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Kambanis PE, Bottera AR, De Young KP. Responses to bright light exposure in individuals with binge-spectrum eating disorders characterized by high dietary restraint and negative affect. Int J Eat Disord 2023; 56:2250-2259. [PMID: 37644851 DOI: 10.1002/eat.24054] [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: 01/24/2023] [Revised: 08/17/2023] [Accepted: 08/17/2023] [Indexed: 08/31/2023]
Abstract
OBJECTIVE Circadian rhythm disruptions are associated with binge eating, can be causal of negative mood, and may be corrected with bright light exposure. A subtype of individuals with binge-spectrum eating disorders are characterized by combined high dietary restraint and negative affect. These individuals have higher eating disorder psychopathology and poorer treatment response. We aimed to test the targeted effects of morning bright light exposure on individuals with binge-spectrum eating disorders, hypothesizing significant reductions in binge eating for those characterized by high dietary restraint and negative affect. METHODS Participants (N = 34 females with binge-eating disorder and bulimia nervosa) used a morning bright light and normal light for 10 consecutive days each, in randomized order. They completed the Change in Eating Disorder Symptoms (CHEDS) scale at baseline, day 12 (when they switched lamps), and day 22. We conducted moderation analyses, clustering data by person, controlling for order, and examining the effect of light condition on binge eating according to baseline restraint and negative affect. RESULTS At high levels of combined dietary restraint and negative affect, participants experienced a reduction in binge eating and food preoccupation following exposure to morning bright light. There were no changes in restrictive eating, body preoccupation, body dissatisfaction, or body checking following exposure to morning bright light for these individuals. DISCUSSION These findings suggest that morning bright light may be a useful adjunct to empirically supported eating disorder treatments that target binge eating, especially for individuals characterized by the difficult to treat restraint/negative affect subtype. PUBLIC SIGNIFICANCE At high levels of combined dietary restraint and negative affect, participants with binge-spectrum eating disorders experienced a reduction in binge eating and food preoccupation following exposure to morning bright light. These findings suggest that morning bright light may be a useful adjunct to empirically supported eating disorder treatments that target binge eating, especially for individuals characterized by the difficult-to-treat restraint/negative affect subtype.
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Affiliation(s)
- P Evelyna Kambanis
- Eating Disorders Clinical and Research Program, Massachusetts General Hospital, Boston, Massachusetts, USA
- Department of Psychiatry, Harvard Medical School, Boston, Massachusetts, USA
| | | | - Kyle P De Young
- Department of Psychology, University of Wyoming, Laramie, Wyoming, USA
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Tesselaar JM, Mendoza RR, Siegel JA, Elbe CI, Caravelli NS, DeJesus J, Fenton M, Victoria BS, Blashill AJ. A qualitative analysis of relationship advice from the perspective of people living with and recovering from eating disorders while in diverse romantic relationships. Eat Disord 2023; 31:632-650. [PMID: 37194296 DOI: 10.1080/10640266.2023.2206753] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 05/18/2023]
Abstract
Eating disorders (EDs) have adverse consequences across life domains, ranging from physical health to interpersonal relationships. While research suggests that romantic partners have the potential to support ED recovery, partners to those with EDs often report feeling confused and helpless in the face of the condition. The extant literature on EDs in relationships centers on the experiences of cisgender, heterosexual women. The present study aimed to garner a more comprehensive understanding of the types of support people with EDs believe are most helpful from romantic partners by analyzing relationship advice from a diverse group of individuals with EDs who were in romantic relationships. As part of a larger study on romantic relationships in ED recovery, we analyzed responses to the question, "If you had to give one piece of advice to someone who learns that their partner has an ED, what would it be?" Through Consensual Qualitative Research-Modified, we identified 29 themes, which we grouped into 7 domains: Foster Open Communication, Create an Environment of Emotional Intimacy, Let Your Partner Guide You, Educate Yourself, Be Compassionate with Yourself, Use Caution when Discussing Food and Bodies, and a Miscellaneous domain. These findings highlight the importance of patience, flexibility, psychoeducation, and self-compassion for individuals working to support their partner's ED recovery, and can inform future couples-based treatments and interventions for EDs.
