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Barnhart WR, Braden AL, Buelow MT. Examining Food-Specific and General Inhibitory Control and Working Memory as Moderators of Relations Between Emotion Regulation Difficulties and Eating Pathology in Adults With Overweight/Obesity: A Preregistered, Cross-Sectional Study. Arch Clin Neuropsychol 2024:acae065. [PMID: 39258629 DOI: 10.1093/arclin/acae065] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2023] [Revised: 07/24/2024] [Accepted: 08/07/2024] [Indexed: 09/12/2024] Open
Abstract
OBJECTIVE Empirical research and theory support the interaction of executive functions (e.g., inhibitory control, working memory) and emotion regulation in guiding goal-oriented behavior; however, applications to eating pathology (e.g., binge eating) are limited. Such research is scant with adults with overweight/obesity (AwO/O), a population reporting high levels of binge eating, emotion regulation difficulties, and deficits in inhibitory control and working memory. We tested interactions between emotion regulation and executive functioning in relation to eating pathology in AwO/O while considering stimuli-specific deficits (e.g., food-specific deficits) in behavioral task performance. METHOD AwO/O (N = 204; MBMI = 32.11; Mage = 38.30 [SD = 12.16]) completed a preregistered, online study assessing demographics and emotion regulation difficulties (Difficulties in Emotional Regulation Scale), inhibitory control (go/no-go task, food and general stimuli), working memory (N-Back Task, food and general stimuli), binge eating (Binge Eating Scale), and disordered eating (Eating Disorder Examination-Questionnaire). RESULTS There was limited evidence of moderation in models examining food-specific and general inhibitory control and working memory, emotion regulation difficulties, and binge eating. Preliminary support was found for emotion regulation difficulties to be more strongly associated with more disordered eating in AwO/O reporting more food-specific and general working memory deficits. Consistent, positive associations between emotion regulation difficulties and eating pathology were observed. CONCLUSIONS Among adults with AwO/O, emotion regulation difficulties are closely related to eating pathology, regardless of performance on working memory and inhibitory control tasks. Clinicians and researchers working with AwO/O may consider how emotion regulation difficulties and working memory deficits work together to influence disordered eating.
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Affiliation(s)
- Wesley R Barnhart
- Department of Psychology, Bowling Green State University, Bowling Green, OH, USA
- Department of Psychiatry, The University of North Carolina at Chapel Hill, Chapel Hill, NC
| | - Abby L Braden
- Department of Psychology, Bowling Green State University, Bowling Green, OH, USA
| | - Melissa T Buelow
- Department of Psychology, The Ohio State University, Columbus, OH, USA
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Stuart S, Schultz J, Molina AP, Siber-Sanderowitz S. Interpersonal Psychotherapy: A Review of Theory, History, and Evidence of Efficacy. Psychodyn Psychiatry 2024; 52:370-407. [PMID: 39254940 DOI: 10.1521/pdps.2024.52.3.370] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/11/2024]
Abstract
Interpersonal psychotherapy (IPT) is an empirically validated treatment for mood disorders, anxiety disorders, eating disorders, and trauma. IPT is based on the concept of "relational frame"-that an individual's experience of psychological distress impacts those around them, and that their social support network impacts the distressed individual. This concept, along with the specific techniques and tools that flow from it and the theoretical bases of IPT (attachment and interpersonal theory) make IPT unique. In this article we review the theoretical bases of IPT (attachment and communication) and provide a brief history of IPT, as well as the evidence supporting its use for a variety of disorders. We also describe its application to groups, adolescents, and other diverse populations. Future directions for research and treatment development are proposed, particularly research in the area of combining IPT with other psychotherapeutic modalities.
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Affiliation(s)
- Scott Stuart
- Director, IPT Institute; Adjunct Professor, University of Southern California, Department of Psychiatry; Professor Emeritus, University of Iowa Department of Psychiatry
| | - Jessica Schultz
- Associate Professor of Psychology, Augustana College, Rock Island, Illinois
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Arbour G, Legendre M, Langlois MF, Bégin C. Novel Guided Self-Help for the treatment of Binge Eating Disorder: Feasibility, Acceptability, and Preliminary Efficacy. CAN J DIET PRACT RES 2024:1-8. [PMID: 39158977 DOI: 10.3148/cjdpr-2024-013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/21/2024]
Abstract
Purpose: Binge eating disorder (BED) is a prevalent eating disorder. Many individuals with BED do not receive evidence-based care due to many barriers. This preliminary study evaluated the feasibility, acceptability, and potential efficacy of a manualized guided self-help (GSH) intervention with support in the form of a culturally adapted manual for a French-Canadian population.Method: Twenty-two women with overweight or obesity meeting the BED diagnostic criteria participated in an 8-week open trial. The GSH programme combined a self-help book and weekly support phone calls. Participants were assessed at baseline, at week 4, postintervention, and 12 weeks following its end. Feasibility was measured by attrition rates, participation, and satisfaction. Acceptability was measured by a questionnaire based on the Theoretical Framework of Acceptability. Potential efficacy outcomes were objective binge eating days, eating disorder symptomatology, depressive symptoms, and propensity to eat intuitively.Results: The GSH programme has proven feasible (4.5% attrition, 91% completion, 95.5% satisfaction) and acceptable. Potential efficacy results showed promising improvements on all outcomes (19% abstinence, 70.9% reduction in objective binge eating days).Conclusion: Although preliminary, this programme warrants further study as it may be an efficient and cost-effective way to deliver GSH for BED patients with accessibility barriers.
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Affiliation(s)
| | | | - Marie-France Langlois
- Centre de recherche du CHUS, Sherbrooke, QC
- Department of Medicine, Division of Endocrinology, Université de Sherbrooke, Sherbrooke, QC
| | - Catherine Bégin
- School of Psychology, Université Laval, Québec, QC
- Centre Nutrition, santé et société (NUTRISS), Institut sur la nutrition et les aliments fonctionnels (INAF), Université Laval, Québec, QC
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Riboldi I, Carrà G. Anti-obesity Drugs for the Treatment of Binge Eating Disorder: Opportunities and Challenges. ALPHA PSYCHIATRY 2024; 25:312-322. [PMID: 39148594 PMCID: PMC11322710 DOI: 10.5152/alphapsychiatry.2024.241464] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/31/2024] [Accepted: 04/16/2024] [Indexed: 08/17/2024]
Abstract
Binge eating disorder (BED) is the most prevalent form of disordered eating, frequently associated with obesity. Both these conditions along with sharing overeating behaviour features can lead to substantial burden of disease and premature mortality. With limited specific evidence available on pharmacotherapy, since lisdexamfetamine is approved only in some countries, new drugs are urgently needed to provide physicians with efficacious prescribing choices when treating BED. Although unique mechanisms underlie psychopathological features of binge eating, including impulsivity, compulsivity, and emotional reactivity, anti-obesity drugs might represent an option for both weight management and symptom reduction in people with BED. The aim of this review is thus to provide a summary of available evidence on the efficacy of anti-obesity drugs for BED. After comprehensively searching for relevant studies in PubMed and the Cochrane Library, as well as for unpublished results in ClinicalTrials.gov, we included 14 clinical trials. Despite the limited sample size and the methodological variability, evidence from available studies suggests that most anti-obesity drugs, namely phentermine/topiramate, naltrexone/bupropion, liraglutide and semaglutide, though not orlistat, might variously achieve improvements for both body weight and severity and frequency of binge episodes. Findings from ongoing clinical trials are likely to provide further insight into the possible role of anti-obesity drugs for treating BED. Since these agents can hold the potential to be misused potentiating dietary restriction and pathological weight loss, it is crucial to promote responsible prescribing practices.
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Affiliation(s)
- Ilaria Riboldi
- School of Medicine and Surgery, University of Milano-Bicocca, Via Cadore, Monza, Italy
| | - Giuseppe Carrà
- School of Medicine and Surgery, University of Milano-Bicocca, Via Cadore, Monza, Italy
- Division of Psychiatry, University College London, Maple House, London, UK
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Rösch SA, Schmidt R, Hilbert A. Predictors of neurofeedback treatment outcome in binge-eating disorder: An exploratory study. Int J Eat Disord 2023; 56:2283-2294. [PMID: 37737523 DOI: 10.1002/eat.24062] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/10/2023] [Revised: 09/05/2023] [Accepted: 09/05/2023] [Indexed: 09/23/2023]
Abstract
OBJECTIVE Knowledge on predictors for treatment response to psychotherapy in binge-eating disorder (BED) is mixed and not yet available for increasingly popular neurofeedback (NF) treatment targeting self-regulation of aberrant brain activity. This study examined eating disorder- and psychopathology-related predictors for NF treatment success in BED. METHOD Patients with BED (N = 78) were randomized to 12 sessions of real-time functional near-infrared spectroscopy (rtfNIRS)-NF, targeting individual prefrontal cortex signal up-regulation, electroencephalography (EEG)-NF, targeting down-regulation of fronto-central beta activity, or waitlist (WL). The few studies assessing predictors for clinical outcomes after NF and evidenced predictors for psychotherapy guided the selection of baseline eating disorder-related predictors, including objective binge-eating (OBE) frequency, eating disorder psychopathology (EDP), food cravings, and body mass index (BMI), and general psychopathology-related predictors, including depressive and anxiety symptoms, impulsivity, emotion dysregulation, and self-efficacy. These questionnaire-based or objectively assessed (BMI) predictors were regressed on outcomes OBE frequency and EDP as key features of BED at post-treatment (t1) and 6-month follow-up (t2) in preregistered generalized mixed models (https://osf.io/4aktp). RESULTS Higher EDP, food cravings, and BMI predicted worse outcomes across all groups at t1 and t2. General psychopathology-related predictors did not predict outcomes at t1 and t2. Explorative analyses indicated that lower OBE frequency and higher self-efficacy predicted lower OBE frequency, and lower EDP predicted lower EDP after the waiting period in WL. DISCUSSION Consistent with findings for psychotherapy, higher eating disorder-related predictors were associated with higher EDP and OBE frequency. The specificity of psychopathological predictors for NF treatment success warrants further examination. PUBLIC SIGNIFICANCE This exploratory study firstly assessed eating disorder- and psychopathology-related predictors for neurofeedback treatment outcome in binge-eating disorder and overweight. Findings showed an association between higher eating disorder symptoms and worse neurofeedback outcomes, indicating special needs to be considered in neurofeedback treatment for patients with a higher binge-eating disorder symptom burden. In general, outcomes and assignment to neurofeedback treatment may be improved upon consideration of baseline psychological variables.
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Affiliation(s)
- Sarah A Rösch
- Integrated Research and Treatment Center Adiposity Diseases, Behavioral Medicine Research Unit, Leipzig University Medical Center, Leipzig, Germany
- International Max Planck Research School NeuroCom, Leipzig, Germany
| | - Ricarda Schmidt
- Integrated Research and Treatment Center Adiposity Diseases, Behavioral Medicine Research Unit, Leipzig University Medical Center, Leipzig, Germany
| | - Anja Hilbert
- Integrated Research and Treatment Center Adiposity Diseases, Behavioral Medicine Research Unit, Leipzig University Medical Center, Leipzig, Germany
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Groshon LC, Pearl RL. Longitudinal associations of binge eating with internalized weight stigma and eating self-efficacy. Eat Behav 2023; 50:101785. [PMID: 37515998 PMCID: PMC10839945 DOI: 10.1016/j.eatbeh.2023.101785] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/30/2022] [Revised: 06/21/2023] [Accepted: 07/21/2023] [Indexed: 07/31/2023]
Abstract
INTRODUCTION Internalized weight stigma (IWS) is linked to binge eating disorder (BED) symptoms and reduced self-efficacy, yet it unknown how changes in these factors may interrelate. The current study examined cross-sectional and longitudinal associations of BED with IWS and eating self-efficacy among treatment-seeking adults with high body weight. Disinhibited eating was explored as a mediator. METHODS Seventy-one adults with high weight and elevated IWS were included in this secondary analysis of a clinical trial that provided 26 weeks of behavioral weight loss (BWL) treatment with (versus without) an additional IWS intervention. Participants underwent a BED diagnostic interview at screening and completed validated measures of binge eating, IWS (including weight bias internalization, self-devaluation, and stereotype endorsement), eating self-efficacy, and disinhibited eating at baseline and week-26. Cross-sectional mediation models tested associations of BED with IWS and eating self-efficacy, explained by disinhibited eating. Linear and logistic regression models, controlling for treatment condition, tested if baseline BED predicted changes in IWS, self-efficacy, and disinhibited eating, and if decreased binge episodes were associated with improved outcomes. RESULTS At baseline, disinhibited eating mediated the relationship between BED and weight self-devaluation (95 % CI = 0.66,3.58), stereotype endorsement (CI = 0.15,0.56), and eating self-efficacy (CI:-14.40,-4.29). Baseline BED did not predict changes in outcomes. Participants with decreased binge episodes reported greater improvements in weight bias internalization (p = 0.04) and eating self-efficacy (p < 0.001). CONCLUSION This study provides novel evidence of longitudinal associations between binge eating, IWS, and eating self-efficacy. IWS warrants further consideration as a treatment target and outcome in studies of BWL and BED.
