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Schaumberg K, Pictor L, Frank M. Adaptive and Maladaptive Exercise in Eating Disorders. Curr Top Behav Neurosci 2024. [PMID: 39042250 DOI: 10.1007/7854_2024_499] [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: 07/24/2024]
Abstract
While exercise is generally associated with positive health outcomes, in the context of eating disorders, exercise has high potential to become maladaptive. Maladaptive exercise is compelled or compulsive in nature for the purposes of weight and shape control or to obtain/avoid other eating disorder-relevant consequences. A transdiagnostic eating disorder feature with moderate-to-high prevalence across restrictive- and bulimic-spectrum eating disorders, maladaptive exercise is often associated with negative mental and physical health sequalae. Several proposed threat- and reward-related biobehavioral mechanisms may initiate or perpetuate maladaptive exercise. While exercise is generally contraindicated during periods of acute medical concern, adaptive forms of exercise are also present among those with eating disorders, and facilitation of adaptive exercise has potential to promote physical and mental health benefits during eating disorder recovery. Detailed assessment and targeted interventions are needed to address the clinical conundrum of how and when to integrate exercise into eating disorder treatment.
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Affiliation(s)
| | - Lauren Pictor
- Department of Psychiatry, University of Wisconsin, Madison, WI, USA
| | - Max Frank
- Department of Psychiatry, University of Wisconsin, Madison, WI, USA
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2
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Mathisen TF, Hay P, Bratland-Sanda S. How to address physical activity and exercise during treatment from eating disorders: a scoping review. Curr Opin Psychiatry 2023; 36:427-437. [PMID: 37435847 PMCID: PMC10552818 DOI: 10.1097/yco.0000000000000892] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 07/13/2023]
Abstract
PURPOSE OF REVIEW This scoping review aimed to provide a recent update on how to address dysfunctional physical activity and exercise (DEx), and on effects and experiences from including supervised and adapted physical activity or exercise (PAE), during treatment of eating disorders. RECENT FINDINGS A systematic search for peer-reviewed publications in the period 2021-2023 generated 10 original studies and 6 reviews, including one meta-analysis (reporting according to PRISMA and SWiM). Findings showed that DEx was effectively managed by use of psychoeducation and/or PAE. Inclusion of PAE as part of treatment showed low-to-moderate impact on health and positive or neutral effects on eating disorder psychopathology. There were no reports of adverse events. For individuals with anorexia nervosa, PAE improved physical fitness with no influence on body weight or body composition unless progressive resistance training was conducted. For individuals with bulimia nervosa, DEx was reduced simultaneously with increased functional exercise and successful implementation of physical activity recommendations during treatment. Experiences by individuals with eating disorders and clinicians, including accredited exercise physiologists, pointed to positive benefits by including PAE in treatment. SUMMARY Lack of consensus about DEx and of recommendations for PAE in official treatment guidelines hinder adequate approaches to these issues in eating disorder treatment.
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Affiliation(s)
| | - Phillipa Hay
- Translational Health Research Institute (THRI), School of Medicine, Western Sydney University
- Mental Health Services, SWSLHD, Campbelltown, Sydney, Australia
| | - Solfrid Bratland-Sanda
- Department of Outdoor Studies, Sports and Physical Education, University of South-Eastern Norway, Bø, Norway
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3
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Alyami SH, Alhamdan A, Alebrahim HM, Almadani AH, Aljuraiban GS, Abulmeaty MMA. Gastric Myoelectric Activity and Body Composition in Women with Binge Eating Disorder and Bulimia Nervosa: A Preliminary Trial Study. J Clin Med 2023; 12:4563. [PMID: 37510678 PMCID: PMC10380395 DOI: 10.3390/jcm12144563] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2023] [Revised: 07/02/2023] [Accepted: 07/06/2023] [Indexed: 07/30/2023] Open
Abstract
Women with eating disorders (EDs) often complain of abnormal gastric responses, which may impact their eating patterns and, consequently, their body composition. Binge eating disorder (BED) and bulimia nervosa (BN) have been shown to affect gastric myoelectric activity (GMA), which may provide a basis for the gastric response in this disease population. This study aimed to examine GMA and body composition in patients with an ED compared to age-body mass index (BMI) matched controls. This case-control study included 18 adults diagnosed with BED or BN compared to 19 age-gender-BMI-matched controls. The electrogastrography with water load test was used to measure GMA during fasting and after water loading to satiety. Body composition was measured using a bioelectric impedance analyzer. The results showed that the ED group had a significantly higher water load than the control group and increased percentages of tachygastria times. Comparing the BED and BN subgroups showed differences in body composition status between the subgroups in the form of less fat mass, muscle mass, and total body water in the BN subgroup. In the BN subgroup, fat mass was associated with the average dominant frequency in the EGG. Thus, measuring GMA may be a promising approach to understanding gastric abnormalities in patients with EDs. Therapies targeting improving body composition in women with BED and BN are recommended in future ED management strategies.
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Affiliation(s)
- Seham H Alyami
- Community Health Sciences Department, College of Applied Medical Sciences, King Saud University, Riyadh 11433, Saudi Arabia
| | - Adel Alhamdan
- Community Health Sciences Department, College of Applied Medical Sciences, King Saud University, Riyadh 11433, Saudi Arabia
| | - Hanan M Alebrahim
- Department of Psychiatry, College of Medicine, King Saud University, Riyadh 12372, Saudi Arabia
| | - Ahmad H Almadani
- Department of Psychiatry, College of Medicine, King Saud University, Riyadh 12372, Saudi Arabia
| | - Ghadeer S Aljuraiban
- Community Health Sciences Department, College of Applied Medical Sciences, King Saud University, Riyadh 11433, Saudi Arabia
| | - Mahmoud M A Abulmeaty
- Community Health Sciences Department, College of Applied Medical Sciences, King Saud University, Riyadh 11433, Saudi Arabia
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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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Quesnel DA, Cooper M, Fernandez-Del-Valle M, Reilly A, Calogero RM. Medical and physiological complications of exercise for individuals with an eating disorder: A narrative review. J Eat Disord 2023; 11:3. [PMID: 36627654 PMCID: PMC9832767 DOI: 10.1186/s40337-022-00685-9] [Citation(s) in RCA: 8] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/07/2022] [Accepted: 11/01/2022] [Indexed: 01/12/2023] Open
Abstract
Individuals with eating disorders (ED) experience prolonged malnutrition, binge episodes, and compensatory behaviours that affect every organ system. Psychological and physiological symptoms are worsened with comorbid dysfunctional exercise, seen in up to 80% of those with an ED. Although return to exercise is an important component of treatment and recovery, little is known about the contraindications and risks of exercise engagement specific to those with an ED. This paper provides a comprehensive narrative review of the medical and physiological complications of engaging in exercise during ED treatment and outlines when exercise may be contraindicated or used in modified or cautionary ways. We conducted a literature search on MEDLINE, PubMed, and PsychArticles to identify relevant articles, which yielded six categories of medical and physiological complications of ED that may be exacerbated by exercise: energy availability, cardiovascular health, electrolyte abnormalities, biomedical function markers, sex hormones, and body composition. We summarize the evidence for these complications for readers and offer an initial set of recommendations for incorporating exercise during ED treatment based on our findings. This review may serve as a resource for members of ED treatment teams to help evaluate more readily and confidently whether exercise is safe for individual patients and when modifications and caution may be warranted.
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Affiliation(s)
- Danika A Quesnel
- Department of Psychological Clinical Science, University of Toronto, 320 Huron Street, Toronto, ON, M5S 3J7, Canada.
| | - Marita Cooper
- Department of Psychiatry and Behavioral Sciences, Children's Hospital of Philadelphia, Philadelphia, PA, USA
| | - Maria Fernandez-Del-Valle
- Department of Functional Biology, University of Oviedo, Oviedo, Spain.,Health Research Institute of the Principality of Asturias (ISPA), Oviedo, Spain
| | - Alanah Reilly
- Alanah Reilly Exercise Physiologist, Brisbane, Australia
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6
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Wyssen A, Munsch S. [Physical Activity in the Prevention and Treatment of Eating Disorders]. PRAXIS 2022; 111:327-332. [PMID: 35473329 DOI: 10.1024/1661-8157/a003840] [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: 06/14/2023]
Abstract
Physical Activity in the Prevention and Treatment of Eating Disorders Abstract. On the one hand, excessive or insufficient physical activity is a phenomenological feature and an important etiological factor in eating disorders. On the other hand, healthy and adaptive physical activity has the potential to support the effectiveness of preventive and therapeutic interventions for eating disorders. Research findings confirm the usefulness of interventions focusing on physical activity as an add-on to psychotherapy. Professionally planned and accompanied interventions of this kind are not counterproductive or dangerous but can have a positive effect on the treatment outcome. The current state of research allows a preliminary formulation of guidelines to embed physical activity interventions into evidence-based treatment approaches. The focus of such interventions lies on the reduction of unhealthy, excessive physical activity and the promotion of flexible physical activity.
