Group therapy for anorexic and bulimic patients. Some aspects on the conduction of group therapy and a critical review of some recent studies

How do women with eating disorders experience a new treatment combining guided physical exercise and dietary therapy? An interview study of women participating in a randomised controlled trial at the Norwegian School of Sport Sciences

OBJECTIVES

To investigate how women with bulimia nervosa (BN) and binge eating disorder (BED) experience participating in a new treatment programme for eating disorders, based on guided physical exercise and dietary therapy.

DESIGN AND PARTICIPANTS

Six women with BN and four with BED were semistructurally interviewed. Transcribed interviews were analysed using a text-condensing analytic approach.

RESULTS

The analysis resulted in four main categories: (1) 'a renewed attitude towards physical activity', (2) 'a new perception of food', (3) 'mixed feelings of being in a heterogeneous treatment group' and (4) 'insight in one's own recovery process', each with 2-4 subcategories to express nuances.

CONCLUSION

The treatment was experienced as beneficial. Improvements in the implementation of the programme were suggested.

TRIAL REGISTRATION NUMBER

NCT02079935.

O grupo multifamiliar como recurso no tratamento dos transtornos alimentares

INTRODUÇÃO: O presente artigo é resultado do trabalho sistemático dos autores com grupos multifamiliares de pacientes com diagnóstico de transtorno alimentar (anorexia nervosa, bulimia nervosa e transtorno alimentar não especificado), conjuntamente com seus familiares. As sessões são oferecidas em um hospital público na cidade de Porto Alegre (RS). MÉTODO: Os registros em vídeo de quatro sessões de terapia de grupo multifamiliar foram analisados qualitativamente utilizando-se a técnica de análise de conteúdo. RESULTADOS: Grupos multifamiliares assim constituídos não foram encontrados na revisão da literatura, e sim apenas relatos de grupos multifamiliares com finalidades exclusivamente psicoeducativas, sem a participação dos pacientes identificados. Na avaliação final, a modalidade de atendimento multifamiliar revelou-se como positiva para o atendimento dos casos avaliados. CONCLUSÕES: A pesquisa demonstrou que esse tipo de abordagem, associado ao tratamento unifamiliar e individual, pode tornar-se uma ferramenta eficaz de tratamento para esses pacientes e suas famílias.

A nutrition and behaviour change group for patients with anorexia nervosa

A pilot outpatient group for patients with anorexia nervosa was developed and co-led by a dietitian and a psychologist on a general hospital eating disorders team. The main goal of the short-term nutrition and behaviour change group was weight gain through normalization of eating. The first three groups conducted in the clinic were evaluated by monitoring group members' weights, collecting pre-treatment and post-treatment scores on the Eating Attitudes Test-26, and comparing earlier and later food records. The mean (+/- standard deviation) patient weight gain per eight-week group cycle was 1.6 (+/- 1.9) kg (p<0.05) and the Eating Attitudes Test-26 score change was -17.1 (+/- 11.5) points (p<0.01). Statistically significant changes were found in consumption of calories (p<0.01), fat (p<0.005), and protein (p<0.02). This treatment approach warrants further refinement and investigation.

Outpatient group therapy for anorexia nervosa: a preliminary study

Group therapy is generally recognized as an important form of psychotherapy for anorexia nervosa patients, but there are few controlled studies of its effectiveness. The aim of the current study was to determine the effectiveness of cognitive-behavioural therapy (CBT) for the treatment of anorexia nervosa in outpatients. Twenty-six outpatients with anorexia nervosa, were assessed for depression (BDI, Beck Depression Inventory), eating psychopathology (EDI, Eating Disorders Inventory), eating attitudes (EAT, Eating Attitudes Test) and weight at the beginning and at the end of the treatment and at one year follow-up. Our results substantiate the effectiveness of the CBT approach as a treatment and also at one year follow-up. Good EAT scores were observed in 70% of our cases after the treatment and in 60% at follow-up. Further research should assess the effectiveness of therapeutic groups more intensively because of their economic advantages.

The use of a group meal in the brief group therapy of bulimia nervosa

The group meal is a technique that can be easily incorporated into traditional forms of short-term group therapy for bulimia nervosa. It is a modification of the exposure and response-prevention model that has been used in the treatment of this population. Patients plan and eat a meal together with the group therapist during one of the group therapy sessions. Over the course of the meal, patients discuss thoughts and feelings as they experience them, allowing for greater depth of therapeutic work than when simply recalling events that occurred between sessions. A case example is described to illustrate several of the important themes that emerge, including reactions to feeling full, family meals, and the relationship between overeating and feelings about the self.