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Affiliation(s)
- Laurie C Groshon
- Department of Clinical and Health Psychology, University of Florida, United States of America.
| | - Rebecca L Pearl
- Department of Clinical and Health Psychology, University of Florida, United States of America
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Raisi A, Zerbini V, Piva T, Belvederi Murri M, Menegatti E, Caruso L, Masotti S, Grazzi G, Mazzoni G, Mandini S. Treating Binge Eating Disorder With Physical Exercise: A Systematic Review and Meta-analysis. JOURNAL OF NUTRITION EDUCATION AND BEHAVIOR 2023; 55:523-530. [PMID: 37245147 DOI: 10.1016/j.jneb.2023.03.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/14/2022] [Revised: 03/29/2023] [Accepted: 03/31/2023] [Indexed: 05/29/2023]
Abstract
OBJECTIVE This review aimed to collect evidence about the effectiveness of exercise programs for managing binge eating disorder (BED) (recurrent binge eating episodes). METHODS Meta-analysis was developed following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses protocol. Articles were searched in PubMed, Scopus, Web of Science, and Cochrane Library. Randomized controlled trials were eligible for inclusion if they reported the effect of an exercise-based program on BED symptoms in adults. Outcomes were changes in binge eating symptom severity, measured through validated assessment instruments, after an exercise-based intervention. Study results were pooled using the Bayesian model averaging for random and fixed effects meta-analysis. RESULTS Of 2,757 studies, 5 trials were included, with 264 participants. The mean age was 44.7 ± 8.1 years for the intervention group and 46.6 ± 8.5 years for the control group. All participants were female. A significant improvement was observed between groups (standardized mean difference, 0.94; 95% credibility interval, -1.46 to -0.31). Patients obtained significant improvements either following supervised exercise programs or home-based exercise prescriptions. IMPLICATIONS FOR RESEARCH AND PRACTICE These findings suggest that physical exercise, within a multidisciplinary clinical and psychotherapeutic approach, may be an effective intervention for managing BED symptoms. Further comparative studies are needed to clarify which exercise modality is associated with greater clinical benefits.
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Affiliation(s)
- Andrea Raisi
- Center for Exercise Science and Sport, Department of Neuroscience and Rehabilitation, University of Ferrara, Ferrara, Italy
| | - Valentina Zerbini
- Center for Exercise Science and Sport, Department of Neuroscience and Rehabilitation, University of Ferrara, Ferrara, Italy
| | - Tommaso Piva
- Center for Exercise Science and Sport, Department of Neuroscience and Rehabilitation, University of Ferrara, Ferrara, Italy.
| | - Martino Belvederi Murri
- Institute of Psychiatry Department of Neuroscience and Rehabilitation University of Ferrara, Ferrara, Italy
| | - Erica Menegatti
- Departement of Environmental Sciences and Prevention, University of Ferrara, Ferrara, Italy
| | - Lorenzo Caruso
- Departement of Environmental Sciences and Prevention, University of Ferrara, Ferrara, Italy
| | - Sabrina Masotti
- Center for Exercise Science and Sport, Department of Neuroscience and Rehabilitation, University of Ferrara, Ferrara, Italy
| | - Giovanni Grazzi
- Center for Exercise Science and Sport, Department of Neuroscience and Rehabilitation, University of Ferrara, Ferrara, Italy; Public Health Department, AUSL Ferrara, Ferrara, Italy; Healthy Living for Pandemic Event Protection (HL-PIVOT) Network, Chicago, IL
| | - Gianni Mazzoni
- Center for Exercise Science and Sport, Department of Neuroscience and Rehabilitation, University of Ferrara, Ferrara, Italy; Public Health Department, AUSL Ferrara, Ferrara, Italy
| | - Simona Mandini
- Center for Exercise Science and Sport, Department of Neuroscience and Rehabilitation, University of Ferrara, Ferrara, Italy
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8
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Valdez-Aguilar M, Vazquez-Arevalo R, López-Aguilar X, Ruíz Martínez AO, Rosinska M, Mancilla-Díaz JM. Online multidisciplinary treatment of binge eating disorder in people with high weight: a case series study. J Eat Disord 2023; 11:86. [PMID: 37264431 DOI: 10.1186/s40337-023-00809-9] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/28/2022] [Accepted: 05/12/2023] [Indexed: 06/03/2023] Open
Abstract
BACKGROUND Binge eating disorder (BED) is the most frequent eating behavior among the general population (Guerdjikova in Med Clin 103:669-680, 2019). Many studies on interventions and BED treatments have been carried out in the United States and Europe, few have been reported in Latin American populations. People with this disorder not only have physical consequences of it but also social and psychological ones, therefore a multidisciplinary treatment approach is a good option to treat this condition. OBJECTIVE To evaluate the feasibility of a multidisciplinary online intervention (i.e., psychological, nutritional, and physical activity) in patients with BED. METHOD The design was a case series study of two clinical treatment groups, with pre-test and post-test psychometric measures along with two follow-ups (at 2 and 6 months). Fifteen people diagnosed with BED (2 men and 13 women), with a mean age of 34.93 years (SD=11.91) and a mean initial BMI of 42, participated in this study. The treatment was carried out over the span of 28 sessions, each one being two hours per week consisting of 1 hour of group therapy and 1 hour of individual therapy. There were four evaluations: pre, post and two follow-ups. RESULTS Five patients did not complete the treatment (30%). The comparisons were made through the non-parametric Friedman test, finding a statistically significant decrease in binge eating symptoms (x2=15.57; p=.001), anxiety symptoms (x2=15.96; p=.001) and depression (x2=15.03; p=.002). There was an improvement in clarity (x2=11.60; p=.010) and emotional regulation (x2=7.75; p=.050), only in women. The patients reduced their body weight, and improved their eating and exercise habits by introducing fruits and vegetables and including 20-30 minutes of physical activity into their daily routine. Regarding the Objective Clinical Change Index, in terms of the objective clinical change, a positive change was observed in all the variables addressed. CONCLUSIONS The data presented allowed us to conclude that the online multidisciplinary intervention was effective in the treatment of BED. Trial registration Retrospectively registered.
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Affiliation(s)
- Mariana Valdez-Aguilar
- Facultad de Estudios Superiores Iztacala, Universidad Nacional Autónoma de México, Estado de México, México.
| | - Rosalia Vazquez-Arevalo
- Facultad de Estudios Superiores Iztacala, Universidad Nacional Autónoma de México, Estado de México, México
| | - Xóchitl López-Aguilar
- Facultad de Estudios Superiores Iztacala, Universidad Nacional Autónoma de México, Estado de México, México
| | | | | | - Juan Manuel Mancilla-Díaz
- Facultad de Estudios Superiores Iztacala, Universidad Nacional Autónoma de México, Estado de México, México
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9
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Spalding WM, Bertoia ML, Bulik CM, Seeger JD. Treatment characteristics among patients with binge-eating disorder: an electronic health records analysis. Postgrad Med 2023; 135:254-264. [PMID: 35037815 DOI: 10.1080/00325481.2021.2018255] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
OBJECTIVES Treatment for adults diagnosed with binge-eating disorder (BED) includes psychotherapy and/or pharmacotherapy and aims to reduce the frequency of binge-eating episodes and disordered eating, improve metabolic-related issues and reduce weight, and address mood symptoms. Data describing real-world treatment patterns are lacking; therefore, this study aims to characterize real-world treatment patterns among patients with BED. METHODS This retrospective study identified adult patients with BED using natural language processing of clinical notes from the Optum electronic health record database from 2009 to 2015. Treatment patterns were examined during the 12 months preceding the BED recognition date and during a follow-up period after BED recognition (1-3 years for most patients). RESULTS Among 1042 patients, 384 were categorized as the BED cohort and 658, who met less stringent criteria, were categorized as probable BED. In the BED cohort, mean ± SD age was 45.2 ± 13.4 years and 81.8% were women (probable BED, 45.9 ± 12.8 years, 80.2%). A greater percentage of patients in the BED cohort were prescribed pharmacotherapy (70.6% [probable BED, 66.9%]) than received/discussed psychotherapy (53.1% [probable BED, 39.2%]) at baseline. In the BED cohort, 54.4% of patients were prescribed antidepressants (probable BED, 52.4%), 25.3% stimulants (probable BED, 20.1%), and 34.4% nonspecific psychotherapy (probable BED, 24.6%) at baseline, with no substantive differences observed during follow-up. Low percentages of patients in the BED cohort received/discussed cognitive behavioral therapy at baseline (12.5% [probable BED, 9.0%) or during follow-up (13.0% [probable BED, 8.8%). Among patients with ≥1 psychotherapy visit, the mean ± SD number of visits in the BED cohort was 1.2 ± 5.9 at baseline (probable BED, 1.7 ± 7.3) and 2.2 ± 7.7 during follow-up (probable BED, 2.6 ± 7.7). CONCLUSION This cohort of patients with BED was treated more frequently with pharmacotherapy than psychotherapy. These data may help inform strategies for reducing differences between real-world treatment patterns and evidence-based recommendations.
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Affiliation(s)
| | | | - Cynthia M Bulik
- Department of Psychiatry, University of North Carolina School of Medicine, Chapel Hill, NC, USA
- Department of Nutrition, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, NC, USA
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
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Legendre M, Bégin C. Group therapy to reduce maladaptive eating behaviors in people with overweight or obesity: Does food addiction impact the treatment response? Eat Behav 2023; 49:101720. [PMID: 36931049 DOI: 10.1016/j.eatbeh.2023.101720] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/24/2022] [Revised: 02/25/2023] [Accepted: 03/09/2023] [Indexed: 03/19/2023]
Abstract
BACKGROUND Given that the presence of food addiction worsens the clinical portrait in people with overweight or obesity, it could also impact the treatment response. The objective was to explore the moderating effect of baseline food addiction (FA) on the treatment response. The associations between changes in FA symptoms and other maladaptive eating behaviors were also examined. METHODS Sixty adults with overweight or obesity were recruited and took part in a 12-session group therapy for compulsive eating. They completed questionnaires on FA and three treatment outcomes (binge eating, grazing, and depressive symptoms). Participants were split into two groups according to their number of baseline FA symptoms (no/mild FA vs. moderate/severe FA) and were compared on all outcomes at four measurement points (baseline, mid-treatment, post-treatment, and 6-month follow-up). Correlations between changes in FA symptoms and all three outcomes from pre- to post-treatment were performed. RESULTS Group and treatment effects were significant for binge eating and grazing but not for depressive symptoms. Interaction effects were not significant for the three outcomes. The reduction in FA symptoms from pre- to post-treatment was positively associated with the reduction in binge eating (r = 0.49) and grazing (r = 0.55). CONCLUSIONS People with moderate/severe FA maintained higher maladaptive eating behaviors than people with no/mild FA from the beginning to the end of the treatment. Progression through treatment followed the same pattern for both groups, suggesting that baseline FA did not have a moderating effect. People with moderate/severe FA would likely benefit from a longer treatment.
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Affiliation(s)
- Maxime Legendre
- School of Psychology, Pavillon Félix-Antoine-Savard, 2325, rue des Bibliothèques, Laval University, Quebec G1V 0A6, QC, Canada.
| | - Catherine Bégin
- School of Psychology, Pavillon Félix-Antoine-Savard, 2325, rue des Bibliothèques, Laval University, Quebec G1V 0A6, QC, Canada.
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Krehbiel J, Halbeisen G, Kühn S, Erim Y, Paslakis G. Too hot to handle: Mood states moderate implicit approach vs. avoidance tendencies toward food cues in patients with obesity and active binge eating disorder. J Psychiatr Res 2021; 143:302-308. [PMID: 34530341 DOI: 10.1016/j.jpsychires.2021.09.031] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/16/2021] [Revised: 08/20/2021] [Accepted: 09/08/2021] [Indexed: 11/27/2022]
Abstract
Patients with binge eating disorder (BED) display recurring episodes of eating large amounts of food in a short period of time, especially during negative mood states. However, the psychological processes linking negative mood to binge eating behavior have not been sufficiently explored. This study investigated the effects of experimentally inducing a negative (sad) mood state upon reaction times in a computerized Approach-Avoidance-Task (AAT) using images of foods and compared to a neutral control procedure in which negative mood was not induced. Differences in reaction times between "pulling" and "pushing away" food cues in the AAT were considered surrogates for fast, automatic (i.e., implicit) preferences ("bias") for either the approach or avoidance of foods. Obese patients with BED (n = 40), weight-matched (obese) individuals (n = 40), and norm-weight controls (n = 29) were asked to approach ("pull") or avoid ("push") images of high- and low-calorie foods following the induction of a negative mood state vs. the neutral control procedure. Sample size was within the common range of previous investigations of the kind. Similar to previous findings, obese patients with BED exhibited an avoidance bias (i.e., faster reaction times in "pushing" compared to "pulling") during the neutral control condition. However, a contrast analysis revealed that negative mood was associated with decreased avoidance bias in obese patients with BED, but not in obese and norm-weight controls. Mood status exerted no effect on BED patients' self-reported (i.e., explicit) ratings of the urge to consume foods. These findings may help to advance current understanding of how negative (sad) mood states may affect binge eating behaviors. Implications of these findings for developing novel treatment approaches are discussed.