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Affiliation(s)
- Andrea Wyssen
- Universitätsklinik für Kinder- und Jugendpsychiatrie und Psychotherapie, Universität Bern, Bern, Schweiz
| | - Simone Munsch
- Klinische Psychologie und Psychotherapie, Departement für Psychologie, Universität Fribourg, Fribourg, Schweiz
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Grilo CM, Kerrigan SG, Lydecker JA, White MA. Physical activity changes during behavioral weight loss treatment by Latinx patients with obesity with and without binge eating disorder. Obesity (Silver Spring) 2021; 29:2026-2034. [PMID: 34582624 PMCID: PMC8612949 DOI: 10.1002/oby.23278] [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: 04/02/2021] [Revised: 06/04/2021] [Accepted: 07/04/2021] [Indexed: 11/08/2022]
Abstract
OBJECTIVE This secondary analysis examined physical activity (PA) changes and their prognostic significance among Latinx patients with obesity, with and without binge eating disorder (BED), who participated in a randomized, placebo-controlled trial testing the addition of orlistat to behavioral weight-loss (BWL) treatment in a "real-world" clinical setting. METHODS In this randomized controlled trial at a community mental health center serving economically disadvantaged Spanish-speaking-only Latinx patients, 79 patients with obesity (40 with BED and 39 without BED) received BWL treatment and were randomized to orlistat or placebo. PA, weight, depression, and binge eating were assessed at baseline, posttreatment (end of treatment [4 months]), and the 6-month follow-up (10 months after baseline). RESULTS PA was low at baseline (9.3% categorized as "active"), increased during treatment (32.9% categorized as "active" at posttreatment), and declined from posttreatment to the 6-month follow-up (28.2% classified as "active"). At baseline, PA was lower among patients with BED than those without BED. Changes in PA during and after treatment did not differ by BED status or medication condition. PA change was associated with reduced depression but not weight loss. CONCLUSIONS Latinx patients with obesity receiving BWL treatment achieved significant, albeit modest, increases in PA. Although PA changes were not associated with weight loss, they were associated with reduced depression. Identifying methods to increase PA further is necessary.
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Affiliation(s)
- Carlos M. Grilo
- Department of Psychiatry, Yale School of Medicine, New Haven, CT, USA
| | | | - Janet A. Lydecker
- Department of Psychiatry, Yale School of Medicine, New Haven, CT, USA
| | - Marney A. White
- Department of Psychiatry, Yale School of Medicine, New Haven, CT, USA
- Department of Social & Behavioral Sciences, Yale School Public Health, New Haven, CT, USA
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Ho D, Verdejo-Garcia A. Interactive influences of food, contexts and neurocognitive systems on addictive eating. Prog Neuropsychopharmacol Biol Psychiatry 2021; 110:110295. [PMID: 33657421 DOI: 10.1016/j.pnpbp.2021.110295] [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: 06/14/2020] [Revised: 10/04/2020] [Accepted: 02/24/2021] [Indexed: 02/08/2023]
Abstract
Compulsive eating is a common symptom of different conditions, including obesity, binge eating disorder and bulimia. One hypothesis is that contemporary food products promote compulsive eating via addiction-like mechanisms. However, what is the addictive substance in food, and what is the phenotypic overlap between obesity / eating disorders and addictions are questions that remain unresolved. In this review, we applied a multilevel framework of addiction, which encompasses the 'drug' (certain foods), the person's mindset, and the context, to improve understanding of compulsive eating. Specifically, we reviewed evidence on the addictive properties of specific foods, the neurocognitive systems that control dietary choices, and their interaction with physical, emotional and social contexts. We focused on different target groups to illustrate distinct aspects of the proposed framework: the impact of food and contextual factors were examined across a continuum, with most studies conducted on healthy participants and subclinical populations, whereas the review of neurocognitive aspects focused on clinical groups in which the alterations linked to addictive and compulsive eating are particularly visible. The reviewed evidence suggest that macronutrient composition and level of processing are associated with the addictive properties of food; there are overlapping neuroadaptations in reward and decision-making circuits across compulsive eating conditions; and there are physical and social contexts that fuel compulsive eating by exploiting reward mechanisms and their interaction with emotions. We conclude that a biopsychosocial model that integrates food, neurobiology and context can provide a better understanding of compulsive eating manifestations in a transdiagnostic framework.
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Affiliation(s)
- Daniel Ho
- Turner Institute for Brain and Mental Health, School of Psychological Sciences, Monash University, Melbourne, Australia
| | - Antonio Verdejo-Garcia
- Turner Institute for Brain and Mental Health, School of Psychological Sciences, Monash University, Melbourne, Australia.
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Binge Eating Disorder: What Is the Role of Physical Activity Associated with Dietary and Psychological Treatment? Nutrients 2020; 12:nu12123622. [PMID: 33255753 PMCID: PMC7761234 DOI: 10.3390/nu12123622] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2020] [Revised: 11/13/2020] [Accepted: 11/22/2020] [Indexed: 11/29/2022] Open
Abstract
Binge eating patients present lower physical activity levels, which could be associated with lower exercise capacity. Specific physical activity can ensure broad beneficial results relating to eating disorders, depression, and body mass index (BMI) in bulimia; however, research on binge eating disorder (BED) is scarce. Our study aimed to investigate the effects of specific training as an addition to conventional treatment of eating disorder symptoms, anthropometric characteristics, and physical performance. Nineteen women with BED were included in a dietary and cognitive-behavioral therapy program. After medical examination, 10 women carried out Combined Aerobic and Anaerobic Exercise Training in addition to conventional treatment (CAAET group), whereas the remaining 9 followed the conventional treatment alone (CTRL group). All of the measurements were assessed before and after six months of treatment. In both groups, we observed a significant decrease in binge episodes, weight, and body mass index, and an increase in exercise capacity. Moreover, the CAAET group presented a greater improvement in aerobic performance than that observed in the CTRL group. Our results suggest that both interventions similarly improved BED symptoms. The addition of physical activity could be important in the long-term maintenance of both weight loss and reduction in binge episodes in BED patients.
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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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Mathisen TF, Rosenvinge JH, Friborg O, Vrabel K, Bratland‐Sanda S, Pettersen G, Sundgot‐Borgen J. Is physical exercise and dietary therapy a feasible alternative to cognitive behavior therapy in treatment of eating disorders? A randomized controlled trial of two group therapies. Int J Eat Disord 2020; 53:574-585. [PMID: 31944339 PMCID: PMC7187559 DOI: 10.1002/eat.23228] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/08/2019] [Revised: 01/06/2020] [Accepted: 01/06/2020] [Indexed: 12/13/2022]
Abstract
OBJECTIVE To compare effects of physical exercise and dietary therapy (PED-t) to cognitive behavioral therapy (CBT) in treatment of bulimia nervosa (BN) and binge-eating disorder (BED). METHOD The active sample (18-40 years of age) consisted of 76 women in the PED-t condition and 73 in the CBT condition. Participants who chose not to initiate treatment immediately (n = 23) were put on a waiting list. Outcome measures were the eating disorder examination questionnaire (EDE-Q), Clinical Impairment Assessment (CIA), Satisfaction with Life Scale (SWLS), Beck Depression Inventory (BDI), and numbers in remission at posttreatment, and at 6-, 12-, and 24-months follow-up. RESULTS Both treatment conditions produced medium to strong significant improvements on all outcomes with long-term effect. The PED-t produced a faster improvement in EDE-Q and CIA, but these differences vanished at follow-ups. Only PED-t provided improvements in BDI, still with no between-group difference. Totally, 30-50% of participants responded favorable to treatments, with no statistical between-group difference. DISCUSSION Both treatments shared a focus on normalizing eating patterns, correcting basic self-regulatory processes and reducing idealized aesthetic evaluations of self-worth. The results point to the PED-t as an alternative to CBT for BN and BED, although results are limited due to compliance and dropout rates. Replications are needed by independent research groups as well as in more clinical settings.
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Affiliation(s)
| | - Jan H. Rosenvinge
- UiT—The Arctic University of Norway, Department of PsychologyFaculty of Health SciencesTromsøNorway
| | - Oddgeir Friborg
- UiT—The Arctic University of Norway, Department of PsychologyFaculty of Health SciencesTromsøNorway
| | | | - Solfrid Bratland‐Sanda
- Department of Outdoor Studies, Sports and Physical EducationUniversity College of Southeast NorwayBøNorway
| | - Gunn Pettersen
- Department of Health and Caring Sciences, Faculty of Health SciencesUiT—The Arctic University of NorwayTromsøNorway
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Kerrigan SG, Lydecker JA, Grilo CM. Associations between physical activity and eating-disorder psychopathology among individuals categorised with binge-eating disorder and bulimia nervosa. Int J Clin Pract 2019; 73:e13401. [PMID: 31397950 PMCID: PMC7112656 DOI: 10.1111/ijcp.13401] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/26/2019] [Revised: 07/17/2019] [Accepted: 08/05/2019] [Indexed: 12/11/2022] Open
Abstract
OBJECTIVE While physical activity (PA) is known to have positive effects on psychological and physical health, little is understood about the association between non-compensatory PA (ie, not compulsive or intended to control weight or shape) and psychopathology among individuals with eating-disorder features. The present study explored associations between non-compensatory PA and psychopathology among adults categorised with bulimia nervosa (BN) and binge-eating disorder (BED). We further explored the association between compensatory PA and psychopathology among those who engaged in that form of "purging." METHOD Participants were recruited through Mechanical Turk, an online recruitment platform. Individuals categorised with core features of BED (N = 138) and BN (N = 138) completed measures of eating-disorder psychopathology (Eating Disorder Examination - Questionnaire [EDE-Q] and Questionnaire on Eating and Weight Patterns - 5), depression (Patient Health Questionnaire - 2) and PA (both non-compensatory and compensatory, measured using the EDE-Q and Godin Leisure-Time Exercise Questionnaire). RESULTS Engagement in non-compensatory PA was associated with lower frequency of binge-eating episodes, lower overvaluation of shape/weight and lower dissatisfaction with shape/weight (Ps < .05). Engagement in compensatory PA was related to greater frequency of binge-eating episodes and greater restraint (Ps < .05). DISCUSSION Non-compensatory PA was associated with lower eating-disorder psychopathology. This suggests that PA is an important, though understudied, health behaviour among persons with features of BED and BN. Future research should examine the potential role of non-compensatory PA in interventions for individuals with core features of these eating disorders.
