treatment of binge eating disorder. J Consult Clin Psychol 80(5):897–906. https://doi.org/10.1037/a0027001
Gallagher KM, Updegraff JA (2012) Health message framing effects on attitudes, intentions, and behavior: a meta-analytic review. Ann Behav Med 43(1):101–116. https://doi.org/10.1007/s12160-011-9308-7
Ort A, Fahr A (2018) Using efficacy cues in persuasive health communication is more effective than employing threats—an experimental study of a vaccination intervention against Ebola. Br J Health Psychol 23(3):665–684. https://doi.org/10.1111/bjhp.12310
Puhl R, Luedicke J, Lee Peterson J (2013) Public reactions to obesity-related health campaigns: a randomized controlled trial. Am J Prev Med 45(1):36–48. https://doi.org/10.1016/j.amepre.2013.02.010
Murray SB, Strober M, Craske MG, Griffiths S, Levinson CA, Strigo IA (2018) Fear as a translational mechanism in the psychopathology of anorexia nervosa. Neurosci Biobehav Rev 95:383–395. https://doi.org/10.1016/j.neubiorev.2018.10.013
This study was supported by the National Institutes of Health (NIH). Dr. Barnes has received research Grants: R03-DK10400801A1 and K23-DK092279. NIH had no role in the study design, collection, analysis and interpretation of data, in the writing of the report, or in the decision to submit the article for publication.
Conflict of interest
On behalf of all authors, the corresponding author states that there is no conflict of interest.
All procedures performed in studies involving human participants were in accordance with the ethical standards of the Yale Human Investigation Committee (i.e., Institutional Research Board) (#1106008713) and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards.
Informed consent was obtained from all individual participants included in the study.
Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.
About this article
Cite this article
Bullock, A.J., Barber, J. & Barnes, R.D. Characterizing fear of weight gain and sensitivity to weight gain in individuals seeking weight loss treatment. Eat Weight Disord (2020). https://doi.org/10.1007/s40519-020-00862-2
- Fear of weight gain
- Sensitivity to weight gain
- Binge-eating disorder