Skip to main content

Thank you for visiting nature.com. You are using a browser version with limited support for CSS. To obtain the best experience, we recommend you use a more up to date browser (or turn off compatibility mode in Internet Explorer). In the meantime, to ensure continued support, we are displaying the site without styles and JavaScript.

  • Original Article
  • Published:

Disordered eating behaviours and cognitions in young women with obesity: relationship with psychological status

Abstract

Objective:

To examine levels of eating disorder behaviours and cognitions of young women with obesity in the Australian Capital Territory, Australia and assess the impact upon psychological status.

Design:

General population cross-sectional survey.

Subjects:

A total of 4891 young women from the community aged 18–42 years, of which 630 were in the obese weight range.

Measurements:

Body mass index (BMI), eating disorder psychopathology (eating disorder examination questionnaire), and psychological distress (K-10).

Results:

Women with obesity had significantly higher levels of dietary restraint, eating concern, weight concern, shape concern, binge eating, misuse of diuretics, use of diet pills and fasting compared to other women in the community. These eating disorder cognitions and behaviours were associated with increased levels of psychological distress. In women with obesity, eating concern, weight concern, shape concern, dietary restraint and decreased age predicted psychological distress in a multivariate model. Among other women in the community, behaviours such as laxative misuse, ‘hard’ exercise and subjective bulimic episodes also contributed to the model predicting psychological distress.

Conclusion:

As disordered eating psychopathology is high in young obese women and negatively impacts upon psychological status, obesity prevention and treatment should consider eating disorder psychopathology and mental health outcomes.

This is a preview of subscription content, access via your institution

Access options

Buy this article

Prices may be subject to local taxes which are calculated during checkout

Similar content being viewed by others

References

  1. Australian Bureau of Statistics (ABS). Health risk factors in Australia 2001,Cat.no. 2812.0. ABS: Canberra Australia, 2003.

  2. Aalto-Setala T, Matrunnen M, Tuulio-Henriksson A, Poikolainen K, Lonnqvist J . One-month prevalence of depression and other DSM-IV disorders among young adults. Psychol Med 2001; 31: 791–801.

    Article  CAS  Google Scholar 

  3. Ghaderi A, Scott B . Prevalence, incidence and prospective risk factors for eating disorders. Acta Psychol Scand 2001; 104: 122–130.

    Article  CAS  Google Scholar 

  4. Hay PJ . The epidemiology of eating disorder behaviours: An Australian community-based survey. Int J Eat Disorder 1998; 23: 371–382.

    Article  CAS  Google Scholar 

  5. Pawluck DE, Gorey, KM . Secular trends in the incidence of anorexia nervosa. Int J Eat Disorder 1998; 23: 347–352.

    Article  CAS  Google Scholar 

  6. Keel PK, Haedt A, Edler C . Purging disorder: an ominous variant of bulimia nervosa? Int J Eat Disorder 2005; 38: 191–199.

    Article  Google Scholar 

  7. Pearlstein T . Eating disorders and comorbidity. Archive of Womens Mental Health 2002; 4: 67–78.

    Article  Google Scholar 

  8. Wardle J, Waller J, Ropoprt L . Body dissatisfaction and binge eating in obese women: role of restraint and depression. Obes Res 2001; 9: 778–787.

    Article  CAS  Google Scholar 

  9. Schwartz M, Brownell K . Obesity and body image. Body image 2004; 1: 43–56.

    Article  Google Scholar 

  10. Vander Wal JS, Thelen MH . Eating and body image concerns among obese and average weight children. Addictive Behaviours 2000; 25: 775–778.

    Article  CAS  Google Scholar 

  11. Ikeda JP, Lyons P, Schawartzman F, Mitchell RA . Self reported dieting experiences of women with body mass indexes of 30 or more. J Am Diet Asso 2004; 104: 972–974.

    Article  Google Scholar 

  12. Broberg AG, Hjalmers I, Nevonen L . Eating disorders, attachment and interpersonal difficulties: A comparison between 18 to 24 year old patients and normal controls. Eur Eat Disord Rev 2001; 9: 381–396.

    Article  Google Scholar 

  13. Wabitsch M . Overweight and obesity in European children: definition and diagnostic procedures, risk factors and consequences for later health outcome. Eur J Pediatr 2000; 159 (suppl): S8–S13.

    Article  Google Scholar 

  14. Graci S, Izzo G, Saviono S, Cattani L, Lezzi G, Berselli ME et al. Weight cycling and cardiovascular risk factors in obesity. Int J Obes 2004; 28: 65–71.

    Article  CAS  Google Scholar 

  15. Friedman KE, Reichmann SK, Costanzo PR, Musante G . Body image partially mediates the relationship between obesity and psychological distress. Obes Res 2002; 10: 33–41.

    Article  Google Scholar 

  16. Wadden T, Phelan S . Assessment of quality of life in obese individuals. Obes Res 2002; 10 Supplementary: 50S–57S.

    Article  Google Scholar 

  17. Onyike CU, Crum RM, Lee HB, Lyketsos CG, Eaton WW . Is obesity associated with major depression? Results from the third national health and nutrition examination survey. Am J Epidemiol 2003; 158: 1139–1147.

    Article  Google Scholar 

  18. Hill AJ, Williams J . Psychological health in a non-clinical sample of obese women. Int J Obes 1998; 22: 578–583.

    Article  CAS  Google Scholar 

  19. Musante GJ, Costanso PR, Friedman KE . The comorbidity of depression and eating dysregulation processes in a diet-seeking obese population: a matter of gender specificity. Int J Eat Disorder 1998; 23: 65–75.

