Abstract
Whereas the manifestation of body image disturbance in binge eating disorder (BED) has been intensively investigated concerning the cognitive–affective component, with regard to the behavioral and the perceptual components of body image disturbance in BED, research is limited and results are inconsistent. Therefore, the present study assessed body image disturbance in BED with respect to the different components of body image in a sample of obese females (n = 31) with BED compared to obese females without an eating disorder (n = 28). The Eating Disorder Inventory-2, the Eating Disorder Examination-Questionnaire, the Body Image Avoidance Questionnaire and the Body Checking Questionnaire as well as a Digital Photo Distortion Technique based on a picture of each participant taken under standardized conditions were employed. Using two-sample t tests, we found that the participants with BED displayed significantly greater impairments concerning the cognitive–affective component of body image than the control group. Concerning the behavioral component, participants with BED reported more body checking and avoidance behavior than the controls, but group differences failed to reach significance after the Bonferroni corrections. Regarding the perceptual component, a significant group difference was found for the perceived “ideal” figure, with the individuals suffering from BED displaying a greater wish for a slimmer ideal figure than the control group. These results support the assumption that body image disturbance is a relevant factor in BED, similar to other eating disorders.
Similar content being viewed by others
References
American Psychiatric Association (2013) Diagnostic and statistical manual of mental disorders, 5th edn. American Psychiatric Publishing, Arlington
American Psychiatric Association (2000) Diagnostic and statistical manual of mental disorders, 4th edn. American Psychiatric Publishing, Arlington
Grucza RA, Przybeck TR, Cloninger CR (2007) Prevalence and correlates of binge eating disorder in a community sample. Compr Psychiat 48:124–131. doi:10.1016/j.comppsych.2006.08.002
Spitzer R, Devlin M, Walsh B, Hasin D, Wing R, Marcus M, Stunkard A, Wadden T, Yanovski S, Agras S, Mitchell J, Nonas C (1992) Binge eating disorder: a multisite field trial of the diagnostic criteria. Int J Eat Disord 11:191–203. doi:10.1002/1098-108X(199204)11:3<191:AID-EAT2260110302>3.0.CO;2-S
Kessler RC, Berglund PA, Chiu WT, Deitz AC, Hudson JI, Shahly V, Aguilar-Gaxiola S et al (2013) The prevalence and correlates of binge eating disorder in the world health organization world mental health surveys. Biol Psychiatry 73:904–914. doi:10.1016/j.biopsych.2012.11.020
Ahrberg M, Trojca D, Nasrawi N, Vocks S (2011) Body image disturbance in binge eating disorder. A review. Eur Eat Disord Rev 19:375–381. doi:10.1002/erv.1100
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 48:187–193. doi:10.1016/j.brat.2009.10.008
Wonderlich SA, Gordon KH, Mitchell JE, Crosby RD, Engel SG (2009) The validity and clinical utility of binge eating disorder. Int J of Eat Disord 42:687–705. doi:10.1002/eat.20719
Slade P (1994) What is body image? Behav Res Ther 32:497–502. doi:10.1016/0005-7967(94)90136-8
Tuschen-Caffier B, Voegele C, Bracht S, Hilbert A (2003) Psychological responses to body shape exposure in patients with bulimia nervosa. Behav Res Ther 41:573–586. doi:10.1016/S0005-7967(02)00030-X
Vocks S, Legenbauer T, Waechter A, Wucherer M, Kosfelder J (2007) What happens in the course of body exposure? Emotional, cognitive, and physiological reactions to mirror confrontation in eating disorders. J Psychosom Res 62:231–239. doi:10.1016/j.jpsychores.2006.08.007
Reas D, Whisenhunt B, Netemeyer R, Williamson D (2002) Development of the body checking questionnaire: a self-report measure of body checking behaviors. Int J Eat Disord 31:324–333. doi:10.1002/eat.10012