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Affiliation(s)
- Juliana M Tesselaar
- Department of Psychology, San Diego State University, San Diego, California, USA
| | - Rebecca R Mendoza
- Department of Psychology, San Diego State University, San Diego, California, USA
| | - Jaclyn A Siegel
- Department of Psychology, San Diego State University, San Diego, California, USA
| | - Connor I Elbe
- Department of Psychology, San Diego State University, San Diego, California, USA
| | - Nicolas S Caravelli
- Department of Psychology, San Diego State University, San Diego, California, USA
| | - Jennifer DeJesus
- Department of Psychology, San Diego State University, San Diego, California, USA
| | - Margo Fenton
- Department of Psychology, San Diego State University, San Diego, California, USA
| | - Brianna S Victoria
- Department of Psychology, San Diego State University, San Diego, California, USA
| | - Aaron J Blashill
- Department of Psychology, San Diego State University, San Diego, California, USA
- SDSU/UC San Diego Joint Doctoral Program in Clinical Psychology, San Diego, California, USA
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Zyoud SH, Shakhshir M, Abushanab AS, Koni A, Shahwan M, Jairoun AA, Al-Jabi SW. Mapping the landscape and structure of global research on binge eating disorder: Visualization and bibliometric analysis. World J Psychiatry 2022; 12:982-994. [PMID: 36051594 PMCID: PMC9331445 DOI: 10.5498/wjp.v12.i7.982] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/18/2022] [Revised: 05/22/2022] [Accepted: 06/27/2022] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND Binge-eating disorder (BED) is a clinical syndrome and is considered the most common type of eating disorder. However, our understanding of the global performance and progress of BED research is limited.
AIM To describe and perform a bibliometric analysis of the state of BED research.
METHODS The term ‘Binge eating’ was searched in the title throughout the previous year’s up to December 31, 2020. We searched the Scopus and Reference Citation Analysis for publications on Binge eating. The VOSviewer software version 1.6.17 was used to produce the network visualization map of the most frequent author, collaborative relationships between countries/regions, and to determine the hotspots related to binge eating research. In addition, conventional bibliometric indicators were generated.
RESULTS The search strategy found 2713 total articles and an average of 62 articles per year. Among them, ‘Article’ represented 82.49% of the publications (n = 2238 articles) and was the most frequent type, followed by reviews (n = 243; 8.96%). The number of publications increased steadily during the last decade of the study period. One hundred and thirty-two countries contributed to binge eating research, with 1495 (55.11%) articles published in the United States, followed by Italy with 256 (9.44%), the United Kingdom with 183 (6.75%), and Germany with 182 (6.71%). Currently, the main hot topics related to BED are ‘type of treatment and management and treatment provided to BED”; “processes and pathways to binge eating”; and ‘diagnosis, signs and symptoms, comorbidities and prevalence and associated factors with BED’.
CONCLUSION The number of publications has increased noticeably during the previous decade. There are indeed relatively few publications on BED from low-and middle-income nations, so much is to be learned from the experience of all countries. Studies on this topic are critical in all countries to discover risk factors and effective intervention measures. Although our findings are preliminary, they imply that the future prospects for interventions aimed at BED management are bright, focusing on complex models of care and long-term maintenance of therapeutic gains.
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Affiliation(s)
- Sa'ed H Zyoud
- Department of Clinical and Community Pharmacy, College of Medicine and Health Sciences, An-Najah National University, Nablus 44839, Palestine
- Poison Control and Drug Information Center, College of Medicine and Health Sciences, An-Najah National University, Nablus 44839, Palestine
- Clinical Research Centre, An-Najah National University Hospital, Nablus 44839, Palestine
| | - Muna Shakhshir
- Department of Nutrition, An-Najah National University Hospital, Nablus 44839, Palestine
| | - Amani S Abushanab
- Department of Clinical and Community Pharmacy, College of Medicine and Health Sciences, An-Najah National University, Nablus 44839, Palestine
| | - Amer Koni
- Department of Clinical and Community Pharmacy, College of Medicine and Health Sciences, An-Najah National University, Nablus 44839, Palestine
- Division of Clinical Pharmacy, Hematology and Oncology Pharmacy Department, An-Najah National University Hospital, Nablus 44839, Palestine
| | - Moyad Shahwan
- Department of Pharmacy, Ajman University, Ajman 346, United Arab Emirates
- Centre of Medical and Bio allied Health Sciences Research, Ajman University, Ajman 346, United Arab Emirates
| | | | - Samah W Al-Jabi
- Department of Clinical and Community Pharmacy, College of Medicine and Health Sciences, An-Najah National University, Nablus 44839, Palestine
