Overvaluation is the term used to describe an emphasis on body image and the influence of this valuation on a person’s self-esteem. In some psychological problems related to eating, such as anorexia nervosa and bulimia, overvaluation is one of the diagnostic criteria and helps clinicians identify the symptomology of the problem.
However, for binge eating (BED), overvaluation is not currently listed as a diagnostic and clinical feature. But should it be? That was the question asked by Carlos M. Grilo, PhD, a Professor of Psychiatry and Director of the Program for Obesity, Weight, and Eating Research (POWER) at the Yale University School of Medicine in Connecticut. Grilo recently chose to explore how overvaluation affected treatment outcome in a way that has not been examined before.
Existing research on BED and overvaluation has only looked at brief follow-ups to determine overall progress. Grilo decided instead to follow up for an entire year after an intensive six month group treatment for BED. He assessed 90 participants before they began either cognitive behavioral therapy (CBT) or behavioral weight loss therapy (BWL). Grilo interviewed them again at the end of the 12-month follow-up period
Grilo found that the 58% of participants who presented with high levels of overvaluation had worse outcomes when compared to those without overvaluation behaviors. This finding persisted even when Grilo accounted for self-esteem and depression. The lower response rate and poorer outcomes in the overvaluation participants were evidenced by more episodes of binge eating and persistent overvaluation.
Grilo believes that this research demonstrates the clinical significance of overvaluation in the diagnosis and treatment of BED. Although this research cannot determine whether it warrants inclusion in the DSM-V, it does suggest that overvaluation should be considered as a subcategory or distinctive feature of BED that has bearing on treatment outcome. Grilo added, “The presence of this cognitive feature could signal to clinicians a more disturbed variant of BED, thus alerting them to patients who might require greater attention.”
Grilo, C. M., et al. (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. Psychological Medicine 43.6 (2013): 1335-44. ProQuest. Web.
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