Examining weight suppression as a predictor and moderator of intervention outcomes in an eating disorder and obesity prevention trial: A replication and extension study

Abstract

Weight suppression (WS) predicts future weight gain and increases in eating disorder symptoms in community and clinical samples but has received minimal attention in obesity and eating disorder prevention programs. In a sample of emerging adults (N = 364) in a randomized controlled trial evaluating two obesity and eating disorder prevention interventions versus a control condition, this study aimed to replicate the findings that WS and its interaction with baseline BMI predict increases in weight and eating disorder symptoms and test a novel hypothesis that WS would moderate the effects of the interventions on change in weight and eating disorder symptoms. Participants completed assessments at baseline, post-intervention, 6-, 12-, and 24-months. WS was calculated as the difference between highest lifetime weight and baseline weight. WS interacted with baseline BMI to predict greater weight gain over 24-months, such that those with high WS and lower baseline BMI gained weight most rapidly. WS did not predict eating disorder symptom change and did not moderate the effects of the prevention programs. Given that individuals with WS are at increased risk for weight gain, expressly targeting this high-risk population with evidence-based obesity prevention programs may be useful. CLINICALTRIALS.GOV REGISTRATION: NCT01680224.

Keywords: Eating disorders; Obesity; Prevention; Weight gain; Weight suppression.

Conflict of interest statement

Declarations of interest: The authors declare no conflicts of interest.

Copyright © 2021 Elsevier Ltd. All rights reserved.

Figures

Fig 1

Weight change over 24 months by baseline WS and BMI. Note. WS = weight suppression (square-root transformed); Low values are 1 SD below the mean: WS: 0.55 kg, BMI: 20.82 kg/m2; High values are 1 SD above the mean: WS: 2.89 kg, BMI: 26.11 kg/m2