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Affiliation(s)
- Johannes Krehbiel
- Department of Psychosomatic Medicine and Psychotherapy, University Hospital Erlangen, Friedrich-Alexander University Erlangen-Nürnberg (FAU), Erlangen, Germany
| | - Georg Halbeisen
- University Clinic of Psychosomatic Medicine and Psychotherapy, Ruhr-University Bochum, Campus East-Westphalia, Lübbecke, Germany
| | - Simone Kühn
- Lise Meiter Group for Environmental Neuroscience, Max Planck Institute for Human Development, Berlin, Germany; University Clinic Hamburg-Eppendorf, Clinic and Policlinic for Psychiatry and Psychotherapy, Hamburg, Germany
| | - Yesim Erim
- Department of Psychosomatic Medicine and Psychotherapy, University Hospital Erlangen, Friedrich-Alexander University Erlangen-Nürnberg (FAU), Erlangen, Germany
| | - Georgios Paslakis
- University Clinic of Psychosomatic Medicine and Psychotherapy, Ruhr-University Bochum, Campus East-Westphalia, Lübbecke, Germany.
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Wyssen A, Meyer AH, Messerli-Bürgy N, Forrer F, Vanhulst P, Lalanne D, Munsch S. BED-online: Acceptance and efficacy of an internet-based treatment for binge-eating disorder: A randomized clinical trial including waitlist conditions. EUROPEAN EATING DISORDERS REVIEW 2021; 29:937-954. [PMID: 34418221 PMCID: PMC9292199 DOI: 10.1002/erv.2856] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2021] [Revised: 07/04/2021] [Accepted: 07/31/2021] [Indexed: 01/21/2023]
Abstract
Objective Internet‐based guided self‐help (GSH) programs increase accessibility and utilization of evidence‐based treatments in binge‐eating disorder (BED). We evaluated acceptance and short as well as long‐term efficacy of our 8‐session internet‐based GSH program in a randomized clinical trial with an immediate treatment group, and two waitlist control groups, which differed with respect to whether patients received positive expectation induction during waiting or not. Method Sixty‐three patients (87% female, mean age 37.2 years) followed the eight‐session guided cognitive‐behavioural internet‐based program and three booster sessions in a randomized clinical trial design including an immediate treatment and two waitlist control conditions. Outcomes were treatment acceptance, number of weekly binge‐eating episodes, eating disorder pathology, depressiveness, and level of psychosocial functioning. Results Treatment satisfaction was high, even though 27% of all patients dropped out during the active treatment and 9.5% during the follow‐up period of 6 months. The treatment, in contrast to the waiting conditions, led to a significant reduction of weekly binge‐eating episodes from 3.4 to 1.7 with no apparent rebound effect during follow‐up. All other outcomes improved as well during active treatment. Email‐based positive expectation induction during waiting period prior to the treatment did not have an additional beneficial effect on the temporal course and thus treatment success, of binge episodes in this study. Conclusion This short internet‐based program was clearly accepted and highly effective regarding core features of BED. Dropout rates were higher in the active and lower in the follow‐up period. Positive expectations did not have an impact on treatment effects. The present internet‐based guided self‐help program adds to the existing research regarding online treatment of binge‐eating disorder and is currently one of the two existing validated programs available in German language. It is based on an established cognitive‐behavioural treatment approach, shows high acceptance by patients and high efficacy after eight guided online sessions, thereby representing the shortest duration of currently evaluated treatments During the internet‐based therapy, the number of weekly binge‐eating episodes, depressive symptoms, eating disorder pathology as well as impairments in psychosocial functioning all significantly decreased. These positive effects were maintained during follow‐up (6 months). Abstainer rate (no binge‐eating during last month) continued to increase during follow‐up with booster sessions An email‐based pre‐treatment positive expectation induction did not alter the temporal course and thus treatment success, of binge episodes
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Affiliation(s)
- Andrea Wyssen
- Department of Psychology, Clinical Psychology and Psychotherapy, University of Fribourg, Fribourg, Switzerland.,University Hospital of Child and Adolescent Psychiatry and Psychotherapy, University of Bern, Bern, Switzerland
| | - Andrea H Meyer
- Department of Psychology, Clinical Psychology and Psychotherapy, University of Fribourg, Fribourg, Switzerland.,Institute of Psychology, Clinical Psychology and Epidemiology, University of Basel, Basel, Switzerland
| | - Nadine Messerli-Bürgy
- Department of Psychology, Clinical Child Psychology & Biological Psychology, University of Fribourg, Fribourg, Switzerland
| | - Felicitas Forrer
- Department of Psychology, Clinical Psychology and Psychotherapy, University of Fribourg, Fribourg, Switzerland
| | - Pierre Vanhulst
- Department of Informatics, Human-IST Institute, University of Fribourg, Fribourg, Switzerland
| | - Denis Lalanne
- Department of Informatics, Human-IST Institute, University of Fribourg, Fribourg, Switzerland
| | - Simone Munsch
- Department of Psychology, Clinical Psychology and Psychotherapy, University of Fribourg, Fribourg, Switzerland
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O'Loghlen E, Grant S, Galligan R. Shame and binge eating pathology: A systematic review. Clin Psychol Psychother 2021; 29:147-163. [PMID: 34010473 DOI: 10.1002/cpp.2615] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2021] [Revised: 05/16/2021] [Accepted: 05/17/2021] [Indexed: 11/10/2022]
Abstract
OBJECTIVE Shame is broadly implicated in the development and maintenance of eating pathology. However, the relationship between shame and binge eating symptoms specifically is less clear. This review aimed to clarify what types of shame are associated with binge eating symptoms and the antecedents and maintenance factors in these relationships. METHOD A systematic search for quantitative and qualitative empirical studies was conducted to identify evidence of the relationship between shame and binge eating symptoms. Altogether, 270 articles were identified and screened for eligibility in the review. RESULTS Results of the relevant empirical studies (n = 31) identified several types of shame associated with binge eating pathology: (i) internal shame, (ii) external shame, (iii) body shame and (iv) binge eating-related shame, as well as several mechanisms and pathways through which shame was associated with binge eating symptoms. DISCUSSION Drawing from the research findings, this review presents an original, integrated model of the cyclical shame-binge eating relationship. Clinical interventions that might break this cycle are discussed, as well as methodological weaknesses which limit causal inferences and important areas of future research.
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Affiliation(s)
- Elyse O'Loghlen
- Department of Psychological Sciences, Swinburne University of Technology, Hawthorn, Victoria, Australia
| | - Sharon Grant
- Department of Psychological Sciences, Swinburne University of Technology, Hawthorn, Victoria, Australia
| | - Roslyn Galligan
- Department of Psychological Sciences, Swinburne University of Technology, Hawthorn, Victoria, Australia
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14
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The association between separation individuation process and binge eating disorder in adolescents aged 12-18. Eat Weight Disord 2021; 26:1089-1096. [PMID: 32926344 DOI: 10.1007/s40519-020-01004-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/23/2020] [Accepted: 08/31/2020] [Indexed: 10/23/2022] Open
Abstract
PURPOSE To evaluate the associations between separation individuation (SI) process and binge eating disorder (BED) in adolescence aged 12-18 years old, as most challenges related to SI process and eating disorders (EDs) tend to arise in this age group. METHODS This is a cross-sectional study of 30 adolescents diagnosed with BED and 332 healthy adolescents as a control group. All adolescents diagnosed with BED underwent clinical interviews and all adolescents in the study filled in self-reported questionnaires. RESULTS Our results highlighted higher levels of need denial (p = 0.014) and rejection expectancy (p = 0.008) of SI difficulties in adolescents with BED as compared to the ones without BED. CONCLUSION This is the first study of its nature providing good evidence for the association between SI process and BED in adolescents. Although these difficulties in SI process by themselves are not evidence of causative link, these results can contribute to the understanding of the causative factors in BED and underpin further research. The correlation can be used as a consideration in the prevention and treatment of BED. LEVEL OF EVIDENCE Level III, case-control analytic study.
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Gill SK, Kaplan AS. A retrospective chart review study of symptom onset, diagnosis, comorbidities, and treatment in patients with binge eating disorder in Canadian clinical practice. Eat Weight Disord 2021; 26:1233-1242. [PMID: 33038001 PMCID: PMC8062397 DOI: 10.1007/s40519-020-01026-y] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/16/2020] [Accepted: 09/21/2020] [Indexed: 11/10/2022] Open
Abstract
PURPOSE In the Canadian healthcare setting, there is limited understanding of the pathways to diagnosis and treatment for patients with binge eating disorder (BED). METHODS This retrospective chart review examined the clinical characteristics, diagnostic pathways, and treatment history of adult patients diagnosed with BED. RESULTS Overall, 202 charts from 57 healthcare providers (HCPs) were reviewed. Most patients were women (69%) and white (78%). Mean ± SD patient age was 37 ± 12.1 years. Comorbidities identified in > 20% of patients included obesity (50%), anxiety (49%), depression and/or major depressive disorder (46%), and dyslipidemia (26%). Discussions regarding a diagnosis of BED were typically initiated more often by HCPs than patients. Most patients (64%) received a diagnosis of BED ≥ 3 years after symptom onset. A numerically greater percentage of patients received (past or current) nonpharmacotherapy than pharmacotherapy (84% vs. 67%). The mean ± SD number of binge eating episodes/week numerically decreased from pretreatment to follow-up with lisdexamfetamine (5.4 ± 2.8 vs. 1.7 ± 1.2), off-label pharmacotherapy (4.7 ± 3.9 vs. 2.0 ± 1.13), and nonpharmacotherapy (6.3 ± 4.8 vs. 3.5 ± 6.0) Across pharmacotherapies and nonpharmacotherapies, most patients reported improvement in symptoms of BED (84-97%) and in overall well-being (80-96%). CONCLUSIONS These findings highlight the importance of timely diagnosis and treatment of BED. Although HCPs are initiating discussions about BED, earlier identification of BED symptoms is required. Furthermore, these data indicate that pharmacologic and nonpharmacologic treatment for BED is associated with decreased binge eating and improvements in overall well-being. LEVEL OF EVIDENCE IV, chart review.
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Affiliation(s)
- Simerpal K Gill
- Bay Adelaide Centre, Medical Affairs, Takeda Canada Inc, 22 Adelaide Street West, Suite 3800, Toronto, ON, M5H 4E3, Canada.
| | - Allan S Kaplan
- Department of Psychiatry, University of Toronto, Toronto, ON, Canada
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Harris SR, Carrillo M, Fujioka K. Binge-Eating Disorder and Type 2 Diabetes: A Review. Endocr Pract 2021; 27:158-164. [PMID: 33554873 DOI: 10.1016/j.eprac.2020.10.005] [Citation(s) in RCA: 24] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/05/2020] [Revised: 09/01/2020] [Accepted: 10/27/2020] [Indexed: 12/31/2022]
Abstract
OBJECTIVE To familiarize health care providers with diagnosis and treatment of binge-eating disorder (BED), a common comorbidity of type 2 diabetes (T2DM). METHODS Literature review of binge eating and T2DM. Key words used in search include BED, T2DM, obesity, and treatment. RESULTS The prevalence of BED in patients with T2DM appears to be much higher than the 2% to 3.5% prevalence seen in the general population. Studies suggest that up to 20% of patients with T2DM have an underlying eating disorder, the most common of which is binge eating. BED is probably underdiagnosed, even though there are multiple simple tools that providers can use to improve screening for the disorder. Though the relationship between BED and hemoglobin A1c control can vary, it appears that binge-eating behaviors can worsen metabolic markers, including glycemic control. Various medications used by patients with diabetes have been associated with new-onset BED, and treatment may be as simple as removing or replacing such agents. Several medications have been found to significantly reduce binge-eating frequency, and potentially, weight. Patients with BED generally benefit from psychotherapy, including cognitive behavioral therapy. CONCLUSION BED, only recently added to the International Classification of Disease-10 diagnostic list, is very common in patients with obesity and T2DM. The diagnosis is important to establish, as treatment or referral for treatment, could potentially improve many of the comorbidities and metrics of T2DM.
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Affiliation(s)
- Samantha R Harris
- Scripps Clinic Medical Group, Division of Diabetes and Endocrinology, La Jolla, California
| | - Maritza Carrillo
- Scripps Clinic Medical Group, Division of Diabetes and Endocrinology, La Jolla, California.
| | - Ken Fujioka
- Scripps Clinic Medical Group, Division of Diabetes and Endocrinology, La Jolla, California
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Juchacz K, Kłos P, Dziedziejko V, Wójciak RW. The Effectiveness of Supportive Psychotherapy in Weight Loss in a Group of Young Overweight and Obese Women. Nutrients 2021; 13:nu13020532. [PMID: 33562001 PMCID: PMC7914739 DOI: 10.3390/nu13020532] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2021] [Revised: 01/28/2021] [Accepted: 02/03/2021] [Indexed: 01/20/2023] Open
Abstract
Overweight and obesity are among the most widespread health problems worldwide. The primary cause of obesity is an inability to control overeating. Therefore, today, obesity needs to be treated more as an eating disorder, i.e., a mental disorder, and thus, it should be approached as such. Taking the above together, this study aimed to assess the impact of supportive psychotherapy on reducing body weight in young overweight and obese women who attempted slimming therapy and, additionally, the possibility of maintaining the weight-loss effect in the long term. Sixty young women aged 20–30 were randomized into three groups that differed in therapeutic management. With the help of an individually selected diet plan, the highest effectiveness in weight loss was demonstrated in people whose weight reduction was supported by goal-oriented psychotherapy. In this group, a sustained effect of slimming and even further weight loss were observed six months following the discontinuation of the therapy. In conclusion, traditional slimming therapies using an individual diet plan and a dietitian’s care are effective; however, supportive psychotherapeutic work provides more beneficial results and maintains the change from a long-term perspective.
