Binge eating disorder and weight-related quality of life

Nutrition Research Newsletter, August, 2004

There has been strong interest in assessing the health-related quality of life (HRQOL) of obese persons in recent years. Many people assume most overweight and obese persons have impaired quality of life. However, certain factors are more easily associated with reduced quality of life than others in persons who are overweight or obese. These factors include gender, degree of overweight, race, age, depression, pain, comorbid conditions, and treatment-seeking status. Determining which factors are associated with poorer quality of life in obese persons may help clinicians identify those patients who are most distressed by their obesity and, therefore, most in need of assistance. Little is known about the role of binge eating disorder (BED) in the HRQOL of obese persons.

The limited number of studies on the role of BED in the quality of life of obese persons suggests that this is an important area in need of further investigation. Therefore, the present study tried to determine whether BED impacts weight-related quality of life in obese individuals seeking treatment for their obesity; and investigated the role of physiological symptoms, BMI, and demographic variables in the relationship between BED and weight-related quality of life.

As part of the study 317 women and 213 men from the Duke Diet and Fitness Center, an intensive residential program for weight loss and lifestyle modifications, completed questionnaires on admission. Weight-related quality of life was assessed using the Impact of Weight on Quality of Life-Lite (IWQOL-Lite). The presence of BED was determined using the Questionnaire on Eating and Weight Patterns-Revised. Psychological symptoms were assessed using the Beck Depression Inventory and the global severity index of the Symptom Checklist 90-R.

Overall prevalence of BED for the sample was 17.9%. Those with BED were, on an average, more likely to be women (75.8% vs. 56.3%), younger, white (98.9% vs. 91.7%), heavier, psychologically distressed and more impaired on total IWQOL-Lite and all IWQOL-Lite subscales. Women reported poorer quality of life for self-esteem, sexual life and total score, whereas men reported poorer quality of life for physical function and public distress. After controlling for demographic variables, BMI and psychological symptoms, BED was not independently associated with weight-related quality of life.

The association between BED and impairment in quality of life that has been previously reported may largely be accounted for by differences between those with and without BED on demographic variables, BMI and psychological symptoms. This study provided little evidence that BED, in and of itself, adversely impacts weight-related HRQOL. Although there was some evidence to suggest that BED may have deleterious effects on weight-related HRQOL for women, this effect was quite small in the current sample and would need to be studied further.

Ronette L. Kolotkin, Eric C. Westman, Truls Ostbye, et al., Does binge eating disorder impact weight-related quality of life? Obes Res 12:999-1005 (June 2004) [Address correspondence to Ronette L. Kolotkin, Obesity and Quality of Life Consulting, 1004 Norwood Avenue, Durham, NC27707]