Perfectionism in Overweight and Obesity: A Scoping Review

People with a high body mass index (BMI) experience high rates of disordered eating behaviors (DEB) and eating disorders (ED). Perfectionism has been identified as a transdiagnostic mechanism across EDs; however, it is unclear whether it can be considered a transdiagnostic, trans-BMI mechanism that should be evaluated and targeted in interventions for overweight/obesity. Further, as perfectionism is generally considered to be a multidimensional construct, it is unknown whether certain dimensions may be associated with higher BMI. The present review synthesizes 80 studies that investigated perfectionism in people with overweight/obesity following PRISMA guidelines. Fifty of the included studies investigated clinical samples, and 30 investigated nonclinical samples. The overall mean BMI was 30.38 (SD = 6.13). Although the majority of studies found no direct relationship between perfectionism and BMI, perfectionism appears to be associated with DEB, indicating its potential transdiagnostic relevance. Further, dimensions of perfectionism such as concern over mistakes were linked to eating pathology across weight categories. Our review highlights the need for a consensus on the definition and assessment of multidimensional perfectionism, the lack of qualitative research, and the need to consider the impact of perfectionism on the lived experiences of people with a high BMI.