Psychological distress in clinical obesity : the role of eating disorder beliefs and behaviours, social comparison and shame

A review of the literature suggested that cognitive theories of eating disorders and social ranking theory of psychological distress may contribute to the understanding of psychological factors in the maintenance of obesity. This study examined the relationships between psychological distress and eating disorder beliefs and behaviours; and social comparison beliefs and submissive behaviours and shame, in a sample of seventy four clinically obese (BMI 30) males and females currently attending NHS dietetic services for support with weight management.;The results found high levels of psychological distress within this sample. Eating disorder beliefs, binge eating behaviour, negative social comparisons, submissive behaviours and shame were all found to be associated with psychological distress. The high inter correlations between the variables and their association with psychological distress suggested they were all measures of a single construct of distress in this sample population. Body Mass Index was not found to be associated with psychological distress in this sample.;These findings provide support for the applicability of cognitive models of eating disorders and social comparison theory to an understanding of distress in clinical obesity. A comprehensive theoretical maintenance model of psychological distress and further weight gain in obesity is proposed based on these findings. The results highlight clinical assessment, formulation and treatment implications for the care of obese individuals presenting to weight management services and areas for future research are suggested.