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Affiliation(s)
| | | | - Carlos M Grilo
- Yale School of Medicine, New Haven, Connecticut
- Yale University, New Haven, Connecticut
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13
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Ströhle A. Sports psychiatry: mental health and mental disorders in athletes and exercise treatment of mental disorders. Eur Arch Psychiatry Clin Neurosci 2019; 269:485-498. [PMID: 29564546 DOI: 10.1007/s00406-018-0891-5] [Citation(s) in RCA: 53] [Impact Index Per Article: 10.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/25/2017] [Accepted: 03/19/2018] [Indexed: 12/11/2022]
Abstract
Sports psychiatry has developed for the past 3 decades as an emerging field within psychiatry and sports medicine. An International society has been established in 1994 and also national interest groups were implemented, mostly within the national organizations for psychiatry, some also containing the topic of exercise treatment of mental disorders. Where are we now 30 years later? We systematically but also selectively review the medical literature on exercise, sport, psychiatry, mental health and mental disorders and related topics. The number of publications in the field has increased exponentially. Most topics keep remaining on the agenda, e.g., head trauma and concussion, drug abuse and doping, performance enhancement, overtraining, ADHD or eating disorders. Supported by the growing literature, evidence-based recommendations have become available now in many clinical areas. A relatively new phenomenon is muscle dysmorphia, observed in weightlifters, bodybuilders but also in college students and gym users. Further, sports therapy of mental disorders has been studied by more and more high-quality randomized controlled clinical trials. Mostly as a complementary treatment, however, for some disorders already with a 1a evidence level, e.g., depression, dementia or MCI but also post-traumatic stress disorder. Being grown up and accepted nowadays, sports psychiatry still represents a fast-developing field. The reverse side of the coin, sport therapy of mental disorders has received a scientific basis now. Who else than sports psychiatry could advance sport therapy of mental disorders? We need this enthusiasm for sports and psychiatry for our patients with mental disorders and it is time now for a broadening of the scope. Optimized psychiatric prevention and treatment of athletes and ideal sport-related support for individuals with mental disorders should be our main purpose and goal.
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Affiliation(s)
- Andreas Ströhle
- Department of Psychiatry and Psychotherapy, Charité-Universitätsmedizin Berlin, corporate member of the Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Campus Charité Mitte, Charitéplatz 1, 10117, Berlin, Germany.
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14
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Foroughi N, Zhu KCY, Smith C, Hay P. The perceived therapeutic benefits of complementary medicine in eating disorders. Complement Ther Med 2019; 43:176-180. [DOI: 10.1016/j.ctim.2019.01.025] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2018] [Revised: 01/30/2019] [Accepted: 01/30/2019] [Indexed: 11/26/2022] Open
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Mathisen TF, Sundgot-Borgen J, Rosenvinge JH, Bratland-Sanda S. Managing Risk of Non-Communicable Diseases in Women with Bulimia Nervosa or Binge Eating Disorders: A Randomized Trial with 12 Months Follow-Up. Nutrients 2018; 10:E1887. [PMID: 30513892 PMCID: PMC6315508 DOI: 10.3390/nu10121887] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2018] [Revised: 11/27/2018] [Accepted: 11/28/2018] [Indexed: 12/12/2022] Open
Abstract
Persons with bulimia nervosa (BN) or binge eating disorder (BED) have an elevated risk of non-communicable diseases (NCDs). However, lowering this risk is rarely addressed in standard cognitive-behavioral treatment (CBT). We aimed to compare CBT with an intervention combining physical exercise and dietary therapy (PED-t), and hypothesized that the PED-t would do better than CBT in lowering the risk of NCD both initially and longitudinally. In this study, 164 women with bulimia nervosa or binge eating disorder were randomly assigned to 16-weeks of outpatient group therapy with either PED-t or CBT. Body composition (BC) was measured by dual-energy X-ray absorptiometry. Measures of physical fitness (VO₂peak and one repetition maximum (1RM) in squats, bench press, and seated row) were also recorded. All measurements were completed baseline, post-treatment, and at 6- and 12-month follow-ups, respectively. Our results showed that PED-t improved more than CBT on mean (99% CI) absolute Vo2peak; 57,2 (84.4, 198.8) mL (g = 0.22, p < 0.001) post-treatment. There were small to medium long-term differences in 1RM after PED-t compared to CBT. BC deteriorated in both groups during follow-up. Neither the PED-t nor the CBT lowered the risk for NCDs. Clearly, other approaches need to be considered to promote physical fitness and lower the risk of NCDs among individuals with BN and BED.
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Affiliation(s)
| | - Jorunn Sundgot-Borgen
- Department of Sports Medicine, Norwegian School of Sport Sciences; Sognsvegen 220, 0806 Oslo, Norway.
| | - Jan H Rosenvinge
- Department of Psychology, Faculty of Health Sciences, UiT- the Arctic University of Norway, N-9037 Tromsø, Norway.
| | - Solfrid Bratland-Sanda
- Department of Sports and Physical Education and Outdoor Sciences, University of South-Eastern Norway, N-3800 Bø in Telemark, Norway.
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Fiechtner L, Fonte ML, Castro I, Gerber M, Horan C, Sharifi M, Cena H, Taveras EM. Determinants of Binge Eating Symptoms in Children with Overweight/Obesity. Child Obes 2018; 14:510-517. [PMID: 30153037 PMCID: PMC6249668 DOI: 10.1089/chi.2017.0311] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/22/2023]
Abstract
BACKGROUND Examining binge eating symptoms before the diagnosis of binge eating disorder in children with obesity could provide important information on prevention of future eating disorders. METHODS We examined the prevalence and multilevel determinants of three binge eating symptoms: (1) sneaking, hiding, or hoarding food; (2) eating in the absence of hunger, and (3) inhibition or embarrassment when eating in front of others among 817 children aged 5-12 years old with overweight/obesity receiving primary care in eastern Massachusetts. We examined the associations of child and parent/household characteristics with the prevalence ratios (PRs) of these three binge eating symptoms. RESULTS Approximately one-third of parents reported that their children would sneak, hide, or hoard food; 40% ate large amounts in the absence of hunger; and 8% were inhibited/embarrassed when eating in front of others. In multivariate analyses, greater screen time was associated with a higher prevalence of sneaking, hiding, or hoarding (PR 1.06, 95% CI: 1.01-1.11). We found that children with severe obesity (PR 1.50, 95% CI: 1.24-1.81 vs. nonsevere obesity) had higher prevalence of eating in the absence of hunger. Increased hours of screen time were associated with higher prevalence of eating in the absence of hunger, (PR: 1.07, 95% CI: 1.03-1.11), whereas longer sleep duration (PR: 0.90, 95% CI: 0.82-0.99) was associated with lower prevalence of eating in the absence of hunger. CONCLUSIONS Eating in the absence of hunger was the most common symptom in our sample and was associated with screen time and sleep. ClinicalTrials.gov NCT01537510.
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Affiliation(s)
- Lauren Fiechtner
- Division of General Academic Pediatrics, Department of Pediatrics, MassGeneral Hospital for Children, Boston, MA.,Department of Gastroenterology and Nutrition, MassGeneral Hospital for Children, Boston, MA.,Address correspondence to: Lauren Fiechtner, MD, MPH, Division of Gastroenterology and Nutrition, Massachusetts General Hospital for Children, 175 Cambridge Street, 5th Floor, Boston, MA 02114
| | - Maria Luisa Fonte
- Unit of Human Nutrition and Dietetics, Department of Public Health, Experimental and Forensic Medicine, University of Pavia, Pavia, Italy
| | - Ines Castro
- Division of General Academic Pediatrics, Department of Pediatrics, MassGeneral Hospital for Children, Boston, MA
| | - Monica Gerber
- Division of General Academic Pediatrics, Department of Pediatrics, MassGeneral Hospital for Children, Boston, MA
| | - Chrissy Horan
- Division of General Academic Pediatrics, Department of Pediatrics, MassGeneral Hospital for Children, Boston, MA
| | - Mona Sharifi
- Section of General Pediatrics, Department of Pediatrics, Yale University School of Medicine, New Haven, CT
| | - Hellas Cena
- Unit of Human Nutrition and Dietetics, Department of Public Health, Experimental and Forensic Medicine, University of Pavia, Pavia, Italy
| | - Elsie M. Taveras
- Division of General Academic Pediatrics, Department of Pediatrics, MassGeneral Hospital for Children, Boston, MA.,Department of Nutrition, Harvard TH Chan School of Public Health, Boston, MA
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Albertz J, Boersma GJ, Tamashiro KL, Moran TH. The effects of scheduled running wheel access on binge-like eating behavior and its consequences. Appetite 2018; 126:176-184. [PMID: 29654852 DOI: 10.1016/j.appet.2018.04.011] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2017] [Revised: 04/02/2018] [Accepted: 04/10/2018] [Indexed: 11/19/2022]
Abstract
Binge eating disorder (BED) is an eating disorder involving repeated, intermittent over consumption of food in brief periods of time, usually with no compensatory behaviors. There are few successful treatments and the underlying neural mechanisms remain unclear. In the current study, we hypothesized that voluntary running wheel (RW) activity could reduce binge-like eating behavior in a rat model. Rats were given intermittent (3 times/wk) limited (1hr) access to a high-fat food (Crisco), in addition to continuously available chow. Crisco was available every Mon, Wed, and Fri for 1hr before dark onset. Rats were divided into 2 groups: those with RW access during the first half of the experiment and sedentary during the second half (RW-SED) and those that were sedentary during the first half of the experiment and had RW access during the second half (SED-RW). Crisco intake was significantly less in both groups during the period of time with a RW present. Within the bingeing RW-SED rats, the gene expression of the orexigenic neuropeptides AgRP and NPY were similar to a non-bingeing sedentary control (CON) group, while the expression of the anorexigenic neuropeptide POMC was significantly increased relative to the SED-RW and CON groups. Despite elevated POMC, the rats continued to binge. Additionally, within both groups, the gene expression of the D2R and Oprm1 in the NAc and the VTA were altered suggesting that the reward system was stimulated by both the bingeing behavior and the running wheel activity. Overall, access to a RW and the resulting activity significantly reduced binge-like behavior as well as modulated the effects of binging on brain appetite and reward systems.
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Affiliation(s)
- Jennifer Albertz
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Gretha J Boersma
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Kellie L Tamashiro
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Timothy H Moran
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, MD, USA.