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Affiliation(s)
- Krzysztof Juchacz
- Department of Clinical Psychology, Poznan University of Medical Study, 60-812 Poznań, Poland;
| | - Patrycja Kłos
- Department of Biochemistry and Medical Chemistry, Pomeranian Medical University, 70-111 Szczecin, Poland;
- Correspondence: (P.K.); (R.W.W.); Tel.: +48-91-466-15-15 (P.K.); +48-61-854-72-74 (R.W.W.)
| | - Violetta Dziedziejko
- Department of Biochemistry and Medical Chemistry, Pomeranian Medical University, 70-111 Szczecin, Poland;
| | - Rafał W. Wójciak
- Department of Clinical Psychology, Poznan University of Medical Study, 60-812 Poznań, Poland;
- Correspondence: (P.K.); (R.W.W.); Tel.: +48-91-466-15-15 (P.K.); +48-61-854-72-74 (R.W.W.)
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Integrated weight loss and cognitive behavioural therapy (CBT) for the treatment of recurrent binge eating and high body mass index: a randomized controlled trial. Eat Weight Disord 2021; 26:249-262. [PMID: 31983019 DOI: 10.1007/s40519-020-00846-2] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/29/2019] [Accepted: 01/08/2020] [Indexed: 02/03/2023] Open
Abstract
PURPOSE The association between binge eating and obesity is increasing. Treatments for disorders of recurrent binge eating comorbid with obesity reduce eating disorder (ED) symptoms, but not weight. This study investigated the efficacy and safety of introducing a weight loss intervention to the treatment of people with disorders of recurrent binge eating and a high body mass index (BMI). METHODS A single-blind randomized controlled trial selected adults with binge eating disorder or bulimia nervosa and BMI ≥ 27 to < 40 kg/m2. The primary outcome was sustained weight loss at 12-month follow-up. Secondary outcomes included ED symptoms. Mixed effects models analyses were conducted using multiple imputed datasets in the presence of missing data. RESULTS Ninety-eight participants were randomized to the Health Approach to Weight Management and Food in Eating Disorders (HAPIFED) or to the Cognitive Behavioural Therapy-Enhanced (CBT-E). No between-group differences were found for percentage of participants achieving weight loss or secondary outcomes, except for reduction of purging behaviour, which was greater with HAPIFED (p = 0.016). Binge remission rates specifically at 12-month follow-up favoured HAPIFED (34.0% vs 16.7%; p = 0.049). Overall, significant improvements in the reduction of ED symptoms were seen in both groups and these were sustained at the 12-month follow-up. CONCLUSION HAPIFED was not superior to CBT-E in promoting clinically significant weight loss and was not significantly different in reducing most ED symptoms. No harm was observed with HAPIFED, in that no worsening of ED symptoms was observed. Further studies should test approaches that target both the management of ED symptoms and the high BMI. LEVEL OF EVIDENCE Level I, randomized controlled trial TRIAL REGISTRATION: US National Institutes of Health clinical trial registration number NCT02464345, date of registration 1 June 2015.
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19
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Glisenti K, Strodl E, King R, Greenberg L. The feasibility of emotion-focused therapy for binge-eating disorder: a pilot randomised wait-list control trial. J Eat Disord 2021; 9:2. [PMID: 33407948 PMCID: PMC7789500 DOI: 10.1186/s40337-020-00358-5] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/23/2020] [Accepted: 12/06/2020] [Indexed: 12/25/2022] Open
Abstract
BACKGROUND Research into psychotherapy for binge-eating disorder (BED) has focused mainly on cognitive behavioural therapies, but efficacy, failure to abstain, and dropout rates continue to be problematic. The experience of negative emotions is among the most accurate predictors for the occurrence of binge eating episodes in BED, suggesting benefits to exploring psychological treatments with a more specific focus on the role of emotion. The present study aimed to explore the feasibility of individual emotion-focused therapy (EFT) as a treatment for BED by examining the outcomes of a pilot randomised wait-list controlled trial. METHODS Twenty-one participants were assessed using a variety of feasibility measures relating to recruitment, credibility and expectancy, therapy retention, objective binge episodes and days, and binge eating psychopathology outcomes. The treatment consisted of 12 weekly one-hour sessions of EFT for maladaptive emotions over 3 months. A mixed model approach was utilised with one between effect (group) using a one-way analysis of variance (ANOVA) to test the hypothesis that participants immediately receiving the EFT treatment would demonstrate a greater degree of improvement on outcomes relating to objective binge episodes and days, and binge eating psychopathology, compared to participants on the EFT wait-list; and one within effect (time) using a repeated-measures ANOVA to test the hypothesis that participation in the EFT intervention would result in significant improvements in outcome measures from pre to post-therapy and then maintained at follow-up. RESULTS Recruitment, credibility and expectancy, therapy retention outcomes indicated EFT is a feasible treatment for BED. Further, participants receiving EFT demonstrated a greater degree of improvement in objective binge episodes and days, and binge eating psychopathology compared to EFT wait-list control group participants. When participants in the EFT wait-list control group then received treatment and outcomes data were combined with participants who initially received the treatment, EFT demonstrated significant improvement in objective binge episodes and days, and binge eating psychopathology for the entire sample. CONCLUSIONS These findings provide further preliminary evidence for the feasibility of individual EFT for BED and support more extensive randomised control trials to assess efficacy. TRIAL REGISTRATION The study was retrospectively registered with the Australian New Zealand Clinical Trials Registry ( ACTRN12620000563965 ) on 14 May 2020.
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Affiliation(s)
- Kevin Glisenti
- School of Psychology and Counselling, Queensland University of Technology, Faculty of Health, Brisbane, Queensland, Australia.
| | - Esben Strodl
- School of Psychology and Counselling, Queensland University of Technology, Faculty of Health, Brisbane, Queensland, Australia
| | - Robert King
- School of Psychology and Counselling, Queensland University of Technology, Faculty of Health, Brisbane, Queensland, Australia
| | - Leslie Greenberg
- Department of Psychology, York University, Faculty of Health, Toronto, Canada
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20
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Norberg MM, Handford CM, Magson NR, Basten C. Reevaluating Cue Exposure and Response Prevention in a Pilot Study: An Updated Treatment for Binge Eating Disorder. Behav Ther 2021; 52:195-207. [PMID: 33483117 DOI: 10.1016/j.beth.2020.04.003] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/11/2019] [Revised: 04/06/2020] [Accepted: 04/08/2020] [Indexed: 12/14/2022]
Abstract
Approximately half of individuals with binge eating disorder (BED) fail to improve when treated with cognitive behavioral therapy; thus, better treatments are needed. Cue exposure and response prevention (CERP) may be one option, but its full potential for reducing binge eating remains unknown because prior applications for binge eating have not utilized the broad range of strategies believed to optimize exposure therapy. The current single-subject AB design investigated the acceptability and effectiveness of a comprehensive CERP treatment among 8 women who met DSM-5 criteria for binge eating disorder. Changes in the number of binges were measured from baseline to the end of treatment, and desire to eat, salivation, and idiographic expectancies of aversive outcomes to food-cue exposure (idiographic CS-US expectancies), including expectancies about ability to tolerate distress when exposed to food cues were measured across the course of treatment. Statistical analysis revealed a significant reduction in the number of binges from baseline to the end of treatment. Across the course of treatment, desire to eat and idiographic CS-US expectancies reduced, and distress tolerance expectancies increased. No participants dropped out and all reported being maximally satisfied with the treatment. Based on these findings, future randomized-control trials with larger samples should examine the efficacy of CERP and mechanisms underlying change with the aim of establishing a more effective treatment for binge eating disorder.
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da Luz FQ, Hay P, Wisniewski L, Cordás T, Sainsbury A. The treatment of binge eating disorder with cognitive behavior therapy and other therapies: An overview and clinical considerations. Obes Rev 2020; 22. [PMID: 33350574 DOI: 10.1111/obr.13180] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/27/2020] [Revised: 11/13/2020] [Accepted: 11/15/2020] [Indexed: 11/29/2022]
Abstract
Binge eating disorder (BED) is a public health problem in several countries. BED is commonly associated with comorbidities such as obesity, diabetes, and depression. Notwithstanding the health problems associated with BED, evidence-based treatments for BED are not widely used by healthcare professionals worldwide. Thus, we provide an overview of the leading evidence-based psychological therapies for BED, with the intention of informing healthcare professionals and the general community and facilitating greater provision of treatment. Cognitive behavior therapy (CBT) for BED is briefly presented, focusing mainly on adaptations and stages of the cognitive behavior therapy-enhanced (CBT-E) transdiagnostic model for eating disorders. We also succinctly discuss the use of CBT in combination with weight management interventions or pharmacotherapy, as well as the use of interpersonal therapy and dialectical behavior therapy for BED. We conclude that there is a variety of evidence-based psychological therapies that can be used by a variety of healthcare professionals (not only by psychologists) to help reduce binge eating and associated psychopathology in people with BED. Given the high and increasing prevalence of BED, as well as the availability of effective evidence-based treatments, we encourage more healthcare professionals to explore up-skilling to assist people with BED.
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Affiliation(s)
- Felipe Q da Luz
- Eating Disorders Program (AMBULIM), Institute of Psychiatry, Faculty of Medicine, University of São Paulo, São Paulo, Brazil
- Charles Perkins Centre, The Boden Collaboration for Obesity, Nutrition, Exercise & Eating Disorders, Faculty of Medicine and Health, The University of Sydney, Sydney, NSW, Australia
| | - Phillipa Hay
- Translational Health Research Institute, School of Medicine, Western Sydney University, Sydney, NSW, Australia
| | - Lucene Wisniewski
- Center for Evidence Based Treatment, Shaker Heights, OH, USA
- Department of Psychological Sciences, Case Western Reserve University, Cleveland, OH, USA
| | - Táki Cordás
- Eating Disorders Program (AMBULIM), Institute of Psychiatry, Faculty of Medicine, University of São Paulo, São Paulo, Brazil
| | - Amanda Sainsbury
- School of Human Sciences, Faculty of Science, The University of Western Australia, Perth, WA, Australia
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Process Evaluation of a Personality Targeted Intervention for Addictive Eating in Australian Adults. Behav Sci (Basel) 2020; 10:bs10120186. [PMID: 33287346 PMCID: PMC7761794 DOI: 10.3390/bs10120186] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2020] [Revised: 11/16/2020] [Accepted: 11/30/2020] [Indexed: 12/11/2022] Open
Abstract
Addictive eating prevalence is estimated at 15-20% in studied populations, and is associated with concurrent mental health conditions and eating disorders as well as overweight and obesity. However, few evidence-based interventions targeting addictive eating are available. The further development of evidence-based interventions requires assessment of intervention feasibility and efficacy. This study aimed to determine the feasibility, including intervention delivery and program acceptability, of FoodFix; a personality targeted intervention for the treatment of addictive eating behaviours in Australian adults. Participants (n = 52) were randomised to intervention (n = 26) or wait-list control groups (n = 26) and received three personalised telehealth sessions with an Accredited Practising Dietitian over seven weeks. Intervention delivery was assessed by tracking adherence to scheduled timing of intervention sessions. Program acceptability of participants was assessed via an online process evaluation survey and program acceptability of intervention providers was assessed via semi-structured phone interviews. In total, 79% of participants adhered to scheduled timing for session two and 43% for session three, defined as within one week (before/after) of the scheduled date. Further, 21% of participants completed the process evaluation survey (n = 11). The majority of participants were extremely/very satisfied with FoodFix (n = 7, 63%). Intervention providers (n = 2) expressed that they felt adequately trained to deliver the intervention, and that the overall session format, timing, and content of FoodFix was appropriate for participants. These findings highlight the importance of assessing intervention feasibility to further understand intervention efficacy.
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Visweswaraiah N, Nathan K. Adolescent Obesity and Eating Disorders: Can Calorie Restriction have a Positive Impact. CURRENT NUTRITION & FOOD SCIENCE 2020. [DOI: 10.2174/1573401315666190114153400] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
Background:
The current obesogenic environment with relatively increased affordability
and availability of high calorie food and beverages, has led to an alarming increase in the prevalence
of obesity and related lifestyle disorders in children and adolescents, predisposing them to accelerated
aging. The increased prevalence may be due to the eating behavior of adolescents, their genetic
and molecular etiology and/or due to the impact of psychological stress and their wrong lifestyle
choices. Calorie restriction has been extensively researched for reducing the obesity in adolescents
and adults but is yet to be successfully implemented.
Objective:
The present review paper focuses on the types of calorie restriction diets, the role of its
mimics and the nutrigenomic mechanisms that may be helpful in reducing obesity and related disorders
in the adolescents. The role of behavioral therapeutic techniques and physical activity has also
been highlighted in addition to the calorie restricted diet for bringing about an overall lifestyle modification
in the management of obesity.
