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Binge-Spectrum Eating Disorders and Higher Body Mass Index Are Associated With Greater Negative Attitudes Towards
Ashley Dunford1,2,3, Wesley R Barnhart4, P Evelyna Kambanis1,2,3
1Eating Disorders Clinical and Research Program, Massachusetts General Hospital, Boston, Massachusetts, USA.
Objective:
Eating disorders (EDs) in individuals with larger bodies are increasingly common and associated with experiences of weight stigma, yet negative attitudes towards obesity (NATO) across EDs and the weight spectrum remain understudied. We examined whether NATO differed across EDs and body mass index (BMI) groups.
Method:
Participants were 322 adults (BMI range = 14.5-72.4 kg/m2) seeking outpatient ED treatment. We hypothesised that EDs commonly characterised by weight/shape concerns (i.e., anorexia nervosa [AN], bulimia nervosa [BN], binge-eating disorder [BED]) would show higher NATO scores than avoidant/restrictive food intake disorder (ARFID) and that individuals at the upper and lower ends of the BMI spectrum (obesity/overweight vs. underweight) would report greater NATO than those in the normal BMI range.
Results:
A one-way ANOVA showed that BN and BED groups reported higher NATO than the ARFID and AN groups. Individuals with obesity endorsed greater NATO than the normal weight and underweight groups. Diagnosis and BMI were associated with NATO, but BMI was no longer significant when included with diagnosis.
Discussion:
NATO appears more strongly related to ED diagnosis than BMI. Individuals with binge-spectrum EDs and those with obesity may be particularly vulnerable. Further investigation inclusive of weight stigma frameworks is needed.
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