40 Chapter 2 interoceptive awareness. In addition, body dissatisfaction predicted outcome in the short term for women and was an overall post-treatment predictor for follow-up. Most of our main results are in line with findings in the literature. First, our results support the notion that higher pretreatment levels of eating disorder pathology predict more eating disorder pathology at post-treatment (Masheb & Grilo, 2008; Thompson-Brenner et al., 2013; Wilson et al., 2010). Moreover, more binge eating pathology at the end of treatment predicted worse outcome at follow-up, which seems to be in line with the only study known to us addressing this issue (Lock et al., 2013). Secondly, a more disturbed body experience predicted worse outcome in the short term for women. This underlines previous findings showing that higher pretreatment body dissatisfaction predicts more eating disorder pathology after treatment (Grilo et al., 2012; Hilbert et al., 2007). The present study adds to this by showing that lesser familiarity with one’s own body at the end of treatment results in more binge eating pathology at follow-up. The fact that body dissatisfaction did not show up as a pretreatment-to-posttreatment predictor in the group as a whole can possibly be explained by the finding that women with BED generally report significantly greater body dissatisfaction than men with BED (Barry et al., 2002; Carano et al., 2006). Thirdly, more interoceptive awareness at baseline predicted better outcome in the short term and remained a post-treatment predictor for follow-up, which is in line with 12-year follow-up results (Fichter et al., 2008). To our knowledge, this is the first study to address the predictive value of interoceptive awareness in BED shortly after treatment. This could indicate that stimulating patients to be more aware of their inner world, helping them to discriminate between sensations and feelings, between hunger and satiety, helps to overcome binge eating both in the short and long term. It should be noted that replication and studies into the causal relationship are needed. Besides similarities, differences do exist between our results and what we expected to find. First, BMI at baseline was not predictive of treatment outcome. In fact, our study shows that a higher BMI at post-treatment predicts less binge eating pathology at follow-up. An explanation could be that, contrary to that of Thompson-Brenner et al. (2013), our sample represents patients with a relatively high average BMI (42.25) and consists of about 55% of patients with BMI ≥ 40. Awareness of the risks associated with such morbid obesity can be an extra motivation to address binge eating. In addition, unlike previous observations (Thompson-Brenner et al., 2013), a low level of education did not predict a positive outcome in the present study. This could indicate that level of education is a less well-established predictor than currently considered.
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