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Mathisen TF, Rosenvinge JH, Friborg O, Pettersen G, Stensrud T, Hansen BH, Underhaug KE, Teinung E, Vrabel K, Svendsen M, Bratland‐Sanda S, Sundgot‐Borgen J. Body composition and physical fitness in women with bulimia nervosa or binge-eating disorder. Int J Eat Disord 2018; 51:331-342. [PMID: 29473191 PMCID: PMC5947292 DOI: 10.1002/eat.22841] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/25/2017] [Revised: 01/25/2018] [Accepted: 01/25/2018] [Indexed: 12/30/2022]
Abstract
OBJECTIVE Knowledge about physical fitness in women with bulimia nervosa (BN) or binge-eating disorder (BED) is sparse. Previous studies have measured physical activity largely through self-report, and physical fitness variables are mainly restricted to body mass index (BMI) and bone mineral density. We expanded the current knowledge in these groups by including a wider range of physical fitness indicators and objective measures of physical activity, assessed the influence of a history of anorexia nervosa (AN), and evaluated predictive variables for physical fitness. METHOD Physical activity, blood pressure, cardiorespiratory fitness (CRF), muscle strength, body composition, and bone mineral density were measured in 156 women with BN or BED, with mean (SD) age 28.4 years (5.7) and BMI 25.3 (4.8) kg m-2 . RESULTS Level of physical activity was higher than normative levels, still <50% met the official physical activity recommendation. Fitness in women with BN were on an average comparable with recommendations or normative levels, while women with BED had lower CRF and higher BMI, VAT, and body fat percentage. We found 10-12% with masked obesity. A history of AN did not predict current physical fitness, still values for current body composition were lower when comparing those with history of AN to those with no such history. DISCUSSION Overall, participants with BN or BED displayed adequate physical fitness; however, a high number had unfavorable CRF and body composition. This finding calls for inclusion of physical fitness in routine clinical examinations and guided physical activity and dietary recommendations in the treatment of BN and BED.
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Affiliation(s)
| | - Jan H. Rosenvinge
- Department of Psychology, Faculty of Health SciencesUiT—The Arctic University of NorwayTromsøNorway
| | - Oddgeir Friborg
- Department of Psychology, Faculty of Health SciencesUiT—The Arctic University of NorwayTromsøNorway
| | - Gunn Pettersen
- Department of Health and Caring SciencesFaculty of Health Sciences, UiT—The Arctic University of NorwayTromsøNorway
| | - Trine Stensrud
- Department of Sports MedicineNorwegian School of Sport SciencesSognsvegen 220N‐0806 OsloNorway
| | - Bjørge Herman Hansen
- Department of Sports MedicineNorwegian School of Sport SciencesSognsvegen 220N‐0806 OsloNorway
| | - Karoline E. Underhaug
- Department of Sports MedicineNorwegian School of Sport SciencesSognsvegen 220N‐0806 OsloNorway
| | - Elisabeth Teinung
- Department of Sports MedicineNorwegian School of Sport SciencesSognsvegen 220N‐0806 OsloNorway
| | | | - Mette Svendsen
- Department of Endocrinology, Obesity and Preventive MedicineOslo University HospitalOsloNorway
| | - Solfrid Bratland‐Sanda
- Department of Outdoor Studies, Sports and Physical EducationUniversity College of Southeast NorwayNotoddenNorway
| | - Jorunn Sundgot‐Borgen
- Department of Sports MedicineNorwegian School of Sport SciencesSognsvegen 220N‐0806 OsloNorway
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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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20
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Mathisen TF, Bratland-Sanda S, Rosenvinge JH, Friborg O, Pettersen G, Vrabel KA, Sundgot-Borgen J. Treatment effects on compulsive exercise and physical activity in eating disorders. J Eat Disord 2018; 6:43. [PMID: 30559966 PMCID: PMC6293524 DOI: 10.1186/s40337-018-0215-1] [Citation(s) in RCA: 40] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/27/2018] [Accepted: 08/29/2018] [Indexed: 12/20/2022] Open
Abstract
BACKGROUND Dysfunctional thoughts- and use of physical activity (PA) are core symptoms of the eating disorders (ED) bulimia nervosa (BN) and binge eating disorder (BED). The compulsive desire for PA complicates a favourable treatment outcome; hence, regular, adapted PA led by personnel with competence in exercise science is rarely part of treatment of BN and BED. The present study compared cognitive behaviour therapy (CBT) with a new treatment combining physical exercise and dietary therapy (PED-t) with respect to the short- and long-term changes in the level of compulsive exercise and actual level of PA in women with BN or BED. METHODS We enrolled 187 women with BN or BED, aged 18-40 years, with BMI 17.5-35, in an outpatient randomised controlled therapy trial. Participants were randomised to PED-t or CBT, while waitlist participants served as a control group during the treatment period. The treatment covered 16 weeks, with 6- and 12 months follow-up, and outcomes included self-reported compulsive exercise (CE) and objectively measured PA, analysed by linear mixed regression models. RESULTS Both CBT and PED-t reduced CE from baseline (P < 0.01, Hedges g ~ 0.4), but with no difference to control group. Compared to baseline, only PED-t significantly reduced the number of patients who scored above cut-off rating for CE, but with no between-group differences. The proportion of participants complying with the official recommendation for PA neither changed following treatment, nor emerged different between the treatment arms. CONCLUSION Both therapies resulted in significant improvements in compulsive exercise, a change not found in the control group, however there were no between-group differences. The findings are tempered by the low statistical power due to a small control group size. The number of participants complying with the recommendation for PA were stable throughout the study, and no change in total PA was found. Presence and intensity of CE decline with treatment, but a need to increase PA towards healthy levels remains unsolved. TRIAL REGISTRATION Approved by the Norwegian Regional Committee for Medical and Health Research Ethics (ID: 2013/1871, 16th of December 2013); registered in Clinical Trials (ID: NCT02079935, 17th of February 2014).
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Affiliation(s)
| | - Solfrid Bratland-Sanda
- Department of Sports and Physical Education and Outdoor Sciences, University of South-Eastern Norway, Bø in Telemark, Norway
| | - Jan H Rosenvinge
- 3Department of Psychology, Faculty of Health Sciences, UiT -The Arctic University of Norway, Tromsø, Norway
| | - Oddgeir Friborg
- 3Department of Psychology, Faculty of Health Sciences, UiT -The Arctic University of Norway, Tromsø, Norway
| | - Gunn Pettersen
- 5Department of Health and Care Sciences, Faculty of Health Sciences, The Arctic University of Norway, Tromsø, Norway
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Abstract
Objective The present study aimed to investigate disordered eating (DE) among Sami compared with non-Sami residing in northern Norway. Design In a cross-sectional design, stratified by sex and ethnicity, associations were tested between DE (Eating Disturbance Scale; EDS-5) and age, education level, BMI category, anxiety and depression, physical activity and consumption of snacks. Setting The SAMINOR 2 Clinical Survey (2012–2014) based on the population of ten municipalities in northern Norway. Subjects Adults aged 40–69 years; 1811 Sami (844 male, 967 female) compared with 2578 non-Sami (1180 male, 1398 female) individuals. Results No overall significant ethnic difference in DE was identified, although comfort eating was reported more often by Sami individuals (P=0·01). Regardless of ethnicity and sex, symptoms of anxiety and depression were associated with DE (P<0·001). Furthermore, DE was more common at lower age and higher BMI values. Education levels were protectively associated with DE among Sami men (P=0·01). DE was associated (OR, 95% CI) with low physical activity in men in general and in non-Sami women (Sami men: 2·4, 1·4, 4·0; non-Sami men: 2·2, 1·4, 3·6; non-Sami women: 1·8, 1·2, 2·9) and so was the consumption of snacks (Sami men: 2·6, 1·3, 5·0; non-Sami men: 1·9, 1·1, 3·1; non-Sami women: 2·1, 1·3, 3·4). Conclusions There were no significant differences regarding overall DE comparing Sami with non-Sami, although Sami more often reported comfort eating. There were significant sex and ethnic differences related to DE and physical activity, snacking and education level.
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22
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Roveda E, Montaruli A, Galasso L, Pesenti C, Bruno E, Pasanisi P, Cortellini M, Rampichini S, Erzegovesi S, Caumo A, Esposito F. Rest-activity circadian rhythm and sleep quality in patients with binge eating disorder. Chronobiol Int 2017; 35:198-207. [PMID: 29144185 DOI: 10.1080/07420528.2017.1392549] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
Recent findings suggest that altered rest-activity circadian rhythms (RARs) are associated with a compromised health status. RARs abnormalities have been observed also in several pathological conditions, such as cardiovascular, neurological, and cancer diseases. Binge eating disorder (BED) is the most common eating disorder, with a prevalence of 3.5% in women and 2% in men. BED and its associate obesity and motor inactivity could induce RARs disruption and have negative consequences on health-related quality of life. However, the circadian RARs and sleep behavior in patients with BED has been so far assessed only by questionnaires. Therefore, the purpose of this study was to determine RARs and sleep parameters by actigraphy in patients with BED compared to a body mass index-matched control group (Ctrl). Sixteen participants (eight obese women with and eight obese women without BED diagnosis) were recruited to undergo 5-day monitoring period by actigraphy (MotionWatch 8®, CamNtech, Cambridge, UK) to evaluate RARs and sleep parameters. In order to determine the RARs, the actigraphic data were analyzed using the single cosinor method. The rhythmometric parameters of activity levels (MESOR, amplitude and acrophase) were then processed with the population mean cosinor. The Actiwatch Sleep Analysis Software (Cambridge Neurotecnology, Cambridge, UK) evaluated the sleep patterns. In each participant, we considered seven sleep parameters (sleep onset: S-on; sleep offset: S-off; sleep duration: SD; sleep latency: SL; movement and fragmentation index: MFI; immobility time: IT; sleep efficiency: SE) calculated over a period of five nights. The population mean cosinor applied to BED and Ctrl revealed the presence of a significant circadian rhythm in both groups (p < 0.001). The MESOR (170.0 vs 301.6 a.c., in BED and Ctrl, respectively; p < 0.01) and amplitude (157.66 vs 238.19 a.c., in BED and Ctrl, respectively p < 0.05) differed significantly between the two groups. Acrophase was not different between BED and Ctrl, as well as all sleep parameters. Both groups displayed a low level of sleep quality (SE 80.7% and 75.7% in BED and Ctrl, respectively). These data provided the first actigraphy-based evidence of RARs disruption and sleep behavior disorder in patients with BED. However, while sleep disorders could be reasonably ascribed to overweight/obesity and the related lower daily physical activity, RARs disruption in this pathology should be ascribed to factors other than reduced physical activity. The circadian timing approach can represent a novel potential tool in the treatment of patients with eating disorders. These data provide exploratory evidence of behavioral association in a small population of patients that, if confirmed in a wider number of subjects and across different populations, may lead to a revision and enhancement of interventions in BED patients.