Conclusion:
Food preferences are acquired in childhood and sound nutritional practices should be
established in childhood to prevent lifestyle disorders and premature aging. Though CR is a known
and preferred non-pharmacological intervention in the management of obesity, its implemention has
not been explored and evaluated extensively. This is a vital area that needs scientific research as the
goals of obesity managements are no longer just weight loss through dietary restrictions. An interdisciplinary
method to lifestyle modification in the management of adolescent obesity addressing all
physiological and psychosocial aspects is recommended.
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Affiliation(s)
- Naveen Visweswaraiah
- Foundation for Assessment and Integration of Traditional Health Systems, Bengaluru, Karnataka, 560027, India
| | - Kousalya Nathan
- Department of Lifestyle Management, Apollo Spectra Hospitals, MRC Nagar RA Puram, Chennai, 600028, India
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Profiling Metacognition in Binge Eating Disorder. JOURNAL OF RATIONAL-EMOTIVE AND COGNITIVE-BEHAVIOR THERAPY 2020. [DOI: 10.1007/s10942-020-00364-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
AbstractResearch has shown that metacognition may play a role in problem eating. In this study we explored whether aspects of metacognition are relevant to the understanding of binge eating in patients with Binge Eating Disorder. We aimed to ascertain: (1) the presence of metacognitive beliefs about binge eating; (2) the goal of, and stop signal for, binge eating; and (3) the impact of binge eating on self-consciousness. Ten Binge Eating Disorder patients took part in the study and were assessed using the metacognitive profiling semi-structured interview. Results suggested that all patients endorsed both positive and negative metacognitive beliefs about binge eating. The goals of binge eating were stop thinking about personal concerns and improve emotional state. All patients reported that they did not know when these goals had been reached. The stop signals for binge eating included physical discomfort, beliefs about binge eating not being the best way to solve problems, and environmental stimuli. All patients also confirmed that a reduction in self-consciousness occurred during a binge eating episode. The results of this study confirm that metacognition may indeed be relevant to the understanding of Binge Eating Disorder.
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Abstract
Yoga and its relation to embodiment and disordered eating has only recently received research attention. Nevertheless, early research indicates that yoga is an effective tool in the prevention and treatment of eating disorders. It is assumed that yoga ameliorates eating disorder symptoms and facilitates a shift from negative towards positive body image and well-being by cultivating positive embodiment (i.e., the ability to feel a sense of connection between mind and body). In order to provide the context of the constructs of disordered eating, embodiment, and yoga, this article presents a brief overview and conceptualization of these constructs. The three major eating disorders and current treatment methods are described. Further, the philosophical roots and theoretical models of embodiment are delineated and their communal core features are outlined. Lastly, the origin, basic principles, and modern interpretations of yoga are discussed.
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Affiliation(s)
- Iris Perey
- Chair of Sport and Health Management, Technical University of Munich , Munich, Germany
| | - Catherine Cook-Cottone
- Department of Counseling, School, and Educational Psychology, University at Buffalo, State University of New York , Albany, USA
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A review of binge eating disorder and obesity. NEUROPSYCHIATRIE : KLINIK, DIAGNOSTIK, THERAPIE UND REHABILITATION : ORGAN DER GESELLSCHAFT ÖSTERREICHISCHER NERVENÄRZTE UND PSYCHIATER 2020; 35:57-67. [PMID: 32346850 DOI: 10.1007/s40211-020-00346-w] [Citation(s) in RCA: 52] [Impact Index Per Article: 13.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/24/2020] [Accepted: 03/24/2020] [Indexed: 12/13/2022]
Abstract
Binge eating disorder (BED) is a mental illness characterised by recurrent binge eating episodes in the absence of appropriate compensatory behaviours. Consequently, BED is strongly associated with obesity. The current review aims to provide an update of the most relevant aspects of BED (e.g., clinical profile, aetiology and treatment approaches), in order not only to facilitate a better understanding of the disorder and its clinical consequences, but also to identify potential targets of prevention and intervention. Patients with BED often present high comorbidity with other medical conditions and psychiatric disorders. Numerous risk factors have been associated with the development and maintenance of the disorder. Moreover, although some treatments for BED have proven to be effective in addressing different key aspects of the disorder, the rates of patients that have ever received specific treatment for BED are very low. The factors involved and how to implement effective treatments will be discussed for the purpose of addressing the eating symptomatology and comorbid obesity.
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Anderson LM, Smith KM, Schaefer LM, Crosby RD, Cao L, Engel SG, Crow SJ, Wonderlich SA, Peterson CB. Predictors and moderators of treatment outcome in a randomized clinical trial for binge-eating disorder. J Consult Clin Psychol 2020; 88:631-642. [PMID: 32338932 DOI: 10.1037/ccp0000503] [Citation(s) in RCA: 20] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
OBJECTIVE The current study examined predictors and moderators of two interventions for binge-eating disorder (BED). METHOD Participants were 112 adults with BED (Mage = 39.7 ± 13.4 years; MBMI = 35.1 ± 13.4 kg/m²; 82% female; 91% Caucasian) randomly assigned to integrative cognitive-affective therapy for BED (ICAT-BED) or guided self-help cognitive-behavioral therapy (CBTgsh). Generalized linear models examined predictors and moderators of objective binge-eating episode (OBE) frequency and OBE abstinence at end-of-treatment (EOT) and 6-month follow-up (FU). RESULTS Lower levels of baseline dietary restraint and emotion regulation difficulties predicted greater reductions in OBE frequency at EOT and FU, respectively. At EOT, greater pretreatment self-control predicted greater reductions in OBE frequency in ICAT-BED than CBTgsh (ps < .05). In addition, low shape/weight overvaluation predicted greater reductions in OBE frequency in ICAT-BED than CBTgsh, whereas high shape/weight overvaluation predicted comparable reductions in OBE frequency across treatments at EOT (ps < .02). At EOT and FU, greater baseline actual-ideal self-discrepancy predicted significantly greater reductions in OBE frequency in ICAT-BED, than CBTgsh (ps < .02). No significant predictor or moderator effects were observed for models examining OBE abstinence. CONCLUSION This study identified two general predictors and four moderators of BED treatment response. However, only one predictor (actual-ideal self-discrepancy) interacted with treatment type to differentially predict OBE frequencies at both EOT and FU. Altogether, findings suggest that ICAT-BED may confer specific and durable improvements in OBE frequencies among individuals with high actual-ideal self-discrepancy. Therefore, patients demonstrating these characteristics may be more likely to benefit from ICAT-BED. (PsycInfo Database Record (c) 2020 APA, all rights reserved).
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Affiliation(s)
- Lisa M Anderson
- Department of Psychiatry and Behavioral Sciences, University of Minnesota Medical School
| | - Kathryn M Smith
- Department of Psychiatry and The Behavioral Sciences, University of Southern California
| | | | | | - Li Cao
- Sanford Center for Biobehavioral Research
| | | | - Scott J Crow
- Department of Psychiatry and Behavioral Sciences, University of Minnesota Medical School
| | | | - Carol B Peterson
- Department of Psychiatry and Behavioral Sciences, University of Minnesota Medical School
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Valbrun LP, Zvonarev V. The Opioid System and Food Intake: Use of Opiate Antagonists in Treatment of Binge Eating Disorder and Abnormal Eating Behavior. J Clin Med Res 2020; 12:41-63. [PMID: 32095174 PMCID: PMC7011935 DOI: 10.14740/jocmr4066] [Citation(s) in RCA: 22] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2019] [Accepted: 12/28/2019] [Indexed: 12/23/2022] Open
Abstract
Eating disorders (EDs) and substance use disorders (SUDs) commonly co-occur, especially in conjunction with affective syndromes, yet little is known about opiate abuse and ED symptoms in patients on naltrexone-bupropion therapy. Moreover, evidence suggests that the opioid system can also be regarded as one of the major systems regulating the anticipatory processes preceding binge eating episodes. The lack of evidence in the effectiveness of psychotherapy treatment in addition to psychotropic mediations compounds the difficulties in stabilizing individuals with EDs. This article aims to exhaustively review literature relating to the use of opioid antagonists in the management of binge eating disorder (BED) and other abnormal eating habits and how this can be augmented by the use of psychological approaches to come up with the most effective therapy or combination of therapies to manage these conditions. Although this approach is promising, it has not been evaluated. A review of the literature pertaining to the use of naltrexone in patients with EDs was performed through PubMed, PsycINFO and MEDLINE. We selected 63 relevant articles published between 1981 and 2018 and those written in English. Search terms included “Opioid antagonists”, “naltrexone”, “bupropion” and “Psychotherapy” each combined with “Binge Eating Disorder”, “Bulimia Nervosa”, “Anorexia Nervosa”, “Eating Disorder”, “EDNOS” and “Obesity”. While working with these articles, we also identified several problems related to use of these methods in real clinical practice. Seventy-seven articles were reviewed, and 63 were selected for inclusion. Data obtained from these sources confirmed that the blockade of opioid receptors diminishes food intake. More recent findings also indicate that the combination of bupropion and naltrexone can induce weight loss. Augmentation of this by introducing psychotherapy may lead to better outcomes. Cognitive behavioral therapy (CBT) was the most frequently recommended psychotherapy intervention, showing efficacy for EDs and chemical addictions as documented by most of the studies, but with uncertain efficacy when utilized as augmentation strategy. There are limited data supporting the use of psychotherapy in augmentation of standard therapy in ED; however, there is evidence to support that psychotherapy is safe in this population and has been effective in cases of patients with opiate addiction with and without psychiatric comorbidities as well as BED. More research is needed to establish treatment guidelines. Combining pharmacotherapeutic and psychotherapeutic interventions leads to the achievement of a better outcome in managing patients with EDs. Involving families or the use of support groups increases chances of adherence to the prescribed interventions resulting in higher rates of remission. However, it is clear that all of these interventions must occur in the context of a comprehensive treatment program. We believe that patient-specific psychotherapy may not only facilitate the treatment process, but also cause significant alterations in eating pattern. This approach for BED may lead to more significant treatment outcomes, but this possibility must be tested in larger samples.
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Affiliation(s)
- Leon P Valbrun
- Department of Psychiatry, Interfaith Medical Center, 1545 Atlantic Avenue, Brooklyn, NY 11213, USA
| | - Valeriy Zvonarev
- School of Behavioral Sciences, California Southern University, 3330 Harbor Blvd, Costa Mesa, CA 92626, USA
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Munsch S, Wyssen A, Vanhulst P, Lalanne D, Steinemann ST, Tuch A. Binge-eating disorder treatment goes online - feasibility, usability, and treatment outcome of an Internet-based treatment for binge-eating disorder: study protocol for a three-arm randomized controlled trial including an immediate treatment, a waitlist, and a placebo control group. Trials 2019; 20:128. [PMID: 30760299 PMCID: PMC6375147 DOI: 10.1186/s13063-019-3192-z] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2018] [Accepted: 01/10/2019] [Indexed: 12/14/2022] Open
Abstract
Background Binge-eating disorder (BED) is characterized by recurrent episodes of loss of control over eating and is related to a higher prevalence of other mental disorders and somatic consequences associated with overweight and obesity. In community-based samples, 2–4% of women and 1–3% men are diagnosed with BED. Psychotherapeutic interventions focusing on maintenance factors of disturbed eating behavior have proven to be effective. However, treatment access is limited for a considerable number of patients with BED. A lack of specialized institutions and treatment resources, but also long distances to treatment facilities for people living in remote or rural areas are often causes of insufficient care. Internet-based guided self-help (GSH) programs have the potential to fill this gap. Methods This project aims to develop and evaluate an Internet-based treatment for BED derived from an evidence-based manualized cognitive behavioral therapy (CBT). The primary goal is to test feasibility and suitability of the Internet-based program and to evaluate the treatment outcome in comparison to a pure and a placebo-inspired waitlist control group (i.e. reduction of binge-eating episodes and eating disorder pathology as primary outcome variables). In total, 60 women and men aged 18–70 years with a BED diagnosis will be recruited. The Internet-based GSH treatment comprises eight sessions followed by three booster sessions. The placebo-inspired waitlist control group receives weekly messages containing information increasing positive expectations regarding the treatment effects during the four-week waiting period. The pure waitlist control group receives weekly messages simply asking patients to fill in a short questionnaire. Discussion The access to evidence-based treatments for BED might be made easier using an Internet-based GSH approach. The present study protocol presents a randomized controlled trial. As well as evaluating the suitability and efficacy of the Internet-based GSH treatment, there will also be a prelimarily investigation on the influence of positive expectations (placebo) for a therapeutic intervention on core symptoms. Trial registration German Clinical Trials Register, DRKS00012355. Registered on 14 September 2017.
