Objective: Persons with bulimia nervosa (BN) often gain weight during treatment, which potentially poses a threat to treatment adherence. Although weight suppression has been found to be a predictor of weight gain in persons with BN, research about the trajectory of weight changes during treatment and other predictors thereof is scarce.

Method: The current study examined weight suppression as well as self-reported binge eating severity and purging frequency at admission as predictors of weight change in 746 persons with BN (95% female) who received inpatient treatment at the Schoen Clinic Roseneck (Prien am Chiemsee, Germany) between 2015 and 2020.

Results: Body mass index (BMI) increased linearly across treatment weeks. Higher weight suppression predicted larger weight gain, particularly in those with a relatively low BMI at admission. More frequent purging and less severe binge eating predicted larger weight gain but high binge eating severity in combination with infrequent purging attenuated this effect.

Conclusions: Results replicate that those with high weight suppression are at higher risk for gaining weight during BN treatment but extend these findings in that this effect additionally depends on current BMI, similar to findings reported in persons with anorexia nervosa. They further demonstrate that the core features of BN-binge eating and purging-also predict weight change both separately and interactively and may, therefore, be considered in psychoeducation and therapy planning.

Keywords: binge eating; bulimia nervosa; purging; weight gain; weight suppression.

© 2025 The Author(s). European Eating Disorders Review published by Eating Disorders Association and John Wiley & Sons Ltd.

目标： 患有神经性贪食症（BN）的人在接受治疗期间往往会体重增加，这可能对治疗依从性构成威胁。尽管已有研究表明体重抑制是 BN 患者体重增加的预测因素，但关于治疗过程中体重变化轨迹及其他预测因素的研究资料很少。

方法： 本研究考察了 746 名在德国 Rose Clinic Roseneck（Prien am Chiemsee）2015 年至 2020 年期间接受住院治疗的 BN 患者（95%为女性），探讨其入院时体重抑制、自我报告暴食严重程度和清除行为频率对体重变化的预测作用。

结果： 在治疗过程中，患者的 BMI 呈线性增加。较高的体重抑制预示着更大的体重增加，尤其是在入院时相对低 BMI 的患者中更为明显。更频繁地清除行为和较轻度的暴食预示着更大的体重增加，但严重的暴食加上不频繁的清除行为会削弱这一效应。

结论： 研究结果证实了具有高体重抑制的人在 BN 治疗期间增重的风险更高，并进一步表明这种影响还取决于目前的 BMI（类似于在神经性厌食症患者中报道的研究发现）。此外，这些结果还证明了 BN 的核心特征——暴饮暴食和清除行为——单独或相互作用地预测体重变化，在心理教育和治疗计划中应予以考虑。

关键词： 暴饮暴食；神经性贪食症；清除行为；体重增加；体重抑制。

© 2025 The Author(s). European Eating Disorders Review published by Eating Disorders Association and John Wiley & Sons Ltd.