Shafran R, Fairburn CG, Robinson P, Lask B (2003) Body checking and its avoidance in eating disorders. Int J Eat Disord 35:93–101. doi:10.1002/eat.10228
Rosen J, Srebnik D, Saltzberg E, Wendt S (1991) Development of a body image avoidance questionnaire. J Consult Clin Psych 3:32–37. doi:10.1037/1040-3590.3.1.32
Farrell C, Lee M, Shafran R (2005) Assessment of body size estimation: a review. Eur Eat Disord Rev 13:75–88. doi:10.1002/erv.622
Vocks S, Legenbauer T, Rueddel H, Troje N (2007) Static and dynamic body image in bulimia nervosa: mental representation of body dimensions and motion patterns. Int J Eat Disord 40:59–66. doi:10.1002/eat.20336
Cash TF, Deagle EA (1997) The nature and extent of body-image disturbance in anorexia nervosa and bulimia nervosa: a meta-analysis. In J Eat Disord 22:107–125. doi:10.1002/(SICI)1098-108X(199709)22:23.0.CO;2-J
Hilbert A, Tuschen-Caffier B (2005) Body-related cognitions in binge-eating disorder and bulimia nervosa. J Soc Clin Psychol 24:561–579. doi:10.1521/jscp.2005.24.4.561
Wilfley DE, Schwartz MB, Spurrell EB, Fairburn CG (2000) Using the eating disorder examination to identify the specific psychopathology of binge eating disorder. Int J Eat Disord 27:259–269. doi:10.1002/(SICI)1098-108X(200004)27:3<259:AID-EAT2>3.0.CO;2-G
Barry DT, Grilo CM, Masheb RM (2003) Comparison of patients with bulimia nervosa, obese patients with eating disorder, and non obese patients with binge eating disorder. J Nerv Ment Dis 191:589–594
Grilo CM, Masheb RM, White MA (2010) Significance of overvaluation of shape/weight in binge-eating disorder: comparative study with overweight and bulimia nervosa. Obesity 18:499–504. doi:10.1038/oby.2009.280
Allison KC, Grilo CM, Masheb RM, Stunkard AJ (2005) Binge eating disorder and night eating syndrome: a comparative study of disordered eating. J Consult Clin Psych 73(6):1107–1115. doi:10.1037/0022-006X.73.6.1107
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 117:414–419. doi:10.1037/0021-843X.117.2.414
Mond JM, Hay PJ, Rodgers B, Owen C (2006) Recurrent binge eating with and without the “undue influence of weight or shape on self-evaluation”: implications for the diagnosis of binge eating disorder. Behav Res Ther 45:929–938. doi:10.1016/j.brat.2006.08.011
Nauta H, Hospers H, Jansen A, Kok G (2000) Cognitions in obese binge eaters and obese non-binge eaters. Cogn Ther Res 5:521–531. doi:10.1023/A:1005510027890
Pearl RL, White MA, Grilo CM (2014) Overvaluation of shape and weight as a mediator between self-esteem and weight bias internalization among patients with binge eating disorder. Eat Behav 15(2):259–261. doi:10.1016/j.eatbeh.2014.03.005
Fichter MN, Quadflieg N, Brandl B (1993) Recurrent overeating: an empirical comparison of binge-eating disorders, bulimia nervosa, and obesity. Int J Eat Disord 14:1–16. doi:10.1002/1098-108X(199307)14:1<1:AID-EAT2260140102>3.0.CO;2-3
Bautista-Diaz ML, Franco-Paredes K, Mancilla-Diaz JM, Alvarez-Rayon G, Lopez-Aguilar X, Ocampo Tellez-Giron T, Soto-Gonzalez Y (2012) Body dissatisfaction and socio-cultural factors in women with and without BED: their relation with eating psychopathology. Eat Weight Disorders: EWD 17(2):e86–e92. doi:10.3275/8243
Mussell MP, Peterson CB, Weller CL, Crosby RD, de Zwaan M, Mitchell JE (1996) Differences in body image and depression among obese women with and without binge eating. Obes Res 4:431–438. doi:10.1002/j.1550-8528.1996.tb00251.x
Reas DL, Grilo CM, Masheb RM, Wilson GT (2005) Body checking and avoidance in overweight patients with binge eating disorder. Int J Eat Disord 37:342–346. doi:10.1002/eat.20092
