Higher weight suppression in eating disorder patients with provisional PTSD admitted to residential treatment.

BACKGROUND

Measures of weight suppression (WS) are recognized indicators of ED severity and outcome. Concurrent posttraumatic stress disorder (PTSD) is also associated with higher symptom severity in patients with ED + PTSD. Those with ED + PTSD may engage in more ED behaviors, including dietary restriction, to regulate their emotions and counteract weight gain. Whether WS is associated with ED + PTSD has not been previously explored.

METHODS

Participants included 2529 patients (91% female) admitted to residential care for DSM-5 defined EDs who gave written informed consent for use of their anonymized data. Patients completed self-report assessments for weight history, including highest and lowest non-pregnant weight at current adult height, and symptoms of EDs and PTSD. Provisional diagnoses of PTSD (PTSD+) were found in 45% of the sample and were made using the Life Events Checklist for DSM-5 and the PTSD Symptom Checklist for DSM-5. Groups with and without PTSD+ were compared in unadjusted analyses (t-tests) and in adjusted analyses using multivariate analyses of variance with age, admission BMI, age of ED onset, gender, ED diagnosis, and Eating Disorder Examination Questionnaire Restraint subscores as covariates.

RESULTS

In the adjusted model, patients with PTSD+ demonstrated significantly higher measures of WS regardless of measurement used, i.e., traditional WS, relative WS and WS at lowest weight (p ≤ .001).

CONCLUSION

This is the first known report of significantly higher measures of WS in ED patients with PTSD+, which reinforce findings indicating PTSD as a marker of higher severity of illness. Potential mechanisms, such as glucocorticoid alterations and mitochondrial dysfunction, are discussed.