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Gu L, Zou Y, Huang Y, Liu Q, Chen H, Chen J. The effect of group cognitive behavior therapy on Chinese patients with anorexia nervosa: an open label trial. J Eat Disord 2021; 9:114. [PMID: 34526151 PMCID: PMC8444542 DOI: 10.1186/s40337-021-00469-7] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/21/2021] [Accepted: 09/01/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND The high cost of treatment for anorexia nervosa (AN) and lack of trained specialists have resulted in limited accessibility of effective treatment to patients with AN, which is particularly problematic in China. To increase the accessibility of evidence-based treatment and reduce the cost of treatment, this study aimed to explore the feasibility and efficacy of group cognitive behavior therapy (G-CBT) adapted from enhanced cognitive behavior therapy for eating disorders (CBT-E) in Chinese AN patients. METHOD A total of 78 patients with AN were assigned to G-CBT or individual outpatient treatment (IOT) and received three months of treatment for AN in each condition. Measures of eating pathology, depression and anxiety were administrated to both intervention groups at three time points: baseline, one month of treatment, and end of treatment; results were compared between groups and over time. RESULTS There were 70 participants included in the final analysis. Both G-CBT and IOT groups showed significant improvement in eating pathology and associated psychopathology (ps < .001) over the course of treatment, but no significant difference in symptom improvement was found between the two groups (ps > .05). G-CBT resulted in additional significant improvement in ED psychopathology over the last two months of treatment, and its overall therapeutic effect was influenced by baseline weight and early symptom improvement. CONCLUSION Preliminary findings from this open label trial suggest that G-CBT adapted from CBT-E is feasible in an outpatient setting and as effective as IOT in facilitating weight regain and reducing psychopathology in Chinese AN patients with little evidence for the superiority of either intervention. TRIAL REGISTRATION The current study was registered at clinical trials.gov on September 23, 2018 (registration number NCT03684239). People with anorexia nervosa (AN) are known to be unmotivated for treatment and prone to relapse. Recovery from AN often needs intensive, long-term treatment from a specialized multidisciplinary team, which is not accessible for most people in China. Given the increasing incidence of AN and lack of eating disorder (ED) specialists in China, it is important to develop short-term cost-effective treatments for AN. In this study, we explored the feasibility and efficacy of group cognitive behavior therapy (G-CBT) adapted from enhanced cognitive behavior therapy (CBT-E) for people with AN from China. We found that G-CBT was as effective as individual outpatient treatment (IOT) typically provided to AN patients at the research site in facilitating weight regain, improving eating behaviors, and reducing ED and other symptoms. We also found that patients receiving G-CBT made more improvements in cognitive symptoms of the ED, which might help maintain treatment gains and prevent relapse in the long run. This potential long-term advantage of G-CBT needs to be verified in long-term follow-up.
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Affiliation(s)
- Lian Gu
- Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, 600 South Wanping Road, Shanghai, China
| | - Yunling Zou
- Shanghai Changning Mental Health Center, Shanghai, China
| | - Yue Huang
- Counseling Services, University of Nevada, Reno, NV, USA
| | - Qiang Liu
- Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, 600 South Wanping Road, Shanghai, China
| | - Han Chen
- Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, 600 South Wanping Road, Shanghai, China
| | - Jue Chen
- Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, 600 South Wanping Road, Shanghai, China.
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An exploratory study of experiences with conventional eating disorder treatment and ceremonial ayahuasca for the healing of eating disorders. Eat Weight Disord 2020; 25:437-444. [PMID: 30474794 DOI: 10.1007/s40519-018-0619-6] [Citation(s) in RCA: 28] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/27/2018] [Accepted: 11/09/2018] [Indexed: 01/29/2023] Open
Abstract
PURPOSE Ayahuasca is a traditional Amazonian medicine that is currently being researched for its potential in treating a variety of mental disorders. This article reports on exploratory qualitative research relating to participant experiences with ceremonial ayahuasca drinking and conventional treatment for eating disorders (EDs). It also explores the potential for ayahuasca as an adjunctive ED treatment. METHODS Thirteen individuals previously diagnosed with an ED participated in a semi-structured interview contrasting their experiences with conventional ED treatment with experiences from ceremonial ayahuasca. The interviews were analyzed using thematic analysis. RESULTS Participant reports were organized with key themes including that ayahuasca: led to rapid reductions in ED thoughts and symptoms; allowed for the healing of the perceived root of the ED; helped to process painful feelings and memories; supported the internalization of greater self-love and self-acceptance; and catalyzed spiritual elements of healing. CONCLUSIONS The results suggest that ayahuasca may have potential as a valuable therapeutic tool, and further research-including carefully controlled clinical trials-is warranted. LEVEL OF EVIDENCE Level V, qualitative descriptive study.