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Affiliation(s)
- E Roveda
- a Department of Biomedical Sciences for Health , University of Milan , Milan , Italy
| | - A Montaruli
- a Department of Biomedical Sciences for Health , University of Milan , Milan , Italy
| | - L Galasso
- a Department of Biomedical Sciences for Health , University of Milan , Milan , Italy
| | - C Pesenti
- a Department of Biomedical Sciences for Health , University of Milan , Milan , Italy
| | - E Bruno
- a Department of Biomedical Sciences for Health , University of Milan , Milan , Italy.,b Department of Preventive and Predictive Medicine , Fondazione IRCCS Istituto Nazionale Tumori , Milan , Italy
| | - P Pasanisi
- b Department of Preventive and Predictive Medicine , Fondazione IRCCS Istituto Nazionale Tumori , Milan , Italy
| | - M Cortellini
- b Department of Preventive and Predictive Medicine , Fondazione IRCCS Istituto Nazionale Tumori , Milan , Italy
| | - S Rampichini
- a Department of Biomedical Sciences for Health , University of Milan , Milan , Italy
| | - S Erzegovesi
- c Department of Clinical Neuroscience , San Raffaele Scientific Institute , Milan , Italy
| | - A Caumo
- a Department of Biomedical Sciences for Health , University of Milan , Milan , Italy
| | - F Esposito
- a Department of Biomedical Sciences for Health , University of Milan , Milan , Italy
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Fornaro M, Solmi M, Veronese N, De Berardis D, Buonaguro EF, Tomasetti C, Perna G, Preti A, Carta MG. The burden of mood-disorder/cerebrovascular disease comorbidity: essential neurobiology, psychopharmacology, and physical activity interventions. Int Rev Psychiatry 2017; 29:425-435. [PMID: 28681620 DOI: 10.1080/09540261.2017.1299695] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
Cardio-vascular diseases (CVDs) and CVD-related disorders (including cerebrovascular diseases; CBVDs) are a major public health concern as they represent the leading cause of mortality and morbidity in developed countries. Patients with CVDs and CBVDs co-morbid with mood disorders, especially bipolar disorder (BD) and major depressive disorder (MDD), suffer reduced quality-of-life and significant disability adjusted for years of life and mortality. The relationship between CVDs/CBVDs and mood disorders is likely to be bidirectional. Evidence for shared genetic risk of pathways involved in stress reaction, serotonin or dopamine signalling, circadian rhythms, and energy balance was reported in genome-wide association studies. There is some evidence of a neuroprotective effect of various antidepressants, which may be boosted by physical exercise, especially by aerobic ones. Patients with CVDs/CBVDs should be routinely attentively evaluated for the presence of mood disorders, with tools aimed at detecting both symptoms of depression and of hypomania/mania. Behavioural lifestyle interventions targeting nutrition and exercise, coping strategies, and attitudes towards health should be routinely provided to patients with mood disorders, to prevent the risk of CVDs/CBVDs. A narrative review of the evidence is herein provided, focusing on pharmacological and physical therapy interventions.
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Affiliation(s)
- Michele Fornaro
- a Department of Neuroscience, Reproductive Science and Odontostomatology , School of Medicine 'Federico II' Naples , Naples , Italy.,b Department of Psychiatry , Columbia University Medical Center, New York State Psychiatric Institute , New York , NY , USA
| | - Marco Solmi
- c Neuroscience Department , University of Padua , Padua , Italy.,d Institute for Clinical Research and Education in Medicine, I.R.E.M , Padua , Italy
| | - Nicola Veronese
- d Institute for Clinical Research and Education in Medicine, I.R.E.M , Padua , Italy.,e Department of Medicine (DIMED), Geriatrics Division , University of Padova , Padova , Italy
| | - Domenico De Berardis
- f Health Service, Department of Mental Health, Psychiatric Service of Diagnosis and Treatment , Hospital 'G. Mazzini' , Teramo , Italy
| | - Elisabetta Filomena Buonaguro
- a Department of Neuroscience, Reproductive Science and Odontostomatology , School of Medicine 'Federico II' Naples , Naples , Italy
| | - Carmine Tomasetti
- a Department of Neuroscience, Reproductive Science and Odontostomatology , School of Medicine 'Federico II' Naples , Naples , Italy
| | - Giampaolo Perna
- g Department of Psychiatry and Neuropsychology , Maastricht University , Maastricht , Netherlands.,h Department of Clinical Neurosciences, FoRiPsi , Hermanas Hospitalarias-Villa San Benedetto Menni Hospital , Albese con Cassano , Como , Italy.,i Department of Psychiatry and Behavioural Sciences, Leonard Miller School of Medicine , University of Miami , Miami , FL , USA
| | - Antonio Preti
- j Center of Liaison Psychiatry and Psychosomatics , University Hospital, University of Cagliari , Monserrato , Cagliari , Italy
| | - Mauro Giovanni Carta
- k Department of Public Health, Clinical and Molecular Medicine , University of Cagliari , Monserrato , Cagliari , Italy
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Galasso L, Montaruli A, Bruno E, Pesenti C, Erzegovesi S, Cè E, Coratella G, Roveda E, Esposito F. Aerobic exercise training improves physical performance of patients with binge-eating disorder. SPORT SCIENCES FOR HEALTH 2017. [DOI: 10.1007/s11332-017-0398-x] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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25
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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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Psychological interventions for eating disorders. Drug Ther Bull 2016; 54:141-144. [PMID: 27979882 DOI: 10.1136/dtb.2016.12.0445] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
Abstract
Eating disorders, including anorexia nervosa, bulimia nervosa and binge eating disorder, are common conditions, characterised by disturbances of eating behaviours and a core psychopathology centred on food, eating and body image concerns.1,2 Eating disorders are associated with medical and psychological comorbidities; a significantly impaired health-related quality of life; a high rate of inpatient, outpatient and emergency care; significant healthcare costs; and increased mortality.3-10 Here, we focus on the evidence for non-drug interventions for eating disorders.
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Boerhout C, Swart M, Voskamp M, Troquete NAC, van Busschbach JT, Hoek HW. Aggression Regulation in Day Treatment of Eating Disorders: Two-Centre RCT of a Brief Body and Movement-Oriented Intervention. EUROPEAN EATING DISORDERS REVIEW 2016; 25:52-59. [DOI: 10.1002/erv.2491] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2016] [Revised: 09/28/2016] [Accepted: 10/18/2016] [Indexed: 11/06/2022]
Affiliation(s)
- Cees Boerhout
- University Center of Psychiatry, University Medical Center Groningen; University of Groningen; Groningen the Netherlands
- PsyQ Eating Disorders; Lentis Psychiatric Institute; Groningen the Netherlands
| | - Marte Swart
- University Center of Psychiatry, University Medical Center Groningen; University of Groningen; Groningen the Netherlands
- PsyQ Eating Disorders; Lentis Psychiatric Institute; Groningen the Netherlands
| | - Marjon Voskamp
- Amarum Center for Eating Disorders; GGNet Mental Health Care; Zutphen the Netherlands
| | - Nadine A. C. Troquete
- Department of General Practice; University Medical Center Groningen, University of Groningen; Groningen the Netherlands
| | - Jooske T. van Busschbach
- University Center of Psychiatry, University Medical Center Groningen; University of Groningen; Groningen the Netherlands
- Windesheim University of Applied Sciences; Zwolle the Netherlands
| | - Hans W. Hoek
- University Center of Psychiatry, University Medical Center Groningen; University of Groningen; Groningen the Netherlands
- Parnassia Psychiatric Institute; The Hague the Netherlands
- Department of Epidemiology, Mailman School of Public Health; Columbia University; New York NY USA
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Affiliation(s)
- M S Reddy
- Asha Bipolar Clinic, Asha Hospital, Hyderabad, Telangana, India E-mail:
| | - M Starlin Vijay
- Asha Bipolar Clinic, Asha Hospital, Hyderabad, Telangana, India E-mail:
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Vancampfort D, Rosenbaum S, Probst M, Connaughton J, Du Plessis C, Yamamoto T, Diedens J, Stubbs B. Top 10 research questions to promote physical activity research in people with binge eating disorder. Eat Disord 2016; 24:326-37. [PMID: 26694684 DOI: 10.1080/10640266.2015.1123988] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
Despite emerging evidence illustrating the benefits of physical activity for people with binge eating disorder, engaging this population in physical activity is challenging. The International Organization of Physical Therapists in Mental Health (IOPTMH) set out to summarize, appraise, and strengthen the direction of physical activity endeavors. This process led to the identification of 10 important research questions which are discussed. Addressing these 10 research questions is critical for developing evidence-based approaches for promoting and sustaining an active lifestyle in people with binge eating disorder.
