Weight control beliefs in the treatment of binge-eating disorder: Why might they matter?

Objective: The belief in personal control over weight (BCWeight) is positively associated, while the belief in control over healthy lifestyle with weight acceptance (BCLifestyle) is negatively associated with disordered eating, body dissatisfaction, and low self-esteem. This study examined how weight control beliefs are impacted by cognitive behavior therapy (CBT) for binge-eating disorder (BED) that provides evidence and choice regarding weight management options; and assessed whether changes in weight control beliefs are associated with treatment outcomes.

Method: Participants were 57 patients consecutively referred to an outpatient eating disorder clinic from 2013-2017 for BED treatment. Using retrospective self-reported program-evaluation data, baseline to post-CBT changes in weight control beliefs were evaluated, as well as whether these changes were associated with the change in the drive for thinness, body dissatisfaction, fear of loss of control over eating, and self-esteem.

Results: BCLifestyle significantly increased over CBT; BCWeight significantly decreased. Increases in BCLifestyle were associated with the reduced drive for thinness, body dissatisfaction, and fear of loss of control overeating. Decreases in BCWeight were associated with improved self-esteem.

Discussion: BED CBT that provides science on weight management options is associated with positive changes in weight control beliefs, which are associated with measures of recovery from BED.

Public Significance Statement: Cognitive behavior therapy (CBT) for binge-eating disorder decreases the belief that one can and should control one's weight, and increases the belief that one should strive for a healthy lifestyle and accept one's weight. These changes in beliefs are associated with improved treatment outcomes. CBT that gives patients evidence on different weight management options addresses patient obesity concerns and is related to positive change in weight control beliefs.