Legenbauer T, Vocks S, Betz S, Báguena Puigcerver MJ, Benecke A, Troje NF, Rueddel H (2011) Differences in the nature of body image disturbances between female obese individuals with versus without a comorbid binge eating disorder: an exploratory study including static and dynamic aspects of body image. Behav Modif 35:162–186. doi:10.1177/0145445510393478
Sorbara M, Geliebter A (2002) Body image disturbance in obese outpatients before and after weight loss in relation to race, gender, binge eating, and age of onset of obesity. Int J Eat Disord 31:416–421. doi:10.1002/eat.10046
Schwartz MB, Brownell KD (2004) Obesity and body image. Body Image 1:43–56. doi:10.1016/S1740-1445(03)00007-X
Stice E, Presnell K, Spangler D (2002) Risk factors for binge eating onset in adolescent girls: a 2-year prospective investigation. Health Psychol 21:131–138. doi:10.1037/0278-6133.21.2.131
First MB, Spitzer RL, Gibbon M, Williams JBW (1996) Structured Clinical Interview for DSM-IV Axis I Disorders, Clinician Version (SCID-CV) American Psychiatric Press Inc., Washington D.C
Wittchen HU, Zaudig M, Fydrich T (1997) Strukturiertes Klinisches Interview fuer DSM-IV Achse I und II. Hogrefe, Goettingen
Cooper MJ, Fairburn CF (1987) The eating disorder examination: a semi-structured interview for the assessment of the specific psychopathology of eating disorders. Int J Eat Disord 6:485–494. doi:10.1002/1098-108X(198701)6:1<1:AID-EAT2260060102>3.0.CO;2-9
Hilbert A, Tuschen-Caffier B (2006) Eating disorder examination, Deutschsprachige Uebersetzung. Verlag fuer Psychotherapie, Muenster
Garner DM (1991) Eating disorder inventory-2. Professional Manual. Psychological assessment resources, Odessa FL
Paul T, Thiel A (2005) Eating Disorder Inventory-2, Deutsche Version. Hogrefe, Goettingen
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 317–332
Hilbert A, Tuschen-Caffier B, Karwautz A, Niederhofer H, Munsch S (2007) Eating disorder examination-questionnaire. Evaluation der deutschsprachigen Uebersetzung. Diagnostica 53:144–154. doi:10.1026/0012-1924.50.2.98
Legenbauer T, Vocks S, Schuett-Stroemel S (2007) Validierung einer deutschsprachigen Version des Body Image Avoidance Questionnaire BIAQ. Diagnostica 53:218–225. doi:10.1026/0012-1924.53.4.218
Vocks S, Moswald C, Legenbauer T (2008) Psychometrische Ueberpruefung einer Deutschsprachigen Fassung des Body Checking Questionnaire (BCQ). Z Kl Psych Psychoth 37:131–140. doi:10.1026/1616-3443.37.2.131
Beck A, Steer R (1987) Manual for the revised beck depression inventory. The Psychological Corporation, San Antonia
Hautzinger M, Bailer M, Worall H, Keller F (1994) Beck-depressions-inventar (BDI). Testhandbuch, 2nd edn. Huber, Bern
Ferring D, Filipp SH (1996) Messung des Selbstwertgefuehls: befunde zu Reliabilitaet, Validitaet und Stabilitaet der Rosenberg-Skala. Diagnostica 42:284–292
Rosenberg M (1965) Society and the adolescent self-image, rev edn. Wesleyan University Press, Middletown
Derogatis LR (1977) SCL-90-R, administration, scoring & procedures manual-I for the R(evised) version. John Hopkins University School of Medicine
Klaghofer R, Braehler E (2001) Konstruktion und teststatistische Pruefung einer Kurzform der SCL-90-R [Development and psychometric evaluation of a short version oft he Symptom Check-List-90-R]. Z Klin Psychol Psychiatr Psychother 49:115–124
Vocks S, Legenbauer T, Heil A (2007) Food intake affects state body image: impact of restrained eating patterns and concerns about eating, weight and shape. Appetite 49:467–475. doi:10.1016/j.appet.2007.03.006
Brodie DA, Slade PD (1988) The relationship between body-image and body-fat in adult women. Psychol Med 18:623–631. doi:10.1017/S0033291700008308
Cohen J (1988) Statistical power analysis for the behavioral sciences, 2nd edn. Lawrence Erlbaum Associates, Hillsdale
De Zwaan M, Mitchell JE, Seim HC, Specker SM, Pyle RL, Raymond NC, Crosby RB (1994) Eating related and general psychopathology in obese females with binge-eating disorders. Int J Eat Disord 15:43–52. doi:10.1002/1098-108X(199401)15:1<43:AID-EAT2260150106>3.0.CO;2-6