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Affiliation(s)
- Davy Vancampfort
- a Department of Neurosciences , KU Leuven - University of Leuven , Kortenberg , Belgium.,b Department of Rehabilitation Sciences , University of Leuven , Leuven , Belgium
| | - Simon Rosenbaum
- c School of Psychiatry , University of New South Wales , Sydney , New South Wales , Australia
| | - Michel Probst
- b Department of Rehabilitation Sciences , University of Leuven , Leuven , Belgium
| | - Joanne Connaughton
- d School of Physiotherapy , University of Notre Dame , Fremantle , Western Australia , Australia
| | - Christy Du Plessis
- e Physiotherapy Department , Free State University , Bloemfontein , South Africa
| | - Taisei Yamamoto
- f Department of Medical Rehabilitation , Kobe Gakuin University , Kobe , Japan
| | - Jolien Diedens
- b Department of Rehabilitation Sciences , University of Leuven , Leuven , Belgium
| | - Brendon Stubbs
- g Physiotherapy Department , South London and Maudsley NHS Foundation Trust , London , UK.,h Health Service and Population Research Department, Institute of Psychiatry , King's College London , London , UK
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Strickland JC, Feinstein MA, Lacy RT, Smith MA. The effects of physical activity on impulsive choice: Influence of sensitivity to reinforcement amount and delay. Behav Processes 2016; 126:36-45. [PMID: 26964905 DOI: 10.1016/j.beproc.2016.03.002] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2015] [Revised: 03/03/2016] [Accepted: 03/05/2016] [Indexed: 11/30/2022]
Abstract
Impulsive choice is a diagnostic feature and/or complicating factor for several psychological disorders and may be examined in the laboratory using delay-discounting procedures. Recent investigators have proposed using quantitative measures of analysis to examine the behavioral processes contributing to impulsive choice. The purpose of this study was to examine the effects of physical activity (i.e., wheel running) on impulsive choice in a single-response, discrete-trial procedure using two quantitative methods of analysis. To this end, rats were assigned to physical activity or sedentary groups and trained to respond in a delay-discounting procedure. In this procedure, one lever always produced one food pellet immediately, whereas a second lever produced three food pellets after a 0, 10, 20, 40, or 80-s delay. Estimates of sensitivity to reinforcement amount and sensitivity to reinforcement delay were determined using (1) a simple linear analysis and (2) an analysis of logarithmically transformed response ratios. Both analyses revealed that physical activity decreased sensitivity to reinforcement amount and sensitivity to reinforcement delay. These findings indicate that (1) physical activity has significant but functionally opposing effects on the behavioral processes that contribute to impulsive choice and (2) both quantitative methods of analysis are appropriate for use in single-response, discrete-trial procedures.
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Affiliation(s)
- Justin C Strickland
- Department of Psychology, Box 7037, Davidson College, Davidson, NC 28035-7037, United States, United States
| | - Max A Feinstein
- Department of Psychology, Box 7037, Davidson College, Davidson, NC 28035-7037, United States, United States
| | - Ryan T Lacy
- Department of Psychology, Box 7037, Davidson College, Davidson, NC 28035-7037, United States, United States
| | - Mark A Smith
- Department of Psychology, Box 7037, Davidson College, Davidson, NC 28035-7037, United States, United States.
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Boerhout C, Swart M, Van Busschbach JT, Hoek HW. Effect of Aggression Regulation on Eating Disorder Pathology: RCT of a Brief Body and Movement Oriented Intervention. EUROPEAN EATING DISORDERS REVIEW 2015; 24:114-21. [DOI: 10.1002/erv.2429] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2015] [Revised: 11/19/2015] [Accepted: 11/21/2015] [Indexed: 11/09/2022]
Affiliation(s)
- Cees Boerhout
- PsyQ Eating Disorders; Lentis Psychiatric Institute; Groningen The Netherlands
- Rob Giel Research Center; University of Groningen, University Medical Center Groningen, University Center of Psychiatry; Groningen The Netherlands
| | - Marte Swart
- PsyQ Eating Disorders; Lentis Psychiatric Institute; Groningen The Netherlands
- Rob Giel Research Center; University of Groningen, University Medical Center Groningen, University Center of Psychiatry; Groningen The Netherlands
| | - Jooske T. Van Busschbach
- Rob Giel Research Center; University of Groningen, University Medical Center Groningen, University Center of Psychiatry; Groningen The Netherlands
- Windesheim University of Applied Sciences; Zwolle The Netherlands
| | - Hans W. Hoek
- University of Groningen, University Medical Center Groningen, University Center of Psychiatry; Groningen The Netherlands
- Parnassia Psychiatric Institute; The Hague The Netherlands
- Department of Epidemiology; Columbia University, Mailman School of Public Health; New York NY USA
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Abstract
There exists a continuous spectrum of overeating, where at the extremes there are casual overindulgences and at the other a 'pathological' drive to consume palatable foods. It has been proposed that pathological eating behaviors may be the result of addictive appetitive behavior and loss of ability to regulate the consumption of highly processed foods containing refined carbohydrates, fats, salt, and caffeine. In this review, we highlight the genetic similarities underlying substance addiction phenotypes and overeating compulsions seen in individuals with binge eating disorder. We relate these similarities to findings from neuroimaging studies on reward processing and clinical diagnostic criteria based on addiction phenotypes. The abundance of similarities between compulsive overeating and substance addictions puts forth a case for a 'food addiction' phenotype as a valid, diagnosable disorder.
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Abstract
We performed a qualitative review of treatment studies of binge eating disorder (BED), focusing on randomized clinical trials (RCTs). Limited effectiveness has been demonstrated for self-help strategies, and substantial effectiveness has been shown for cognitive behavioral therapy (CBT) and interpersonal therapy (IPT). CBT and IPT may each be more effective than behavior weight loss therapy (BWLT) for reducing binge eating over the long term. The stimulant pro-drug lisdexamfetamine dimesylate (LDX) is the only drug approved by the FDA for the treatment of BED in adults based on 2 pivotal RCTs. Topiramate also decreases binge eating behavior, but its use is limited by its adverse event profile. Antidepressants may be modestly effective over the short term for reducing binge eating behavior and comorbid depressive symptoms, but are not associated with clinically significant weight loss. A RCT presented in abstract form suggests that intranasal naloxone may decrease time spent binge eating. There is no RCT of obesity surgery in BED, but many patients with BED seek and receive such surgery. While some studies suggest patients with BED and obesity do just as well as patients with obesity alone, other studies suggest that patients with BED have more post-operative complications, less weight loss, and more weight regain. This evidence suggests that patients with BED would benefit from receiving highly individualized treatment.
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The Freiburg sport therapy program for eating disordered outpatients: a pilot study. Eat Weight Disord 2015; 20:319-27. [PMID: 25694219 DOI: 10.1007/s40519-015-0182-3] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/26/2014] [Accepted: 02/03/2015] [Indexed: 10/24/2022] Open
Abstract
PURPOSE Many patients with anorexia or bulimia nervosa use physical activity as a method to influence weight and shape and/or exercise in a compulsive manner. This form of exercising is associated with a more severe illness and higher relapse rates. In a proof-of-concept study, effects of a newly developed sport therapy program aiming to reduce unhealthy exercising were assessed. METHODS Thirty-six patients with eating disorders took part in four group terms of the program, each lasting 3 months. They were compared to a matched control group. Main outcome criterion was a reduction in the total score of the commitment to exercise scale (CES). RESULTS In the completer analysis, we found statistically significant reductions in the CES total score over time (time × group; p = 0.003) and significant improvements in overall eating psychopathology and quality of life (pre → post). The dropout rate was high (34 %), mainly due to external reasons (time schedule, etc.). CONCLUSIONS Findings point to specific effects of a newly developed outpatient sport therapy program for eating disorders. Detailed assessments of patients before assigning them to the program will be necessary to reduce dropout rates. The next step has to be a randomized controlled study.
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Soundy A, Stubbs B, Probst M, Gyllensten AL, Skjaerven LH, Catalan-Matamoros D, Vancampfort D. Considering the Role of Physical Therapists Within the Treatment and Rehabilitation of Individuals With Eating Disorders: An International Survey of Expert Clinicians. PHYSIOTHERAPY RESEARCH INTERNATIONAL 2015; 21:237-246. [PMID: 26267762 DOI: 10.1002/pri.1637] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2014] [Revised: 02/27/2015] [Accepted: 04/19/2015] [Indexed: 12/26/2022]
Abstract
PURPOSE Recent research has demonstrated that physical therapy may benefit the physical and mental health of people with eating disorders (EDs). Because this is a new and developing field, this study aimed to investigate the experience, practices and knowledge of international physical therapy experts to inform clinical practice, education and research. METHODS An international cross-sectional survey design was undertaken with experienced physical therapists within the field of EDs. Physical therapist responses were analysed with descriptive statistics and thematic analysis as appropriate. RESULTS Twenty-eight international physical therapists participated. On average, participants had 6.9 years (95% confidence interval: 3.1-10.7, n = 27) of clinical experience working in ED settings and devoted approximately 39.3% (95% confidence interval: 23.8-54.8, n = 27) of their time to treating individuals with EDs. Participants reported that physical therapy interventions have a diverse range of benefits on the physical, mental and disease-specific factors (e.g. binges) in people with EDs. The key role of physical therapists includes improving body awareness, especially during physical activity combined with psycho-education about healthy doses of physical activity. Physical therapists were able to identify a range of barriers and facilitators to physical activity in people with EDs. DISCUSSION This paper provides a first step towards understanding the role and value of physical therapists working with individuals with EDs. Copyright © 2015 John Wiley & Sons, Ltd.
