28 Chapter 2 remission from binge eating after treatment (Grilo et al., 2012; Hilbert et al., 2007) and higher pretreatment levels of body dissatisfaction predict BED outcome at the 12-year follow-up (Fichter et al., 2008). The reduction of eating disorder-related pathology to within the normal range at post-treatment is the best predictor of recovery at follow up (Lock et al., 2013). Some evidence suggests that other predictors related to eating disorder pathology, such as high baseline levels of emotional eating and BMI, predict a poorer treatment outcome (Fichter et al., 2008; Ricca et al., 2010; Thompson-Brenner et al., 2013). The difference between one’s current body weight and highest adult body weight, however, is not predictive of percentage reduction in binge eating episodes nor does it predict abstinence from binge eating (Zunker et al. 2011). Some research on predictors related to clinical characteristics suggests that lower self-esteem and more interpersonal problems at baseline predict more eating disorder pathology at post-treatment (Hilbert et al., 2007; Wilson et al., 2010). Whereas some studies suggest that depression levels predict remission from binge eating (Wilson et al., 2010) and that more negative affect leads to more eating disorder psychopathology (Masheb & Grilo, 2008), other studies do not show such a relationship (Grilo et al, 2012; Ricca et al., 2010). Furthermore, data on concomitant Axis I and II classifications are mixed. In some studies, comorbidity on Axis I (i.e. depression) was found to be a predictor for less remission of binge eating in the longer term (Castellini et al., 2011; Fichter et al., 2008; Wilson et al., 2010) and the presence of personality disorders, particularly cluster C, predicted more post-treatment eating disorder psychopathology (Masheb & Grilo, 2008). In other studies however, no predictive value was found for any Axis I or II disorder (Grilo et al., 2012; Ricca et al., 2010). The evidence on predictors related to demographic variables is also mixed. Older age of BED onset predicted less eating disorder pathology (i.e. remission from binge eating) at post-treatment in one study, but not in another (Grilo et al., 2012 and Masheb & Grilo, 2008, respectively). Age at presentation for treatment did not predict levels of eating pathology at post-treatment in one study (Masheb & Grilo, 2008), whereas in another study, older age at presentation for treatment predicted greater reduction in objective bulimic episodes and greater rates of cessation of objective bulimic episodes (ThompsonBrenner et al., 2013). When looking at the long term, lower age was associated with full recovery (Castellini et al., 2011). Additionally, in one study, BED patients with less than a college education were more likely to remit from binge eating at post-treatment than patients with a higher education (Grilo et al., 2012). However, when looking at aggregated data of 11 studies, a lower level of education (less than high school) predicted more objective bulimic episodes at post-treatment (Thompson-Brenner et al., 2013).
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