Kuehnel RH, Wadden TA (1994) Binge-eating disorder, weight cycling, and psychopathology. Int J Eat Disord 15:321–329. doi:10.1002/eat.2260150403
Vocks S, Legenbauer T, Troje N, Schulte D (2006) Koerperbildtherapie bei Essstoerungen: beeinflussung der perzeptiven, kognitiv-affektiven und behavioralen Koerperbildkomponente. [Body image therapy in eating disorders: Interaction of the perceptual, cognitive-affective and behavioral body image components]. Z Kl Psych Psychoth 35:286–295. doi:10.1026/1616-3443.35.4.286
Jacobi C, Paul T, de Zwaan M, Nutzinger DO, Dahme B (2004) The specificity of self-concept disturbances in eating disorders. Int J Eat Disord 35:1–7. doi:10.1002/eat.10240
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 months follow-up. Psychol Med 43:1335–1344. doi:10.1017/S0033291712002097
Fairburn CG, Cooper Z, Shafran R (2003) Cognitive behavior therapy for eating disorders: a “transdiagnostic” theory and treatment. Behav Res Ther 41:509–528. doi:10.1016/S0005-7967(02)00088-8
Telch CF, Stice E (1998) Psychiatric comorbidity in women with binge eating disorder: prevalence rates from a non-treatment seeking sample. J Consult Clin Psych 66:768–776. doi:10.1037/0022-006X.66.5.768
Fairburn CG, Stice E, Cooper Z, Doll HA, Norman PA, O’Connor ME (2003) Understanding persistence in bulimia nervosa: a 5-year naturalistic study. J Consult Clin Psych 71:103–109. doi:10.1037/0022-006X.71.1.103
Jacobi C, Hayward C, de Zwaan M, Kraemer HC, Agras S (2004) Coming to terms with risk factors for eating disorders: application of risk terminology and suggestion for a general taxonomy. Psychol Bull 130:19–65. doi:10.1037/0033-2909.130.1.19
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 46:208–2011. doi:10.1002/eat.22082
Dingemans AE, Spinhoven P, van Furth EF (2007) Predictors and mediators of treatment outcome in patients with binge eating disorder. Behav Res Ther 45:551–2562. doi:10.1016/j.brat.2007.06.003
Vocks S, Tuschen-Caffier B, Pietrowsky R, Rustenbach SJ, Kersting A, Herpertz S (2010) Meta-analysis on the effectiveness of psychological and pharmacological treatments for binge eating disorder. Int J Eat Disord 43:205–217. doi:10.1002/eat.20696
Delinsky SS, Wilson GT (2006) Mirror exposure for the treatment of body image disturbance. Int J Eat Disord 39:108–116. doi:10.1002/eat.20207
Dingemans AE, Van Furth EF (2012) Binge eating disorder psychopathology in normal weight and obese individuals. Int J Eat Disord 45:135–138. doi:10.1002/eat.20905
Simmons JP, Nelson LD, Simonsohn U (2011) False-positive psychology: undisclosed flexibility in data collection and analysis allows presenting anything as significant. Psychol Sci 22:1359–1366. doi:10.1177/0956797611417632
Grilo CM, Ivezaj V, White MA (2015) Evaluation of the DSM-5 severity indicator for binge eating disorder in a community sample. Behav Res Ther 66:72–76. doi:10.1016/j.brat.2015.01.004
Author information
Authors and Affiliations
Corresponding author
Ethics declarations
Conflict of interest
There is no conflict of interest to be disclosed on this paper.
Ethical approval
The study was approved of by the ethic commission of the Ruhr-University, Bochum.
Informed consent
All participants have given informed consent.
Rights and permissions
About this article
Cite this article
Lewer, M., Nasrawi, N., Schroeder, D. et al. Body image disturbance in binge eating disorder: a comparison of obese patients with and without binge eating disorder regarding the cognitive, behavioral and perceptual component of body image. Eat Weight Disord 21, 115–125 (2016). https://doi.org/10.1007/s40519-015-0200-5
Received:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s40519-015-0200-5