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Affiliation(s)
- Simone Munsch
- Department of Clinical Psychology and Psychotherapy, University of Fribourg, Rue de Faucigny 2, 1700, Fribourg, Switzerland.
| | - Andrea Wyssen
- Department of Clinical Psychology and Psychotherapy, University of Fribourg, Rue de Faucigny 2, 1700, Fribourg, Switzerland
| | - Pierre Vanhulst
- Human-IST Institute, University of Fribourg, Boulevard de Perolles 90, 1700, Fribourg, Switzerland
| | - Denis Lalanne
- Human-IST Institute, University of Fribourg, Boulevard de Perolles 90, 1700, Fribourg, Switzerland
| | - Sharon T Steinemann
- Department of General Psychology and Methodology, University of Basel, Missionsstrasse 62a, 4055, Basel, Switzerland
| | - Alexandre Tuch
- Department of General Psychology and Methodology, University of Basel, Missionsstrasse 62a, 4055, Basel, Switzerland.,Swiss Health Observatory, Federal Statistical Office, Espace de l'Europe 10, 2010, Neuchâtel, Switzerland
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31
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Rubo M, Forrer F, Munsch S. [E-Therapies for Anorexia Nervosa, Bulimia Nervosa and Binge Eating Disorder]. PRAXIS 2019; 108:911-915. [PMID: 31662114 DOI: 10.1024/1661-8157/a003350] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Abstract
E-Therapies for Anorexia Nervosa, Bulimia Nervosa and Binge Eating Disorder Abstract. Eating disorders can often be treated with psychotherapy, but mostly due to a lack of trained clinicians, the majority of the persons concerned do not receive any treatment. In recent years, internet-based psychotherapy (e-therapy) was proposed and tested in several pilot projects as a novel possibility to offer a larger number of places on a treatment program with a constant number of available clinicians. Recent results are promising, but before an implementation into standard care can take place, more detailed knowledge must be provided as to which patients may be recommended this type of therapy as an equivalent alternative to traditional face-to-face therapy.
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Affiliation(s)
- Marius Rubo
- Klinische Psychologie und Psychotherapie, Universität Fribourg
| | | | - Simone Munsch
- Klinische Psychologie und Psychotherapie, Universität Fribourg
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Hilbert A, Herpertz S, Zipfel S, Tuschen-Caffier B, Friederich HC, Mayr A, Crosby RD, de Zwaan M. Early Change Trajectories in Cognitive-Behavioral Therapy for Binge-Eating Disorder. Behav Ther 2019; 50:115-125. [PMID: 30661552 DOI: 10.1016/j.beth.2018.03.013] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/27/2017] [Revised: 03/29/2018] [Accepted: 03/29/2018] [Indexed: 11/17/2022]
Abstract
Rapid response is considered the most well-established outcome predictor across treatments of binge-eating disorder (BED), including cognitive-behavioral therapy (CBT). This study sought to identify latent trajectories of early change in CBT and compare them to common rapid response classifications. In a multicenter randomized trial, 86 adults with BED (DSM-IV) or subsyndromal BED provided weekly self-reports of binge eating over the first 4 weeks of CBT, which were analyzed to predict binge eating, depression, and body mass index at posttreatment, 6-, and 18-month follow-up. Using latent growth mixture modeling, three patterns of early change-including moderate and low decreasing-as well as low stable binge eating were identified, which significantly predicted binge-eating remission at 6-month follow-up. Other classifications of rapid response based on Receiver Operating Characteristics curve analyses or on the literature (≥ 10% reduction in binge eating at week 1, ≥ 70% reduction in binge eating at week 4) only predicted posttreatment remission or overall depression, respectively. Latent change trajectories, but not other rapid response classifications, predicted binge-eating frequency over time. A fine-grained analysis of change over the first 4 weeks of CBT for BED revealed different trajectories of early change in binge eating that led to an improved prediction of binge-eating outcome, compared to that of common rapid response classifications. Thorough monitoring of early change trajectories during treatment may have clinical utility.
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Wierenga CE, Lavender JM, Hays CC. The potential of calibrated fMRI in the understanding of stress in eating disorders. Neurobiol Stress 2018; 9:64-73. [PMID: 30450374 PMCID: PMC6234260 DOI: 10.1016/j.ynstr.2018.08.006] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2017] [Revised: 05/18/2018] [Accepted: 08/17/2018] [Indexed: 12/18/2022] Open
Abstract
Eating disorders (ED), including Anorexia Nervosa (AN), Bulimia Nervosa (BN), and Binge Eating Disorder (BED), are medically dangerous psychiatric disorders of unknown etiology. Accumulating evidence supports a biopsychosocial model that includes genetic heritability, neurobiological vulnerability, and psychosocial factors, such as stress, in the development and maintenance of ED. Notably, stress hormones influence appetite and eating, and dysfunction of the physiological stress response has been implicated in ED pathophysiology. Stress signals also appear associated with food reward neurocircuitry response in ED, providing a possible mechanism for the role of stress in appetite dysregulation. This paper provides a review of some of the interacting psychological, behavioral, physiological, and neurobiological mechanisms involved in the stress response among individuals with ED, and discusses novel neuroimaging techniques to address potential physiological confounds of studying neural correlates of stress in ED, such as calibrated fMRI.
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Affiliation(s)
- Christina E Wierenga
- University of California San Diego, Department of Psychiatry, San Diego, CA, USA
| | - Jason M Lavender
- University of California San Diego, Department of Psychiatry, San Diego, CA, USA
| | - Chelsea C Hays
- SDSU/UC San Diego Joint Doctoral Program in Clinical Psychology, San Diego, CA, USA
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Glisenti K, Strodl E, King R. Emotion-focused therapy for binge-eating disorder: A review of six cases. Clin Psychol Psychother 2018; 25:842-855. [PMID: 30118179 DOI: 10.1002/cpp.2319] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2017] [Revised: 06/06/2018] [Accepted: 07/14/2018] [Indexed: 12/13/2022]
Abstract
OBJECTIVE This study aimed to provide preliminary evidence of the usefulness of emotion-focused therapy (EFT) for binge-eating disorder (BED). METHODS We used a single-subject design in which 12 weeks of individual EFT were applied nonconcurrently to six female adult participants with BED, following three weekly baseline sessions. Participants were assessed for binge-eating psychopathology and emotion regulation difficulties on a weekly basis during baseline and treatment. They were assessed on a 2-, 4-, and 8-week basis during posttreatment, and they were assessed for binge-eating episodes, eating disorder attitudes, alexithymia, and psychiatric comorbidity at pretreatment and posttreatment. RESULTS All cases experienced reliable recovery from binge-eating psychopathology and a significant decrease in binge-eating frequency. For all cases, there was reliable improvement or recovery on eating and shape concerns, and there was improvement on weight concern for the majority of cases. For all cases, reliable recovery or improvement occurred in overall emotion regulation. Most cases that were in the clinical range pretreatment recovered for anxiety, and reliable improvement in or recovery from depression occurred for all cases. There was reliable recovery or improvement in alexithymia for half of the cases; however, the other half experienced no change or deteriorated. There were no treatment dropouts. CONCLUSION Individual EFT demonstrates potential as a psychological treatment for BED. The current study provides preliminary evidence to guide the development of a more extensive trial to test the efficacy of individual EFT for BED as well as to identify possible mechanisms of change.
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Affiliation(s)
- Kevin Glisenti
- School of Psychology and Counselling, Queensland University of Technology, Brisbane, Australia
| | - Esben Strodl
- School of Psychology and Counselling, Queensland University of Technology, Brisbane, Australia
| | - Robert King
- School of Psychology and Counselling, Queensland University of Technology, Brisbane, Australia
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Sensation seeking, binge-type eating disorders, victimization, and PTSD in the National Women's Study. Eat Behav 2018; 30:120-124. [PMID: 30012278 DOI: 10.1016/j.eatbeh.2018.07.001] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/08/2017] [Revised: 06/28/2018] [Accepted: 07/03/2018] [Indexed: 12/31/2022]
Abstract
OBJECTIVE Higher degrees of sensation seeking (SS) are reported in community and clinical samples of individuals with eating disorders with binge-type features (BTEDs), but no reports exist in representative probability samples of adult women. Additionally, SS has been linked to victimization and PTSD, also associated with BTEDs, yet interrelationships between these variables are unexplored. METHODS A national, probability sample of 3006 adult women (≥18 y/o) completed structured telephone interviews including assessments for victimization, PTSD, bulimia nervosa (BN) and binge eating disorder (BED). The survey included the 6 items of the Disinhibition-Intentions for the Future (DIF) subscale of Zuckerman's Sensation Seeking Scale-VI, which asks how likely participants would be to engage in given activities. Total SS score (TSSS-DIFS) was the sum of the 6 items' scores. Differences among the 3 groups (BN, BED, non-BN/BED) were compared using ANOVA covaried by age and post-hoc t-tests. Multiple regression tested the effects of age, number of victimization experiences (NVE), lifetime PTSD, and BTEDs on TSSS-DIFS. RESULTS There were significant differences in TSSS-DIFS across BTED diagnoses (p ≤ .001). Participants with BN (p ≤ .002) and those with BED (p ≤ .01) had significantly higher scores than those without BTEDs. These findings persisted in both groups after correcting for NVE and lifetime PTSD. TSSS-DIFS was significantly higher in participants with BTED with PTSD versus those without (p ≤ .025). DISCUSSION SS traits related to disinhibition occur more commonly in U.S. adult women with BN and BED, even after controlling for NVE and PTSD, which were also associated with higher TSSS-DIFS.
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Ghaderi A, Odeberg J, Gustafsson S, Råstam M, Brolund A, Pettersson A, Parling T. Psychological, pharmacological, and combined treatments for binge eating disorder: a systematic review and meta-analysis. PeerJ 2018; 6:e5113. [PMID: 29942715 PMCID: PMC6015752 DOI: 10.7717/peerj.5113] [Citation(s) in RCA: 41] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2018] [Accepted: 06/06/2018] [Indexed: 12/03/2022] Open
Abstract
Objective To systematically review the efficacy of psychological, pharmacological, and combined treatments for binge eating disorder (BED). Method Systematic search and meta-analysis. Results We found 45 unique studies with low/medium risk of bias, and moderate support for the efficacy of cognitive behavior therapy (CBT) and CBT guided self-help (with moderate quality of evidence), and modest support for interpersonal psychotherapy (IPT), selective serotonin reuptake inhibitors (SSRI), and lisdexamfetamine (with low quality of evidence) in the treatment of adults with BED in terms of cessation of or reduction in the frequency of binge eating. The results on weight loss were disappointing. Only lisdexamfetamine showed a very modest effect on weight loss (low quality of evidence). While there is limited support for the long-term effect of psychological treatments, we have currently no data to ascertain the long-term effect of drug treatments. Some undesired side effects are more common in drug treatment compared to placebo, while the side effects of psychological treatments are unknown. Direct comparisons between pharmaceutical and psychological treatments are lacking as well as data to generalize these results to adolescents. Conclusion We found moderate support for the efficacy of CBT and guided self-help for the treatment of BED. However, IPT, SSRI, and lisdexamfetamine received only modest support in terms of cessation of or reduction in the frequency of binge eating. The lack of long-term follow-ups is alarming, especially with regard to medication. Long-term follow-ups, standardized assessments including measures of quality of life, and the study of underrepresented populations should be a priority for future research.
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Affiliation(s)
- Ata Ghaderi
- Division of Psychology, Department of Clinical Neuroscience, Karolinska Institute, Sweden
| | - Jenny Odeberg
- Swedish Agency for Health Technology Assessment, and Assessment of Social Services, Stockholm, Sweden
| | - Sanna Gustafsson
- University Health Care Research Centre, Faculty of Medical Sciences, University College of Örebro, Örebro, Sweden.,Centre for Psychiatry Research, Department of Clinical Neuroscience, Karolinska Institute, Stockholm, Sweden
| | - Maria Råstam
- Department of Clinical Sciences, Lund University, Lund, Sweden.,Gillberg Neuropsychiatry Centre, University of Gothenburg, Gothenburg, Sweden
| | - Agneta Brolund
- Swedish Agency for Health Technology Assessment, and Assessment of Social Services, Stockholm, Sweden
| | - Agneta Pettersson
- Swedish Agency for Health Technology Assessment, and Assessment of Social Services, Stockholm, Sweden
| | - Thomas Parling
- Centre for Psychiatry Research, Department of Clinical Neuroscience, Karolinska Institute, Stockholm, Sweden.,Stockholm Health Care Services, Stockholm County Council, Stockholm, Sweden
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Pacanowski CR, Mason TB, Crosby RD, Mitchell JE, Crow SJ, Wonderlich SA, Peterson CB. Weight Change over the Course of Binge Eating Disorder Treatment: Relationship to Binge Episodes and Psychological Factors. Obesity (Silver Spring) 2018. [PMID: 29533531 PMCID: PMC5915913 DOI: 10.1002/oby.22149] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
OBJECTIVE Treatment for binge eating disorder (BED), a condition associated with both excess adiposity and psychological distress, has not typically produced significant weight loss despite reducing binge eating. Characterizing factors that promote or inhibit weight loss in individuals with co-occurring BED and obesity may help explain overall nonsignificant weight changes during treatment. METHODS In this study, 189 adults with BED participated in a randomized clinical trial evaluating the efficacy of 5 months of cognitive behavioral therapy. Assessments included measured height and weight at baseline, midtreatment, end of treatment (EOT), and 6-month follow-up, the Eating Disorder Examination interview, and questionnaires. RESULTS During treatment, there was a mean weight gain of 1.3 ± 12.0 lb. Twenty-two percent of the sample lost ≥ 5 lb, and 25% of the sample gained ≥ 8 lb. Results showed that baseline objective binge eating episodes predicted weight over treatment. Changes in weight were significantly positively related to concurrent changes in shape concern, weight concern, and disinhibition, but not binge eating episodes. Changes in objective binge eating episodes from baseline to EOT were associated with changes in weight from EOT to follow-up. CONCLUSIONS Further investigation of eating behavior during BED treatment to understand the energy balance contributions to weight change or stability is warranted.
