42 Chapter 2 difficulties in executive functioning (e.g. set shifting, planning and problem solving) as assessed with neuropsychological tests (Fitzpatrick et al., 2013; Roberts et al., 2007; Van den Eynde et al., 2011). Perhaps obese BED patients could benefit from cognitive remediation therapy as is currently being studied in patients with anorexia nervosa (Tchanturia et al., 2013). Besides insufficiency, lower levels of anxiety and, remarkably, higher levels of hostility at post-treatment predicted better outcome. The same applies to more somatic complaints. One might argue that somatic complaints motivate to target binge eating pathology. Looking at personality characteristics, lower pretreatment levels of ineffectiveness and higher levels of perfectionism predicted better outcome. The same applies to higher pretreatment levels of extraversion. These findings seem to suggest that feeling less ineffective, being more perfectionistic and more extravert helps one to engage in the process of change that is required in treatment. Remarkably, higher post-treatment levels of conscientiousness predicted worse outcome at follow-up. This seems to be contradictory to the finding that being more perfectionistic leads to better outcome, yet could perhaps be explained by the lack of differentiation of the EDI between self-oriented and socially prescribed perfectionism (see Sherry et al., 2004). Lastly, contrary to Deumens et al. (2012), we found no evidence for social embedding, openness (NEO-PI-R), depressive symptoms (BDI) and agoraphobia (SCL-90) as predictors for binge eating pathology. In addition, the predictive value of extraversion (NEO-PI-R) was reversed and we found predictors that Deumens and colleagues did not find. These differences might be explained by the fact that, although we made use of partly the same sample, we used a larger sample and we used a more specific outcome measure as operationalisation of binge eating pathology (EDI bulimia scale scores instead of the composite score used by Deumens et al., 2012).We have to be careful in translating the present findings to clinical practice, as the causal status of the predictors found has yet to be established. For now, the present results could mean that patients can benefit from an enhanced focus on body dissatisfaction (more specifically, lack of familiarity with one’s own body) and interoceptive awareness. Specific techniques such as mirror exposure, mindfulness and bodily awareness exercises can be helpful apart from more traditional cognitive and behavioural techniques. Furthermore, it might be helpful to optimize drive for thinness within the boundaries set by a regular and sufficient eating pattern. This can be done by giving clear information on both the consequences of (morbid) obesity and on the risks of strict dieting. Future research, however, should show whether influencing these factors does actually lead to improvement of treatment outcome.
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