Exploring effectiveness of CBT in obese patients with binge eating disorder: personality functioning is associated with clinically significant change

The Dutch Body Shape Questionnaire among patients with binge-eating disorder: psychometrics and norms of the full version (BSQ34) and the short version (BSQ8C)

PURPOSE

This study examined the psychometric properties and provided normative data of the Dutch Body Shape Questionnaire (BSQ34) and its shortened BSQ8C among patients with binge-eating disorder.

METHODS

The two versions of the BSQ were administered to patients with binge-eating disorder (N = 155) enrolled for treatment, and to a community sample (N = 333). The translation and back-translation of the BSQ were performed by translators with and without eating-disorder expertise. Internal consistency, concurrent validity, test-retest reliability, incremental validity, and sensitivity to change were determined. A receiver-operating-characteristic curve-analysis was used to establish criterion-related validity, for which the Eating Disorder Examination-Shape concern subscale, was used. Uni-dimensionality of the instrument was investigated with confirmatory factor analysis. Norms (population-based T-scores and clinical percentile-scores) were determined.

RESULTS

The psychometric properties of the BSQs were satisfactory. The BSQ34 discriminated well in body-shape dissatisfaction between patients with binge-eating disorder and the community sample (area-under-the-curve value = 0.91-0.98) and had a unidimensional factor structure. Comparing structural invariance between both samples revealed that scaler invariance was not supported, indicating that items may be interpreted differently by patients with binge-eating disorder and subjects from the community. Analyses were repeated for the BSQ8C, which yielded similar results.

CONCLUSION

The results indicated that both versions of the BSQ appeared suitable to screen for body-shape dissatisfaction among patients with binge-eating disorder. The BSQ34 supplies valuable information on the various types of concerns respondents have, which are critical to consider in clinical settings; the BSQ8C is recommended as a short screening tool.

LEVEL OF EVIDENCE

Level III: Evidence obtained from well-designed cohort or case-control analytic studies.

Online Compassion Focused Therapy for overeating: Feasibility and acceptability pilot study

OBJECTIVE

This pilot study aims to investigate the feasibility, acceptability, and potential effectiveness of online Compassion Focused Therapy for overeating (CFT-OE).

METHOD

Eighteen Portuguese women seeking treatment for overeating were enrolled in this study, and 15 participants completed the CFT-OE. This was a single-arm study. Participants were assessed at pre- and post-intervention and 3-month follow-up. All participants completed measures assessing binge eating, cognitive restraint, uncontrolled eating, emotional eating, general eating psychopathology, general and body shame, self-criticism, self-compassion, and fears of self-compassion.

RESULTS

The treatment attrition rate was 16.7%, which is relatively low compared to other similar online interventions. Participants gave positive feedback on the program and indicated they would recommend it to people with similar difficulties. CFT-OE improved self-compassion and reduced eating psychopathology symptoms, general and body shame, self-criticism, and fears of self-compassion. Clinical significance analysis showed that the majority of participants were classified as in recovery in all measures at post-intervention and 3-month follow-up.

DISCUSSION

Preliminary results suggest that the online CFT-OE program is an acceptable and feasible intervention. Results also suggest that CFT-OE is beneficial for the treatment of women with difficulties with overeating. A future randomized controlled trial is necessary to establish the effectiveness of the CFT-OE.

PUBLIC SIGNIFICANCE

This study indicates that online CFT-OE is a feasible and adequate intervention for women who struggle with overeating. This therapy showed promising results in reducing eating disorder symptoms, shame, and self-criticism and improving self-compassion. As an online intervention, CFT-OE may be more accessible and offer an alternative to in-person therapy.