(PS14-4) Relationships Between Shape Vigilance, Preoccupation with Shape and Weight, and CBT Treatment Outcomes Among Individuals with Binge-spectrum Eating Disorders

Body image disturbance is considered a core feature of eating disorders (EDs) and is associated with slower improvements in cognitive-behavioral therapy (CBT). As a broad construct, body image disturbance encompasses several cognitive and behavioral features, yet it is unclear what specific features are most associated with treatment outcomes. In particular, two factors critical to examine include vigilance about shape and preoccupation with shape/weight. These factors are meaningful to study as they represent both a behavioral (shape vigilance) and cognitive (preoccupation) aspect of body image disturbance and are under-researched regarding treatment outcomes. Additionally, it is unknown if these certain facets prevent optimal treatment response, which could help tailor interventions. Thus, the current study aimed to conduct a granular investigation of body image disturbance by examining relationships between baseline levels of preoccupation and shape vigilance, and CBT outcomes (loss of control eating, dietary restraint, and compensatory behaviors) in a sample of individuals with binge-spectrum EDs. Secondary analyses were conducted from a combined dataset of four CBT for binge-spectrum ED treatment studies (n = 192). Linear regressions revealed that higher baseline shape vigilance significantly predicted more frequent post-treatment compensatory behaviors after controlling for baseline compensatory behaviors, F(1, 152) = 27.23, p < .001. However, preoccupation with shape/weight did not significantly predict any post-treatment outcomes. This study demonstrates the clinical utility of examining specific facets of body image disturbance in the treatment of EDs while highlighting a promising avenue for future CBT augmentations to improve overall treatment outcomes. In particular, individuals exhibiting high shape vigilance and engaging in compensatory behaviors may benefit from a CBT augmentation that targets shape vigilance, prompting the need for further research to assess its impact on treatment outcomes.