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Affiliation(s)
- Andy Soundy
- School of Sport, Exercise and Rehabilitation Sciences, University of Birmingham, Birmingham, B15 2TT, UK
| | - Brendon Stubbs
- School of Health and Social Care, University of Greenwich, London, SE9 2UG, UK
| | - Michel Probst
- University Psychiatric Centre, KU Leuven, Leuvensesteenweg 517, B-3070, Kortenberg, Belgium.,Department of Neurosciences, KU Leuven, Leuvensesteenweg 517, B-3070, Kortenberg, Belgium.,Department of Rehabilitation Sciences, KU Leuven, Tervuursevest 101, B-3001, Leuven, Belgium
| | | | - Liv Helvik Skjaerven
- Faculty of Health and Social Sciences, Department of Occupational Therapy, Physiotherapy and Radiography, Bergen University College, Bergen, Norway
| | - Daniel Catalan-Matamoros
- University Carlos III of Madrid, Madrid, Spain.,Spanish Association of Physiotherapists in Mental Health, Madrid, Spain
| | - Davy Vancampfort
- University Psychiatric Centre, KU Leuven, Leuvensesteenweg 517, B-3070, Kortenberg, Belgium.,Department of Neurosciences, KU Leuven, Leuvensesteenweg 517, B-3070, Kortenberg, Belgium.,Department of Rehabilitation Sciences, KU Leuven, Tervuursevest 101, B-3001, Leuven, Belgium
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Mama SK, Schembre SM, O'Connor DP, Kaplan CD, Bode S, Lee RE. Effectiveness of lifestyle interventions to reduce binge eating symptoms in African American and Hispanic women. Appetite 2015; 95:269-74. [PMID: 26188275 DOI: 10.1016/j.appet.2015.07.015] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2014] [Revised: 07/09/2015] [Accepted: 07/14/2015] [Indexed: 10/23/2022]
Abstract
OBJECTIVE Lifestyle interventions that promote physical activity and healthy dietary habits may reduce binge eating symptoms and be more feasible and sustainable among ethnic minority women, who are less likely to seek clinical treatment for eating disorders. The purpose of this study was to investigate (1) whether participating in a lifestyle intervention is a feasible way to decrease binge eating symptoms (BES) and (2) whether changes in BES differed by intervention (physical activity vs. dietary habits) and binge eating status at baseline (binger eater vs. non-binge eater) in African American and Hispanic women. METHOD Health Is Power (HIP) was a longitudinal randomized controlled trial to promote physical activity and improve dietary habits. Women (N = 180) who completed anthropometric measures and questionnaires assessing fruit and vegetable and dietary fat intake, BES and demographics at baseline and post-intervention six months later were included in the current study. RESULTS Over one-fourth (27.8%) of participants were categorized as binge-eaters. Repeated measures ANOVA demonstrated significant two- and three-way interactions. Decreases in BES over time were greater in binge eaters than in non-binge eaters (F(1,164) = 33.253, p < .001), and women classified as binge eaters who participated in the physical activity intervention reported greater decreases in BES than non-binge eaters in the dietary habits intervention (F(1,157) = 5.170, p = .024). DISCUSSION Findings suggest behavioral interventions to increase physical activity may lead to reductions in BES among ethnic minority women and ultimately reduce the prevalence of binge eating disorder and health disparities in this population.
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Affiliation(s)
- Scherezade K Mama
- Department of Health Disparities Research, The University of Texas MD Anderson Cancer Center, 1400 Pressler St., Unit 1440, Houston, TX 77030-3906, USA; Texas Obesity Research Center, Department of Health and Human Performance, University of Houston, 3855 Holman St., Garrison Gym Rm 104, Houston, TX 77204-6015, USA.
| | - Susan M Schembre
- Department of Behavioral Science, The University of Texas MD Anderson Cancer Center, 1155 Pressler St., Unit 1330, Houston, TX 77030, USA.
| | - Daniel P O'Connor
- Texas Obesity Research Center, Department of Health and Human Performance, University of Houston, 3855 Holman St., Garrison Gym Rm 104, Houston, TX 77204-6015, USA.
| | - Charles D Kaplan
- Hamovitch Center for Science in the Human Services, School of Social Work, University of Southern California, 669 W. 34th Street, Montgomery Ross Fisher Building, Los Angeles, CA 90089-0411, USA.
| | - Sharon Bode
- Texas Obesity Research Center, Department of Health and Human Performance, University of Houston, 3855 Holman St., Garrison Gym Rm 104, Houston, TX 77204-6015, USA.
| | - Rebecca E Lee
- College of Nursing and Health Innovation, Arizona State University, 550 N. 3rd,St., Phoenix, AZ 85004, USA.
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Amianto F, Ottone L, Abbate Daga G, Fassino S. Binge-eating disorder diagnosis and treatment: a recap in front of DSM-5. BMC Psychiatry 2015; 15:70. [PMID: 25885566 PMCID: PMC4397811 DOI: 10.1186/s12888-015-0445-6] [Citation(s) in RCA: 76] [Impact Index Per Article: 8.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/18/2014] [Accepted: 03/18/2015] [Indexed: 12/21/2022] Open
Abstract
INTRODUCTION Binge Eating Disorders is a clinical syndrome recently coded as an autonomous diagnosis in DSM-5. Individuals affected by Binge Eating Disorder (BED) show significantly lower quality of life and perceived health and higher psychological distress compared to the non-BED obese population. BED treatment is complex due to clinical and psychological reasons but also to high drop-out and poor stability of achieved goals. The purpose of this review is to explore the available data on this topic, outlining the state-of-the-art on both diagnostic issues and most effective treatment strategies. METHODS We identified studies published in the last 6 years searching the MeSH Term "binge eating disorder", with specific regard to classification, diagnosis and treatment, in major computerized literature databases including: Medline, PubMed, PsychINFO and Science Direct. RESULTS A total of 233 studies were found and, among them, 71 were selected and included in the review. REVIEW Although Binge Eating Disorder diagnostic criteria showed empirical consistency, core psychopathology traits should be taken into account to address treatment strategies. The available body of evidence shows psychological treatments as first line interventions, even if their efficacy on weight loss needs further exploration. Behavioral and self-help interventions evidenced some efficacy in patients with lower psychopathological features. Pharmacological treatment plays an important role, but data are still limited by small samples and short follow-up times. The role of bariatric surgery, a recommended treatment for obesity that is often required also by patients with Binge Eating Disorder, deserves more specific studies. Combining different interventions at the same time does not add significant advantages, planning sequential treatments, with more specific interventions for non-responders, seems to be a more promising strategy. CONCLUSIONS Despite its recent inclusion in DSM-5 as an autonomous disease, BED diagnosis and treatment strategies deserve further deepening. A multidisciplinary and stepped-care treatment appears as a promising management strategy. Longer and more structured follow-up studies are required, in order to enlighten long term outcomes and to overcome the high dropout rates affecting current studies.
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Affiliation(s)
- Federico Amianto
- Department of Neurosciences, University of Torino, Psychiatric Clinic, Via Cherasco 11, 10126, Turin, Italy.
| | - Luisa Ottone
- Department of Neurosciences, University of Torino, Psychiatric Clinic, Via Cherasco 11, 10126, Turin, Italy.
| | - Giovanni Abbate Daga
- Department of Neurosciences, University of Torino, Psychiatric Clinic, Via Cherasco 11, 10126, Turin, Italy.
| | - Secondo Fassino
- Department of Neurosciences, University of Torino, Psychiatric Clinic, Via Cherasco 11, 10126, Turin, Italy.
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Körperliches Training bei neurologischen und psychischen Erkrankungen. DER NERVENARZT 2014; 85:1521-8. [DOI: 10.1007/s00115-013-3978-2] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
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Vancampfort D, Probst M, Adriaens A, Pieters G, De Hert M, Stubbs B, Soundy A, Vanderlinden J. Changes in physical activity, physical fitness, self-perception and quality of life following a 6-month physical activity counseling and cognitive behavioral therapy program in outpatients with binge eating disorder. Psychiatry Res 2014; 219:361-6. [PMID: 24929440 DOI: 10.1016/j.psychres.2014.05.016] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/30/2014] [Revised: 05/02/2014] [Accepted: 05/12/2014] [Indexed: 11/16/2022]
Abstract
The aim of the current study was to explore the associations between changes in the number of binges, physical activity participation, physical fitness, physical self-perception and quality of life following a 6-month physical activity counseling and cognitive behavioral program in patients with binge eating disorder (BED). In total 34 (31 women) outpatients with BED (38.5±10.7 years) completed a 6-month 1-day per week group-based program. Participants completed the 36-item Short Form Health Survey, the Baecke Physical Activity questionnaire, the Physical Self Perception Profile and performed a 6-min walk test (6MWT) at baseline, after 3 and 6 months. Except for physical activity at work, physical strength and self-worth perception, all parameters significantly improved after 6 months. The effect sizes ranged from -0.33 for the number of binges to 1.67 for participation in sports activities. Significant increases in leisure time physical activity were associated with significant improvements in physical health related quality of life, perceived sports competence and physical fitness and in perceived body attractiveness. The significant reduction in the number of binges was associated with significant improvements in physical health related quality of life. Future research should focus on detailing which techniques can stimulate physical activity participation in patients with BED.