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Affiliation(s)
- Carly R Pacanowski
- Department of Behavioral Health and Nutrition, University of Delaware, Newark, Delaware, USA
| | - Tyler B Mason
- Department of Preventive Medicine, University of Southern California Keck School of Medicine, Los Angeles, California, USA
- Department of Clinical Research, Neuropsychiatric Research Institute, Fargo, North Dakota, USA
- Department of Psychiatry and Behavioral Science, University of North Dakota School of Medicine and Health Sciences, Fargo, North Dakota, USA
| | - Ross D Crosby
- Department of Clinical Research, Neuropsychiatric Research Institute, Fargo, North Dakota, USA
- Department of Psychiatry and Behavioral Science, University of North Dakota School of Medicine and Health Sciences, Fargo, North Dakota, USA
| | - James E Mitchell
- Department of Clinical Research, Neuropsychiatric Research Institute, Fargo, North Dakota, USA
- Department of Psychiatry and Behavioral Science, University of North Dakota School of Medicine and Health Sciences, Fargo, North Dakota, USA
| | - Scott J Crow
- Department of Psychiatry, University of Minnesota Medical School, Minneapolis, Minnesota, USA
- The Emily Program, University of Minnesota, St. Paul, Minnesota, USA
| | - Stephen A Wonderlich
- Department of Clinical Research, Neuropsychiatric Research Institute, Fargo, North Dakota, USA
- Department of Psychiatry and Behavioral Science, University of North Dakota School of Medicine and Health Sciences, Fargo, North Dakota, USA
| | - Carol B Peterson
- Department of Psychiatry, University of Minnesota Medical School, Minneapolis, Minnesota, USA
- The Emily Program, University of Minnesota, St. Paul, Minnesota, USA
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Blanchet C, Mathieu MÈ, St-Laurent A, Fecteau S, St-Amour N, Drapeau V. A Systematic Review of Physical Activity Interventions in Individuals with Binge Eating Disorders. Curr Obes Rep 2018; 7:76-88. [PMID: 29460067 DOI: 10.1007/s13679-018-0295-x] [Citation(s) in RCA: 27] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
PURPOSE OF REVIEW Our systematic review aims to assess the overall evidence available in the literature regarding the role of physical activity (PA) in individuals with binge eating disorder (BED) and better understand the potential underlying mechanisms of action. RECENT FINDINGS Currently, the most effective and well-established psychological treatment for BED is cognitive behavioral therapy (CBT) with a remission rate around 80%. CBT is sometimes combined with pharmacotherapy targeting comorbidities associated with BED, such as obesity and depression. Another avenue of treatment that has been less studied is PA. It has been suggested that PA addresses the underlying mechanisms of BED and, thus, increases treatment efficiency. This systematic review provides additional knowledge concerning the benefits of PA in the treatment of individuals with BED including reduction of binge eating (BE) episodes and improvement in other associated comorbidities. Potential mechanisms of action of PA include neurochemical alterations affecting the reward system, reduction of negative affect, and its anorexigenic effects.
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Affiliation(s)
- Claudine Blanchet
- Département des Sciences de l'activité physique, Université du Québec à Trois-Rivières, Trois-Rivières, Canada
| | - Marie-Ève Mathieu
- Département de kinésiologie, Université de Montréal, Montréal, QC, Canada
| | - Audrey St-Laurent
- Département des Sciences de l'activité physique, Université du Québec à Trois-Rivières, Trois-Rivières, Canada
| | - Shirley Fecteau
- Centre intégré universitaire en santé et services sociaux de la Capitale-Nationale, Faculté de Médecine, Université Laval, Québec City, QC, Canada
| | - Nathalie St-Amour
- Département des Sciences infirmières, Université du Québec à Rimouski, Lévis, QC, Canada
- Programme de traitement des troubles du comportement alimentaire, Clinique St-Amour, Lévis, QC, Canada
| | - Vicky Drapeau
- Département d'éducation physique, PEPS, Université Laval, 2300, rue de la Terrasse, suite 2214, Québec City, QC, G1V 0A6, Canada.
- Centre de recherche de l'Institut universitaire de cardiologie et de pneumologie de Québec, Québec City, QC, Canada.
- Institut sur la nutrition et les aliments fonctionnels (INAF), Université Laval, Québec City, QC, Canada.
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Potential psychological & neural mechanisms in binge eating disorder: Implications for treatment. Clin Psychol Rev 2018; 60:32-44. [DOI: 10.1016/j.cpr.2017.12.004] [Citation(s) in RCA: 36] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2017] [Revised: 12/13/2017] [Accepted: 12/20/2017] [Indexed: 02/08/2023]
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Gomez Penedo JM, Constantino MJ, Coyne AE, Bernecker SL, Smith-Hansen L. Patient baseline interpersonal problems as moderators of outcome in two psychotherapies for bulimia nervosa. Psychother Res 2018; 29:799-811. [PMID: 29347888 DOI: 10.1080/10503307.2018.1425931] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/18/2022] Open
Abstract
Objective: We tested an aptitude by treatment interaction; namely, whether patients' baseline interpersonal problems moderated the comparative efficacy of cognitive-behavioral therapy (CBT) vs. interpersonal psychotherapy (IPT) for bulimia nervosa (BN). Method: Data derived from a randomized-controlled trial. Patients reported on their interpersonal problems at baseline; purge frequency at baseline, midtreatment, and posttreatment; and global eating disorder severity at baseline and posttreatment. We estimated the rate of change in purge frequency across therapy, and the likelihood of attaining clinically meaningful improvement (recovery) in global eating disorder severity by posttreatment. We then tested the interpersonal problem by treatment interactions as predictors of both outcomes. Results: Patients with more baseline overly communal/friendly problems showed steeper reduction in likelihood of purging when treated with CBT vs. IPT. Patients with more problems of being under communal/cold had similar reductions in likelihood of purging across both treatments. Patients with more baseline problems of being overly agentic were more likely to recover when treated with IPT vs. CBT, whereas patients with more problems of being under agentic were more likely to recover when treated with CBT vs. IPT. Conclusions: Interpersonal problems related to communion and agency may inform treatment fit among two empirically supported therapies for BN.
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Affiliation(s)
| | - Michael J Constantino
- b Department of Psychological and Brain Sciences , University of Massachusetts Amherst , Amherst , MA , USA
| | - Alice E Coyne
- b Department of Psychological and Brain Sciences , University of Massachusetts Amherst , Amherst , MA , USA
| | - Samantha L Bernecker
- b Department of Psychological and Brain Sciences , University of Massachusetts Amherst , Amherst , MA , USA.,d Present address: Department of Psychology , Harvard University , Cambridge , MA , USA
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Burton AL, Abbott MJ. The revised short-form of the Eating Beliefs Questionnaire: Measuring positive, negative, and permissive beliefs about binge eating. J Eat Disord 2018; 6:37. [PMID: 30450206 PMCID: PMC6219185 DOI: 10.1186/s40337-018-0224-0] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/03/2018] [Accepted: 10/04/2018] [Indexed: 12/17/2022] Open
Abstract
BACKGROUND The Eating Beliefs Questionnaire (EBQ) is a self-report assessment tool that measures positive and negative beliefs about food and eating that are believed to play a key role in maintaining binge eating behaviour that occurs in individuals with Bulimia Nervosa, Binge Eating Disorder and other atypical eating disorders. The present study aimed to further refine this measure with the addition of a third scale to assess permissive beliefs about eating, also thought to play a crucial role in the maintenance of binge eating. Permissive beliefs are defined as beliefs about eating that provide justification for the individual to engage in a binge eating episode. METHODS After consultation with the literature and endorsement from 10 experts in eating disorders, 19 permissive belief items were generated. Eight hundred eighty-three participants were recruited to complete a test battery online that included the EBQ and the new permissive items. RESULTS An exploratory factor analysis (n = 441) found a three-factor solution (positive, negative and permissive beliefs) explaining 63.4% of variance. A confirmatory factor analysis (n = 442) provided support for the three-factor model, with the data best supporting a shorter 18-item questionnaire. The revised scale demonstrated good internal consistency, as well as good convergent validity with measures of related eating disorder symptoms, emotional regulation, mood and anxiety. CONCLUSIONS With the addition of a third scale to measure permissive beliefs, the revised short-form of the EBQ offers clinicians and researchers a brief comprehensive tool for the measurement of positive, negative and permissive beliefs about binge eating.
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Affiliation(s)
- Amy L Burton
- Clinical Psychology Unit, School of Psychology, The University of Sydney, 94 Mallett St, Camperdown, 2050 Australia
| | - Maree J Abbott
- Clinical Psychology Unit, School of Psychology, The University of Sydney, 94 Mallett St, Camperdown, 2050 Australia
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Abstract
PURPOSE OF REVIEW Obesity is a chronic illness and its prevalence is growing worldwide and numerous factors play a role in the regulation of food intake. The prefrontal cortex (PFC) is involved in high-order executive function, regulation of limbic reward regions, and the inhibition of impulsive behaviors. Understanding the role of the PFC in the control of appetite regulation may contribute to a greater understanding of the etiology of obesity and could improve weight loss outcomes. RECENT FINDINGS Neuroimaging studies have identified lower activation in the left dorsolateral PFC (DLPFC) in obese compared to lean individuals and others have focused on efforts to improve cognitive control in this area of the brain. The DLPFC is a critical brain area associated with appetitive control, food craving, and executive functioning, indicating a candidate target area for treatment. Further studies are needed to advance our understanding of the relationship between obesity, appetite, and the DLPFC and provide validation for the effectiveness of novel treatments in clinical populations.
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Affiliation(s)
- Marci E Gluck
- Obesity and Diabetes Clinical Research Section, Phoenix Epidemiology and Clinical Research Branch, National Institute of Diabetes and Digestive and Kidney Diseases, National Institutes of Health, 4212 North 16th Street, Room 541, Phoenix, AZ, 85016, USA.
| | - Pooja Viswanath
- Obesity and Diabetes Clinical Research Section, Phoenix Epidemiology and Clinical Research Branch, National Institute of Diabetes and Digestive and Kidney Diseases, National Institutes of Health, 4212 North 16th Street, Room 541, Phoenix, AZ, 85016, USA
| | - Emma J Stinson
- Obesity and Diabetes Clinical Research Section, Phoenix Epidemiology and Clinical Research Branch, National Institute of Diabetes and Digestive and Kidney Diseases, National Institutes of Health, 4212 North 16th Street, Room 541, Phoenix, AZ, 85016, USA
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Mason TB, Crosby RD, Kolotkin RL, Grilo CM, Mitchell JE, Wonderlich SA, Crow SJ, Peterson CB. Correlates of weight-related quality of life among individuals with binge eating disorder before and after cognitive behavioral therapy. Eat Behav 2017; 27:1-6. [PMID: 28843136 PMCID: PMC5700842 DOI: 10.1016/j.eatbeh.2017.08.001] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/28/2017] [Revised: 08/16/2017] [Accepted: 08/17/2017] [Indexed: 01/12/2023]
Abstract
Individuals with obesity and binge eating disorder (BED) report poorer weight-related quality of life (WRQOL) compared to individuals with obesity alone. Cognitive behavioral therapy (CBT), the best available treatment for BED, does not consistently produce weight loss or improvements in weight QOL. The purpose of the current study was to examine baseline and longitudinal associations between eating-related and psychosocial variables and dimensions of weight QOL. We examined associations between predictor variables, including body mass index (BMI), eating disorder (ED) psychopathology, and psychosocial factors, in relation to three dimensions of WRQOL among 171 patients whom received CBT for BED. Participants completed interviews and self-report measures at baseline prior to CBT and at end of treatment. At baseline the following associations were significant: BMI, ED psychopathology, and self-esteem were associated with weight-related self-esteem; gender, BMI, and self-esteem were associated with weight-related public distress (i.e., stigma and worry in public because of one's weight); and age, BMI, and ED psychopathology were associated with weight-related physical function. At end of treatment, the following associations were significant: changes in ED psychopathology and coping predicted weight-related self-esteem; changes in coping and self-esteem predicted weight-related public distress; and changes in BMI and subjective binge eating predicted weight-related physical function. Overall, changes in a number of ED and associated symptoms were associated with improvements in WRQOL.