    Article  CAS  Google Scholar 

  20. Hsu LKG, Mulliken B, McDonagh B, Krupa Das S, Rand W, Fairburn CG et al. Binge eating disorder in extreme obesity. Int J Obes 2002; 26: 1398–1403.

    Article  CAS  Google Scholar 

  21. Pinaquy S, Chabrol H, Simon C, Louvet JP, Barbe P . Emotional eating, alexithymia and binge-eating disorder in obese women. Obes Res 2003; 11: 195–201.

    Article  Google Scholar 

  22. Sanchéz-Johnsen LAP, Dymek M, Alverdy J, Grange DL . Binge eating and eating related cognitions and behaviour in ethnically diverse obese women. Obe Res 2003; 11: 1002–1009.

    Article  Google Scholar 

  23. Jackson TD, Grilo CM, Masheb RM . Teasing history, onset of obesity, current eating disorder psychopathology, body dissatisfaction and psychological functioning in binge eating disorder. Obes Res 2000; 8: 451–458.

    Article  CAS  Google Scholar 

  24. Nauta H, Hospers HJ, Jansen A, Kok G . Cognitions in obese binge eaters and obese non binge eaters. Cognitive Ther Res 2000; 24: 521–531.

    Article  Google Scholar 

  25. Mitchell JE, Mussell MP . Comorbidity and binge eating disorder. Addictive Behaviours 1995; 20: 725–732.

    Article  CAS  Google Scholar 

  26. Yanovski SZ, Nelson JE, Dubbert BK, Spitzer RL . Association of binge eating disorder and psychiatric comorbidity in obese subjects. Am J Psychiat 1993; 150: 1472–1479.

    Article  CAS  Google Scholar 

  27. Yanovski SZ . Binge eating disorder and obesity in 2003: could treating and eating disorder have a positive effect on the obesity epidemic? Int J Eat Disorder 2003; 34: S117–S120.

    Article  Google Scholar 

  28. Mond JM, Hay PJ, Rodgers B, Owen C . Eating Disorder Examination Questionnaire (EDE-Q): norms for young adult women. Behav Res Ther 2006; 44: 53–62.

    Article  CAS  Google Scholar 

  29. Mond JM, Hay PJ, Rodgers B, Owen C, Beumont PJV . Validity of the eating disorder examination questionnaire (EDE-Q) in screening for eating disorders in community samples. Behav Res Ther 2004; 42: 551–567.

    Article  CAS  Google Scholar 

  30. National health and medical research. Clinical practice guidelines for the management of overweight and obesity in adults. Commonwealth of Australia: Canberra, 2003.

  31. Beglin SJ, Fairburn CG . Evaluation of a new instrument for the detection of eating disorders. Psychiat Res 1992; 44: 191–201.

    Article  CAS  Google Scholar 

  32. Fairburn CG, Cooper Z . The eating disorder examination. In: Fairburn CG, Wilson GT (eds). Binge Eating: Nature Assessment and Treatment, 12th ed. Guilford Press: New York, 1993, pp 317–360.

    Google Scholar 

  33. Mond JM, Hay PJ, Rodgers B, Owen C, Beumont PJV . Temporal stability of the eating disorder examination questionnaire (EDE-Q). Int J Eat Disorder 2004; 36: 195–203.

    Article  Google Scholar 

  34. Andrews G, Slade T . Interpreting scores on the Kessler Psychological Distress Scale. Aust NZ J Publ Heal 2001; 25: 494–497.

    Article  CAS  Google Scholar 

  35. Mond JM, Hay PJ, Rodgers B, Owen C, Beumont PJV . Assessing quality of life in eating disorder patients. Qual Life Res 2005; 14: 171–178.

    Article  CAS  Google Scholar 

  36. Stunkard AJ, Sorensen TIA . Obesity and socioeconomic status-a complex relationship. New Engl J Med 1993; 329: 1036–1037.

    Article  CAS  Google Scholar 

  37. Fairburn CG, Harrison PJ . Eating Disorders. Lancet 2003; 361: 407–416.

    Article  Google Scholar 

  38. Minniti A, Bissoli L, Di Francesco V, Olivieri M, Mandragona R, Mazzali G et al. The relationship between body image and quality of life in treatment seeking overweight women. Eating and Weight Disorders 2004; 9: 206–210.

    Article  CAS  Google Scholar 

  39. De Zwann M, Mitchell JE, Howell M, Monson N, Swan-Kremeier L, Roerig JL et al. Two measures of health related quality of life in morbid obesity. Obes Res 2002; 10: 1143–1151.

    Article  Google Scholar 

  40. Shaw K, O'Rourke P, Del Mar C, Kenardy J . Psychological interventions for overweight or obesity. Cochrane Database Sys Rev 2005; Issue 2. Art. No.: CD003818. DOI:10.1002/14651858.CD003818.pub2.

  41. Hay PJ, Bacaltchuk J, Stefano S . Psychotherapy for bulimia nervosa and binging. Cochrane Database Sys Rev 2004; Issue 3. Art. No.: CD000562. DOI:10.1002/14651858.CD000562.pub2.

Download references

Acknowledgements

This research was assisted with funding from the NSW Institute of Psychiatry in the form of a research training fellowship for Jonathan Mond. A funding grant was also received from the Australian Capital Territory Department of Health and Community Care.

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to A Darby.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Darby, A., Hay, P., Mond, J. et al. Disordered eating behaviours and cognitions in young women with obesity: relationship with psychological status. Int J Obes 31, 876–882 (2007). https://doi.org/10.1038/sj.ijo.0803501

Download citation

  • Received:

  • Revised:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1038/sj.ijo.0803501

Keywords

This article is cited by

Search

Quick links