Health-Related Quality of Life in Women with Eating Disorders: Association with Subjective and Objective Binge Eating

  • Janet D. Latner
  • Joanna K. Vallance
  • Geoffrey Buckett


This study examined health-related quality of life (QOL) and its association with different forms of binge eating in 53 women with eating disorders. Participants had enrolled in treatment for anorexia nervosa, bulimia nervosa, binge eating disorder, or other eating disorders not otherwise specified and completed measures of QOL, eating-related psychopathology, and mood disturbance. Eating- and mood-related psychopathology, and to a lesser extent, mental-component QOL scores, were severely impaired in this sample relative to population norms. QOL was significantly and independently predicted by subjective bulimic episodes and compensatory behaviors, including food avoidance, laxative abuse, and self-induced vomiting, accounting for 32% of the variance. Subjective bulimic episodes and food avoidance also independently predicted the physical-component QOL, accounting for 27% of the variance. These findings suggest that subjective bulimic episodes may be independently associated with impairment in QOL and may require specific attention as targets of treatment.


Eating disorders Binge eating Subjective bulimic episodes Objective bulimic episodes Quality of life 


  1. American Psychiatric Association. (2000). Diagnostic and statistical manual of mental disorders (4th ed.). Washington, DC: Author.Google Scholar
  2. Beck, A. T., Steer, R. A., Ball, R., & Ranieri, W. F. (1996). Comparison of Beck Depression Inventories-IA and -II in psychiatric outpatients. Journal of Personality Assessment, 67, 588–597.PubMedCrossRefGoogle Scholar
  3. Beck, A. T., Ward, C. H., Mendelson, M., Mock, J., & Erbaugh, J. (1961). An inventory for measuring depression. Archives of General Psychiatry 4, 561–571.PubMedGoogle Scholar
  4. Black, C. M., & Wilson, G. T. (1996). Assessment of eating disorders: Interview versus questionnaire. International Journal of Eating Disorders, 20, 43–50.PubMedCrossRefGoogle Scholar
  5. Carter, J. C., Aime, A. A., & Mills, J. S. (2001). Assessment of bulimia nervosa: A comparison of interview and self-report questionnaire methods. International Journal of Eating Disorders, 30, 187–192.PubMedCrossRefGoogle Scholar
  6. Doll, H. A., Petersen, S. E., & Stewart-Brown, S. L. (2005). Eating disorders and emotional and physical well-being: Associations between student self-reports of eating disorders and quality of life as measured by the SF-36. Quality of Life Research, 14, 705–717.PubMedCrossRefGoogle Scholar
  7. Fairburn, C. G., & Beglin, S. J. (1994). Assessment of eating disorders: Interview or self-report questionnaire? International Journal of Eating Disorders, 16, 363–370.PubMedGoogle Scholar
  8. Fairburn, C. G., & Cooper, Z. (1993). The Eating Disorder Examination. In C. G. Fairburn & G. T. Wilson (Eds.), Binge eating: Nature, assessment, and treatment (12th ed., pp. 317–332). New York: Guilford Press.Google Scholar
  9. Gonzalez-Pinto, A., Inmaculada, F., Cristina, R., Corres Blanca, F., Sonsoles, E., Fernando, R., et al. (2004). Purging behaviors and comorbidity as predictive factors of quality of life in anorexia nervosa. International Journal of Eating Disorders, 36, 445–450.PubMedCrossRefGoogle Scholar
  10. Grilo, C. M., Lozano, C., & Elder, K. A. (2005). Inter-rater and test-retest reliability of the spanish language version of the Eating Disorder Examination interview: Clinical and research implications. Journal of Psychiatric Practice, 11, 231–240.PubMedCrossRefGoogle Scholar
  11. Grilo, C. M., Masheb, R. M., Lozano-Blanco, C., & Barry, D. T. (2004). Reliability of the Eating Disorder Examination in patients with binge eating disorder. International Journal of Eating Disorders, 35, 80–85.PubMedCrossRefGoogle Scholar
  12. Grilo, C. M., Masheb, R. M., & Wilson, G. T. (2001). A comparison of different methods for assessing the features of eating disorders in patients with binge eating disorder. Journal of Consulting and Clinical Psychology, 69, 317–322.PubMedCrossRefGoogle Scholar
  13. Hay, P. (2003). Quality of life and bulimic eating disorder behaviors: Findings from a community-based sample. International Journal of Eating Disorders, 33, 434–442.PubMedCrossRefGoogle Scholar
  14. Hay, P., & Mond, J. (2005). How to ‘count the cost’ and measure burden? A review of health-related quality of life in people with eating disorders. Journal of Mental Health, 14, 539–552.CrossRefGoogle Scholar
  15. Hildebrandt, T., & Latner, J. D. (2006). Effect of self-monitoring on binge eating: Treatment response or “binge drift”? European Eating Disorders Review, 14, 16–22.CrossRefGoogle Scholar
  16. Knight, R. G. (1984). Some general population norms for the short form Beck Depression Inventory. Journal of Clinical Psychology, 40, 751–753.PubMedCrossRefGoogle Scholar