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Affiliation(s)
- Tyler B Mason
- Department of Preventative Medicine, University of Southern California, Los Angeles, CA, United States.
| | - Ross D Crosby
- Department of Clinical Research, Neuropsychiatric Research Institute, Fargo, ND, United States; Department of Psychiatry and Behavioral Science, University of North Dakota School of Medicine and Health Sciences, Fargo, ND, United States
| | - Ronette L Kolotkin
- Quality of Life Consulting, Durham, NC, United States; Department of Community and Family Medicine, Duke University School of Medicine, Durham, NC, United States; Western Norway University of Applied Sciences, Førde, Norway; Centre of Health Research, Førde Hospital Trust, Førde, Norway; Morbid Obesity Centre, Vestfold Hospital Trust, Tønsberg, Norway
| | - Carlos M Grilo
- Yale University School of Medicine, New Haven, CT, United States
| | - James E Mitchell
- Department of Clinical Research, Neuropsychiatric Research Institute, Fargo, ND, United States; Department of Psychiatry and Behavioral Science, University of North Dakota School of Medicine and Health Sciences, Fargo, ND, United States
| | - Stephen A Wonderlich
- Department of Clinical Research, Neuropsychiatric Research Institute, Fargo, ND, United States; Department of Psychiatry and Behavioral Science, University of North Dakota School of Medicine and Health Sciences, Fargo, ND, United States
| | - Scott J Crow
- University of Minnesota Medical School, Minneapolis, MN, United States; The Emily Program, St. Paul, MN, United States
| | - Carol B Peterson
- University of Minnesota Medical School, Minneapolis, MN, United States; The Emily Program, St. Paul, MN, United States
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Affiliation(s)
- Arif Önder
- Department of Child and Adolescent Psychiatry, Manisa Psychiatric Hospital, Merkez/Şehzadeler/Manisa, Turkey
| | - Aslı Sürer Adanir
- Department of Child and Adolescent Psychiatry, Akdeniz University School of Medicine, Antalya, Turkey
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McCuen-Wurst C, Ruggieri M, Allison KC. Disordered eating and obesity: associations between binge-eating disorder, night-eating syndrome, and weight-related comorbidities. Ann N Y Acad Sci 2017; 1411:96-105. [PMID: 29044551 DOI: 10.1111/nyas.13467] [Citation(s) in RCA: 175] [Impact Index Per Article: 25.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2017] [Revised: 08/04/2017] [Accepted: 08/14/2017] [Indexed: 12/14/2022]
Abstract
Binge-eating disorder (BED) and night-eating syndrome (NES) are two forms of disordered eating associated with overweight and obesity. While these disorders also occur in nonobese persons, they seem to be associated with weight gain over time and higher risk of diabetes and other metabolic dysfunction. BED and NES are also associated with higher risk of psychopathology, including mood, anxiety, and sleep problems, than those of similar weight status without disordered eating. Treatments are available, including cognitive behavior therapy (CBT), interpersonal psychotherapy, lisdexamfetamine, and selective serotonin reuptake inhibitors (SSRIs) for BED; and CBT, SSRIs, progressive muscle relaxation, and bright light therapy for NES.
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Affiliation(s)
- Courtney McCuen-Wurst
- Department of Psychiatry, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, Pennsylvania
| | - Madelyn Ruggieri
- Department of Psychiatry, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, Pennsylvania
| | - Kelly C Allison
- Department of Psychiatry, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, Pennsylvania
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Concurrent Improvement in Both Binge Eating and Depressive Symptoms with Naltrexone/Bupropion Therapy in Overweight or Obese Subjects with Major Depressive Disorder in an Open-Label, Uncontrolled Study. Adv Ther 2017; 34:2307-2315. [PMID: 28918581 PMCID: PMC5656719 DOI: 10.1007/s12325-017-0613-9] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2017] [Indexed: 11/26/2022]
Abstract
Introduction Binge eating disorder (BED) is associated with obesity and major depressive disorder (MDD). Naltrexone extended-release (ER)/bupropion ER (NB) is approved as an adjunct to diet and physical activity for chronic weight management. In a prospectively designed 24-week open-label, single-arm, single-site trial of 25 women with MDD and overweight/obesity, NB reduced weight and depressive symptoms. Methods This post hoc analysis investigated the relationship between change in self-reported binge eating behavior (evaluated with the Binge Eating Scale [BES]) and changes in weight, control of eating, and depressive symptoms. Results At baseline, 91% of subjects had moderate or severe BES scores, suggesting BED. BES scores were significantly improved from week 4, and by week 24, 83% reported “little or no problem.” Improvement in BES scores correlated with improvement in depressive symptoms and control of eating. Conclusion NB may be effective in reducing binge eating symptoms associated with MDD and overweight/obesity. Evaluation of NB in BED appears warranted. Funding Orexigen Therapeutics, Inc.
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Abstract
Binge eating is a distressing symptom common to bulimia nervosa (BN), anorexia nervosa binge/purge subtype (AN-BP) and binge-eating disorder (BED). Over the last 40 years, many attempts have been made to conceptualise this symptom in terms of its antecedents, function, triggers, consequences, and maintaining factors. Cognitive theories of binge eating have evolved as new evidence has emerged. This literature review summarises the main and most influential cognitive models of binge eating across different eating disorder presentations. Many theories have examined binge eating in the context of restriction or compensatory behaviours, as is often observed in cases of BN. Few theories have examined binge eating as it occurs in BED specifically. The long-term efficacy of cognitive behavioural therapy (CBT) treatment based on these models leaves much to be desired, and indicates that there may be maintaining factors of binge eating not addressed in the typical CBT treatment for eating disorders. More recent cognitive models of binge eating propose possible maintaining beliefs, but further study is required to validate these models. Suggestions for future research are presented.
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Hilbert A, Petroff D, Herpertz S, Kersting A, Pietrowsky R, Tuschen-Caffier B, Vocks S, Schmidt R. Meta-analysis of the effectiveness of psychological and medical treatments for binge-eating disorder (MetaBED): study protocol. BMJ Open 2017; 7:e013655. [PMID: 28360240 PMCID: PMC5372140 DOI: 10.1136/bmjopen-2016-013655] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/15/2022] Open
Abstract
INTRODUCTION Binge-eating disorder (BED) was included as its own diagnostic entity in the Fifth Edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5). An increasing number of treatment studies have been published, but an up-to-date comprehensive meta-analysis on diverse treatment approaches for BED is lacking. In an updated and extension of a previous meta-analysis, the goals of this study are to assess the short-term and long-term effectiveness of psychological and medical treatments for BED. METHODS AND ANALYSIS We will search bibliographic databases and study registries, including manual searches for studies published before January 2016. The search strategy will include terms relating to binge eating and diverse forms of psychological and medical interventions. Language will be restricted to English. The studies included will be treatment studies, that is, randomised-controlled trials, and non-randomised and non-controlled studies, for individuals with BED (DSM-IV or DSM-5), and studies that provided a pre-treatment and at least one post-treatment or follow-up assessment of binge eating. The primary outcomes will be the number of binge-eating episodes, abstinence from binge eating and diagnosis of BED at post-treatment and/or follow-up(s), and changes from pre-treatment to post-treatment and/or follow-up(s). Likewise, as secondary outcomes, eating disorder and general psychopathology, quality of life, and body weight will be analysed and adverse events and treatment drop-out will be examined. Study search, selection and data extraction, including risk of bias assessment, will be independently performed by 2 reviewers and consensus will be sought. Moderator analyses will be conducted, and equity aspects will be considered. Sensitivity analyses will be conducted to determine the robustness of the results. ETHICS AND DISSEMINATION Ethical approval is not required for this meta-analysis. Published in a peer-reviewed journal and disseminated electronically and in print, this meta-analysis will form the basis of the renewal of the German evidence-based S3 Guidelines of Diagnosis and Treatment of Eating Disorders, specifically BED. TRIAL REGISTRATION NUMBER CRD42016043604.
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Affiliation(s)
- Anja Hilbert
- Department of Medical Psychology and Medical Sociology, Department of Psychosomatic Medicine and Psychotherapy, University of Leipzig Medical Center, Leipzig, Germany
| | - David Petroff
- Clinical Trial Center Leipzig, University of Leipzig, Leipzig, Germany
| | - Stephan Herpertz
- Department of Psychosomatic Medicine, LWL-University Clinic, Ruhr-University Bochum, Bochum, Germany
| | - Anette Kersting
- Department of Psychosomatic Medicine and Psychotherapy, University of Leipzig Medical Center, Leipzig, Germany
| | - Reinhard Pietrowsky
- Department of Clinical Psychology, Institute of Experimental Psychology, University of Düsseldorf, Düsseldorf, Germany
| | | | - Silja Vocks
- Department of Clinical Psychology and Psychotherapy, Institute of Psychology, University of Osnabrück, Osnabrück, Germany
| | - Ricarda Schmidt
- Department of Medical Psychology and Medical Sociology, Department of Psychosomatic Medicine and Psychotherapy, University of Leipzig Medical Center, Leipzig, Germany
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Palavras MA, Hay P, Filho CADS, Claudino A. The Efficacy of Psychological Therapies in Reducing Weight and Binge Eating in People with Bulimia Nervosa and Binge Eating Disorder Who Are Overweight or Obese-A Critical Synthesis and Meta-Analyses. Nutrients 2017; 9:nu9030299. [PMID: 28304341 PMCID: PMC5372962 DOI: 10.3390/nu9030299] [Citation(s) in RCA: 49] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2017] [Revised: 03/10/2017] [Accepted: 03/14/2017] [Indexed: 02/07/2023] Open
Abstract
Recurrent binge eating episodes, the core feature of Bulimia Nervosa (BN) and Binge Eating Disorder (BED), are frequently comorbid with obesity. Psychological interventions, notably Cognitive Behavioural Therapy (CBT), are effective for binge eating reduction in BED or BN but less so for weight loss. Behavioural Weight Loss Therapy (BWLT) shows effectiveness for binge eating reduction and weight loss but the latter appears poorly sustained over time. Our aim was to review evidence for efficacy of psychological therapies for BN/BED associated with overweight or obesity in reducing binge frequency and weight. A systematic search for randomized controlled trials with adult samples who had BN or BED was conducted considering articles in English, French, Spanish and Portuguese with no restrictions for the timeline publication ending in March 2016. A quality appraisal of the trials and meta-analyses comparing BWLT to CBT were done. This review identified 2248 articles for screening and 19 published articles were selected. No trials of BN were identified. This review found CBT was favoured compared to BWLT with regard to short-term binge eating reduction. However, insufficient evidence was found for superiority for BWLT efficacy compared to CBT considering binge eating remission, reduction of binge eating frequency and weight loss. More research is needed to test the efficacy of psychological treatments for BED or BN with co-morbid overweight or obesity, including trials evaluating binge eating remission and weight loss in the long-term.
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Affiliation(s)
- Marly Amorim Palavras
- Eating Disorders Program (PROATA), Department of Psychiatry, Federal University of São Paulo (UNIFESP), São Paulo 04038-000, Brazil.
- School of Medicine, Western Sydney University, Sydney 2751, Australia.
| | - Phillipa Hay
- CAPES Foundation, Ministry of Education of Brazil, Brasilia 70047-900, Brazil.
- Centre for Health Research, School of Medicine, Western Sydney University, Sydney 2751, Australia.
| | - Celso Alves Dos Santos Filho
- Eating Disorders Program (PROATA), Department of Psychiatry, Federal University of São Paulo (UNIFESP), São Paulo 04038-000, Brazil.
| | - Angélica Claudino
- Eating Disorders Program (PROATA), Department of Psychiatry, Federal University of São Paulo (UNIFESP), São Paulo 04038-000, Brazil.
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Carrard I, Rothen S, Kruseman M, Khazaal Y. Assessment of Dysfunctional Cognitions in Binge-Eating Disorder: Factor Structure and Validity of the Mizes Anorectic Cognitions Questionnaire-Revised (MAC-R). Front Psychol 2017; 8:208. [PMID: 28261139 PMCID: PMC5311073 DOI: 10.3389/fpsyg.2017.00208] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2016] [Accepted: 02/01/2017] [Indexed: 11/28/2022] Open
Abstract
Background: Dysfunctional cognitions regarding weight and shape and their implications for self-esteem are considered core features of anorexia nervosa and bulimia nervosa. However, they have also been associated with the severity of binge eating disorder (BED). Therefore, they should be screened with appropriate instruments to tailor treatment to individual patient needs. The Mizes Anorectic Cognitions-Revised (MAC-R) is a self-report questionnaire that lists dysfunctional cognitions related to three hypothesized core beliefs typical of the psychopathology of eating disorders: weight and eating as the basis of approval from others; the belief that rigid self-control is fundamental to self-worth; and the rigidity of weight- and eating-regulation efforts. Objectives: The goal of the study was to confirm the factor structure and to assess the validity of the MAC-R among a sample that met full-threshold and subthreshold criteria for BED. Methods: We used data of women meeting full-threshold (n = 94) and subthreshold (n = 22) criteria for BED to conduct confirmatory factor analyses and to compute Spearman's correlations, in order to assess factorial, convergent, and discriminant validity. Results: Two models having a structure of three factors with or without a total score proved to be acceptable. The MAC-R total score was correlated with questionnaires assessing dimensions related to eating disorder psychopathology, adding to the validity of the questionnaire. Conclusion: These results were similar to those found in studies on the psychometric properties of the MAC among samples with anorexia nervosa or bulimia nervosa, encouraging the use of the MAC-R as a research or clinical tool in order to further document the core beliefs underlying BED.
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Affiliation(s)
- Isabelle Carrard
- Department of Nutrition and Dietetics, School of Health Sciences, University of Applied Sciences and Arts Western Switzerland (HES-SO) Geneva, Switzerland
| | - Stephane Rothen
- Department of Psychiatry, Geneva University Hospitals Geneva, Switzerland
| | - Maaike Kruseman
- Department of Nutrition and Dietetics, School of Health Sciences, University of Applied Sciences and Arts Western Switzerland (HES-SO) Geneva, Switzerland
| | - Yasser Khazaal
- Department of Psychiatry, Geneva University Hospitals Geneva, Switzerland
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