A comparison of traditional and developmental measures of weight suppression in residential patients with bulimia nervosa

Objective Weight suppression (WS) is associated with many eating disorder (ED)‐related symptoms. However, traditional calculations of WS do not consider the age or height at which one's highest past weight was reached. Lowe et al. (2022) found that developmental WS (DWS) was associated with a wider variety of ED‐related symptoms compared with traditional WS (TWS). This study replicated and extended these findings in a larger sample of individuals with bulimia nervosa (BN) at a residential ED treatment center. Methods Participants were 1051 female patients with BN. We examined the relations between each WS measure and ED symptoms, emotional symptoms, and weight history variables. Results TWS and DWS showed a similar number of relations with ED‐related symptoms. DWS was positively related to behavioral symptoms (e.g., vomiting), and negatively related to cognitive symptoms (e.g., weight/eating concern). TWS was positively related to highest premorbid, highest postmorbid, and lowest postmorbid weights. DWS was also positively related to highest premorbid z‐scored body mass index (zBMI), but negatively related to lowest and highest postmorbid zBMI. Conclusions DWS, relative to TWS, may better capture the psychobiological impact of the weight discrepancy that a measure of WS is meant to reflect. Public Significance Weight suppression, the difference between an individual's past highest weight and current weight, is significantly related to many ED‐related symptoms. This study found that a new weight suppression measure, based on expected weight‐for‐height during physical development, relates to ED characteristics in a different manner from the traditional measure of weight suppression, showing positive associations with behavioral symptoms and negative associations with cognitive symptoms.