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Affiliation(s)
- Davy Vancampfort
- UPC KU Leuven, Campus Kortenberg, KU Leuven Department of Neurosciences, Leuvensesteenweg 517, B-3070 Kortenberg, Belgium; KU Leuven Department of Rehabilitation Sciences, KU Leuven, Tervuursevest 101, 3001 Leuven, Belgium.
| | - Michel Probst
- UPC KU Leuven, Campus Kortenberg, KU Leuven Department of Neurosciences, Leuvensesteenweg 517, B-3070 Kortenberg, Belgium; KU Leuven Department of Rehabilitation Sciences, KU Leuven, Tervuursevest 101, 3001 Leuven, Belgium
| | - An Adriaens
- UPC KU Leuven, Campus Kortenberg, KU Leuven Department of Neurosciences, Leuvensesteenweg 517, B-3070 Kortenberg, Belgium
| | - Guido Pieters
- UPC KU Leuven, Campus Kortenberg, KU Leuven Department of Neurosciences, Leuvensesteenweg 517, B-3070 Kortenberg, Belgium
| | - Marc De Hert
- UPC KU Leuven, Campus Kortenberg, KU Leuven Department of Neurosciences, Leuvensesteenweg 517, B-3070 Kortenberg, Belgium
| | - Brendon Stubbs
- School of Health and Social Care, University of Greenwich, Eltham, London SE9 2UG, UK
| | - Andy Soundy
- Department of Physiotherapy, University of Birmingham, 52 Pritchatts Road, Birmingham B15 2TT, UK
| | - Johan Vanderlinden
- UPC KU Leuven, Campus Kortenberg, KU Leuven Department of Neurosciences, Leuvensesteenweg 517, B-3070 Kortenberg, Belgium
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Metral M, Guardia D, Bauwens I, Guerraz M, Lafargue G, Cottencin O, Luyat M. Painfully thin but locked inside a fatter body: abnormalities in both anticipation and execution of action in anorexia nervosa. BMC Res Notes 2014; 7:707. [PMID: 25298129 PMCID: PMC4201671 DOI: 10.1186/1756-0500-7-707] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2014] [Accepted: 10/02/2014] [Indexed: 11/25/2022] Open
Abstract
Background People with anorexia nervosa (AN) usually report feeling broader than they really are. The objective of the present study was to better understand the body schema's involvement in this false self-representation in AN. We tested the potential for correction of the body schema impairment via the sensorimotor feedback provided by a real, executed action and relative to an imagined action. We also took account of the impact of the AN patients’ weight variations on the task outcomes. Methods Fourteen inpatient participants with AN and fourteen control participants were presented with a doorway-like aperture. The participants had to (i) judge whether or not various apertures were wide enough for them to pass through in a motor imagery task and then (ii) actually perform the action by passing through various apertures. Results We observed a higher passability ratio (i.e. the ratio between the critical aperture size and shoulder width) in participants with AN (relative to controls) for both motor imagery and real action. Moreover, the magnitude of the passability ratio was positively correlated with weight recovery. Conclusion The body schema alteration in AN appears to be strong enough to affect the patient's actions. Furthermore, the alteration resists correction by the sensorimotor feedback generated during action. This bias is linked to weight variations. The central nervous system might be locked to a false representation of the body that cannot be updated. Moreover, these results prompt us to suggest that emotional burden during weight recovery could also alter sensorimotor aspects of body representation. New therapeutic methods should take account of body schema alterations in AN as adjuncts to psychotherapy.
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Affiliation(s)
| | | | | | | | | | | | - Marion Luyat
- LNFP (Laboratory of Functional Neuroscience and Pathology) EA4559, F-59000 Lille, France.
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Machado GC, Ferreira ML. Physiotherapy improves eating disorders and quality of life in bulimia and anorexia nervosa. Br J Sports Med 2014; 48:1519-20. [PMID: 25136082 DOI: 10.1136/bjsports-2014-094088] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Affiliation(s)
- Gustavo C Machado
- The George Institute for Global Health, Sydney Medical School, University of Sydney, Sydney, New South Wales, Australia
| | - Manuela L Ferreira
- The George Institute for Global Health, Sydney Medical School, University of Sydney, Sydney, New South Wales, Australia
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Vancampfort D, De Herdt A, Vanderlinden J, Lannoo M, Adriaens A, De Hert M, Stubbs B, Soundy A, Probst M. The functional exercise capacity and its correlates in obese treatment-seeking people with binge eating disorder: an exploratory study. Disabil Rehabil 2014; 37:777-82. [PMID: 25030711 DOI: 10.3109/09638288.2014.942000] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
PURPOSE The primary aim was to compare the functional exercise capacity between obese treatment-seeking people with and without binge eating disorder (BED) and non-obese controls. The secondary aim was to identify clinical variables including eating and physical activity behaviour, physical complaints, psychopathology and physical self-perception variables in obese people with BED that could explain the variability in functional exercise capacity. METHODS Forty people with BED were compared with 20 age-, gender- and body mass index (BMI)-matched obese persons without BED and 40 age and gender matched non-obese volunteers. A 6-minute walk test (6MWT), the Baecke physical activity questionnaire, the Symptom Checklist-90, the Physical Self-Perception Profile and the Eating Disorder Inventory were administered. Physical complaints before and after the 6MWT were also documented. RESULTS The distance achieved on the 6MWT was significantly lower in obese participants with BED (512.1 ± 75.8 m versus 682.7 ± 98.4, p < 0.05) compared to non-obese controls. No significant differences were found between obese participants with and without BED. Participants with BED reported significantly (p < 0.05) more musculoskeletal pain and fatigue after the walk test than obese and non-obese controls. A forward stepwise regression analysis demonstrated that sports participation and perceived physical strength explained 41.7% of the variance on the 6MWT in obese participants with BED. CONCLUSION Physical activity participation, physical self-perception and perceived physical discomfort during walking should be considered when developing rehabilitation programs for obese people with BED. IMPLICATIONS FOR REHABILITATION Rehabilitation programmes in people with binge eating disorder should incorporate a functional exercise capacity assessment. Clinicians involved in the rehabilitation of people with binge eating disorder should consider depression and lower self-esteem as potential barriers. Clinicians should take into account the frequently observed physical discomfort when developing rehabilitation programmes for people with binge eating disorder.
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Affiliation(s)
- Davy Vancampfort
- KU Leuven Department of Neurosciences, University Psychiatric Centre KU Leuven, Campus Kortenberg , Kortenberg , Belgium
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Vancampfort D, De Herdt A, Vanderlinden J, Lannoo M, Soundy A, Pieters G, Adriaens A, De Hert M, Probst M. Health related quality of life, physical fitness and physical activity participation in treatment-seeking obese persons with and without binge eating disorder. Psychiatry Res 2014; 216:97-102. [PMID: 24530157 DOI: 10.1016/j.psychres.2014.01.015] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/03/2013] [Revised: 01/06/2014] [Accepted: 01/09/2014] [Indexed: 10/25/2022]
Abstract
This study compared the mental and physical health related quality of life (HRQL) of 40 obese persons with BED with 20 age, gender and body mass index (BMI) matched obese persons without BED and 40 age and gender matched non-obese volunteers. Variables contributing to the variability in HRQL were identified. Participants were asked to fill in the MOS 36-item Short Form Health Survey (SF-36), the Symptoms Checklist-90 (SCL-90), the Baecke questionnaire, the bulimia subscale of the Eating Disorder Inventory and the Body Attitude Test. All participants also performed a 6-minute walk test (6MWT). BED patients showed a significant impaired physical and mental HRQL compared with obese and non-obese control groups. In the BED-group female participants showed a significantly more impaired mental HRQL than male participants (40.0±21.2 versus 66.6±10.1). The distance achieved on the 6MWT (512.1±75.8m) explained 22.5% of the variability in physical HRQL in the obese BED-group while gender and the SCL-90 depression score (39.1±12.2) explained 47.1% of the variability in mental HRQL. The present findings suggest that the treatment of obese individuals with BED might benefit by giving more attention to HRQL, depressive symptoms and physical fitness.
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Affiliation(s)
- Davy Vancampfort
- University Psychiatric Centre Catholic University Leuven, Campus Kortenberg, Leuvensesteenweg 517, B-3070 Kortenberg, Belgium; Faculty of Kinesiology and Rehabilitation Sciences, Catholic University Leuven, Tervuursevest 101, 3001 Leuven, Belgium.
| | - Amber De Herdt
- Faculty of Kinesiology and Rehabilitation Sciences, Catholic University Leuven, Tervuursevest 101, 3001 Leuven, Belgium
| | - Johan Vanderlinden
- University Psychiatric Centre Catholic University Leuven, Campus Kortenberg, Leuvensesteenweg 517, B-3070 Kortenberg, Belgium
| | - Matthias Lannoo
- Department of Abdominal Surgery, University Hospital Gasthuisberg, Leuven, Belgium
| | - Andrew Soundy
- School of Health and Population Sciences, College of Medicine and Dentistry, University of Birmingham, UK
| | - Guido Pieters
- University Psychiatric Centre Catholic University Leuven, Campus Kortenberg, Leuvensesteenweg 517, B-3070 Kortenberg, Belgium
| | - An Adriaens
- University Psychiatric Centre Catholic University Leuven, Campus Kortenberg, Leuvensesteenweg 517, B-3070 Kortenberg, Belgium
| | - Marc De Hert
- University Psychiatric Centre Catholic University Leuven, Campus Kortenberg, Leuvensesteenweg 517, B-3070 Kortenberg, Belgium
| | - Michel Probst
- University Psychiatric Centre Catholic University Leuven, Campus Kortenberg, Leuvensesteenweg 517, B-3070 Kortenberg, Belgium; Faculty of Kinesiology and Rehabilitation Sciences, Catholic University Leuven, Tervuursevest 101, 3001 Leuven, Belgium
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Vancampfort D, Vanderlinden J, Stubbs B, Soundy A, Pieters G, Hert MD, Probst M. Physical Activity Correlates in Persons with Binge Eating Disorder: A Systematic Review. EUROPEAN EATING DISORDERS REVIEW 2013; 22:1-8. [DOI: 10.1002/erv.2255] [Citation(s) in RCA: 30] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
Affiliation(s)
- Davy Vancampfort
- Department of Neurosciences; University Psychiatric Center-Catholic University of Leuven; Kortenberg Belgium
- Department of Rehabilitation Sciences; KU Leuven; Leuven Belgium
| | - Johan Vanderlinden
- Department of Neurosciences; University Psychiatric Center-Catholic University of Leuven; Kortenberg Belgium
| | - Brendon Stubbs
- School of Health and Social Care; University of Greenwich; London UK
| | - Andrew Soundy
- School of Sport, Exercise & Rehabilitation Sciences; University of Birmingham; UK
| | - Guido Pieters
- Department of Neurosciences; University Psychiatric Center-Catholic University of Leuven; Kortenberg Belgium
| | - Marc De Hert
- Department of Neurosciences; University Psychiatric Center-Catholic University of Leuven; Kortenberg Belgium
| | - Michel Probst
- Department of Neurosciences; University Psychiatric Center-Catholic University of Leuven; Kortenberg Belgium
- Department of Rehabilitation Sciences; KU Leuven; Leuven Belgium
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