  17. Latner, J. D., & Clyne, C. (2008). The diagnostic validity of the criteria for binge eating disorder. International Journal of Eating Disorders, 41, 1–14.PubMedCrossRefGoogle Scholar
  18. Latner, J. D., Hildebrandt, T., Rosewall, J. K., Chisholm, A. M., & Hayashi, K. (2007). Loss of control over eating reflects eating disturbances and general psychopathology. Behaviour Research and Therapy, 45, 2203–2211.PubMedCrossRefGoogle Scholar
  19. Loeb, K. L., Wilson, G. T., Gilbert, J. S., & Labouvie, E. (2000). Guided and unguided self-help for binge eating. Behaviour Research and Therapy, 38, 259–272.PubMedCrossRefGoogle Scholar
  20. Mishra, G., & Schofield, M. J. (1998). Norms for the physical and mental health component summary scores of the SF-36 for young, middle-aged and older Australian women. Quality of Life Research, 7, 215–220.PubMedCrossRefGoogle Scholar
  21. Mond, J. M., Hay, P. J., Rodgers, B., Owen, C., & Beumont, P. J. V. (2004). Validity of the Eating Disorder Examination Questionnaire (EDE-Q) in screening for eating disorders in community samples. Behaviour Research and Therapy, 42, 551–567.PubMedCrossRefGoogle Scholar
  22. Mond, J. M., Hay, P. J., Rodgers, B., Owen, C., & Beumont, P. J. V. (2005). Assessing quality of life in eating disorder patients. Quality of Life Research, 14, 171–178.PubMedCrossRefGoogle Scholar
  23. Mond, J. M., Hay, P. J., Rodgers, B., & Owen, C. (2006a). An update on the definition of “excessive exercise” in eating disorders research. International Journal of Eating Disorders, 39, 147–153.PubMedCrossRefGoogle Scholar
  24. Mond, J. M., Hay, P. J., Rodgers, B., & Owen, C. (2006b). Eating Disorder Examination Questionnaire (EDE-Q): Norms for young adult women. Behaviour Research and Therapy, 44, 53–62.PubMedCrossRefGoogle Scholar
  25. Mond, J., Hay, P., Rodgers, B., Owen, C., Crosby, R., & Mitchell J. (2006c). Use of extreme weight control behaviors with and without binge eating in a community sample: Implications for the classification of bulimic-type eating disorders. International Journal of Eating Disorders, 39, 294–302.PubMedCrossRefGoogle Scholar
  26. Niego, S. H., Pratt, E. M., & Agras, W. S. (1997). Subjective or objective binge: Is the distinction valid? International Journal of Eating Disorders, 22, 291–298.PubMedCrossRefGoogle Scholar
  27. Padierna, A., Quintana, J. M., Arostegui, I., Gonzalez, N., & Horcajo, M. J. (2000). The health-related quality of life in eating disorders. Quality of Life Research, 9, 667–674.PubMedCrossRefGoogle Scholar
  28. Scott, K. M., Tobias, M. I., Sarfati, D., & Haslett, S. J. (1999). SF-36 health survey reliability, validity and norms for New Zealand. Australian and New Zealand Journal of Public Health, 23, 401–407.PubMedCrossRefGoogle Scholar
  29. Sprinkle, S. D., Lurie, D., Insko, S. L., Atkinson, G., Jones, G., Logan, A. R., et al. (2002). Criterion validity, severity cut scores, and test-retest reliability of the Beck Depression Inventory-II in a university counseling center sample. Journal of Counseling Psychology, 49, 381–385.CrossRefGoogle Scholar
  30. Storch, E. A., Roberti, J. W., & Roth, D. A. (2004). Factor structure, concurrent validity, and internal consistency of the Beck Depression Inventory–second edition in a sample of college students. Depression and Anxiety, 19, 187–189.PubMedCrossRefGoogle Scholar
  31. Telch, C. F., Pratt, E. M., & Niego, S. H. (1998). Obese women with binge eating disorder define the term binge. International Journal of Eating Disorders, 24, 313–317.PubMedCrossRefGoogle Scholar
  32. Vitousek, K., Watson, S., & Wilson, G. T. (1998). Enhancing motivation for change in treatment-resistant eating disorders. Clinical Psychology Review, 18, 391–420.PubMedCrossRefGoogle Scholar
  33. Walsh, B. T., Fairburn, C. G., Mickley, D., Sysko, R., & Parides, M. K. (2004). Treatment of bulimia nervosa in a primary care setting. American Journal of Psychiatry, 161, 556–561.PubMedCrossRefGoogle Scholar
  34. Ware, J. E., Kosinski, M., & Keller, S. (1994). SF-36 physical and mental summary scales: A users manual. Boston, Massachusetts: The Health Institute, New England Medical Centre.Google Scholar
  35. Ware, J., & Sherbourne, C. (1992). The MOS 36-item Short-Form Health Survey (SF-36). Medical Care, 30, 473–483.PubMedCrossRefGoogle Scholar
  36. Wilfley, D. E., Schwartz, M. B., Spurrell, E. B., & Fairburn, C. G. (1997). Assessing the specific psychopathology of binge eating disorder patients: Interview or self-report? Behaviour Research and Therapy, 35, 1151–1159.PubMedCrossRefGoogle Scholar

Copyright information

© Springer Science+Business Media, LLC 2008

Authors and Affiliations

  • Janet D. Latner
    • 1
  • Joanna K. Vallance
    • 2
  • Geoffrey Buckett
    • 3
  1. 1.Department of PsychologyUniversity of Hawaii at ManoaHonoluluUSA
  2. 2.Department of PsychologyUniversity of CanterburyChristchurchNew Zealand
  3. 3.Princess Margaret HospitalChristchurchNew Zealand

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