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Bäck M, Falkenström F, Gustafsson SA, Andersson G, Holmqvist R. Reduction in depressive symptoms predicts improvement in eating disorder symptoms in interpersonal psychotherapy: results from a naturalistic study. J Eat Disord 2020; 8:33. [PMID: 32637100 PMCID: PMC7333417 DOI: 10.1186/s40337-020-00308-1] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/30/2019] [Accepted: 06/03/2020] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Interpersonal psychotherapy (IPT) can be effective for both Bulimia Nervosa (BN) and co-occurring depression. While changes in symptoms of Eating disorder (ED) and depression have been found to correlate, it is unclear how they interact during treatment and in which order the symptoms decrease. METHODS Thirty-one patients with BN and depressive symptoms received IPT using the manual IPT-BNm in a naturalistic design. The outcome was measured with the Eating Disorder Examination Questionnaire (EDE-Q) and the Montgomery Åsberg Depression Rating Scale (MADRS-S). Symptom improvement at each session was measured with Repeated Evaluation of Eating Disorder Symptoms (REDS) and the Patient Health Questionnaire-9 (PHQ-9). RESULTS Significant improvements with large effect sizes were found on both ED symptoms and depression. The rates of change were linear for both BN and depression. A strong correlation between reduction of depressive symptoms and ED symptoms was found. Depressive symptom reduction at one session predicted improvement of ED symptoms at the next session. CONCLUSIONS IPT-BNm had an effect on both BN and co-occurring depressive symptoms. The analyses indicated that reduction in depressive symptoms preceded reduction in bulimic symptoms.
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Affiliation(s)
- Malin Bäck
- Department of Behavioural Sciences and Learning, Linköping University, Linköping, Sweden.,Futurum: Academy for Health and Care, Jönköping, Region Jönköping County Sweden
| | - Fredrik Falkenström
- Department of Behavioural Sciences and Learning, Linköping University, Linköping, Sweden
| | - Sanna Aila Gustafsson
- Faculty of Medicine and Health, University Health Care Research Center, Örebro University, Örebro, Sweden
| | - Gerhard Andersson
- Department of Behavioural Sciences and Learning, Linköping University, Linköping, Sweden.,Department of Clinical Neuroscience, Karolinska Institute, Stockholm, Sweden
| | - Rolf Holmqvist
- Department of Behavioural Sciences and Learning, Linköping University, Linköping, Sweden
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Bäck M, Gustafsson SA, Holmqvist R. Interpersonal psychotherapy for eating disorders with co-morbid depression: A pilot study. EUROPEAN JOURNAL OF PSYCHOTHERAPY & COUNSELLING 2017. [DOI: 10.1080/13642537.2017.1386226] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Affiliation(s)
- Malin Bäck
- Futurum: Academy for Health and Care, Region Jönköping County, Jönköping, Sweden
- Department of Behavioural Research and Learning, Linköping University, Linköping, Sweden
| | - Sanna Aila Gustafsson
- Faculty of Medicine and Health, University Health Care Research Center, Region Örebro County, Örebro University, Örebro, Sweden
- Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden
| | - Rolf Holmqvist
- Department of Behavioural Sciences and Learning, Linköping University, Linköping, Sweden
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Yehuda S, Rabinovitz S. The Role of Essential Fatty Acids in Anorexia Nervosa and Obesity. Crit Rev Food Sci Nutr 2017; 56:2021-35. [PMID: 26068122 DOI: 10.1080/10408398.2013.809690] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
The two basic questions in food intake study are what we eat, and how much do we eat. Most research is directed toward the control of how much is eaten. This is likely the result of the increased number of individuals with eating disorders in the Western world. Feeding behavior is highly complex, and is controlled by many psychological, physiological, biochemical, and immunological factors. The aim of this review is to clarify the involvement of fatty acids in eating disorders such as anorexia and binge eating disorder. The review will describe the modified fatty acid profile observed in individuals with anorexia or binge eating disorder, and discuss on what factors fatty acids can exert beneficial effects. In addition, the differences and similarities between anorexia and binge eating disorder will be discussed. We suggest that beneficial effects of essential fatty acids on both anorexia and binge eating disorder can be explained by the stabilizing effect of those fatty acids on the neuronal membrane fluidity index.
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Affiliation(s)
- Shlomo Yehuda
- a Psychopharmacology Lab , Department of Psychology, Bar Ilan University , Ramat Gan , Israel
| | - Sharon Rabinovitz
- a Psychopharmacology Lab , Department of Psychology, Bar Ilan University , Ramat Gan , Israel.,b School of Criminology, University of Haifa , Mount Carmel , Israel
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Lindstedt K, Kjellin L, Gustafsson SA. Adolescents with full or subthreshold anorexia nervosa in a naturalistic sample - characteristics and treatment outcome. J Eat Disord 2017; 5:4. [PMID: 28265410 PMCID: PMC5333469 DOI: 10.1186/s40337-017-0135-5] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/17/2016] [Accepted: 01/26/2017] [Indexed: 12/18/2022] Open
Abstract
BACKGROUND Anorexia Nervosa (AN) destroys developmentally important early years of many young people and knowledge is insufficient regarding course, treatment outcome and prognosis. Only a few naturalistic studies have been conducted within the field of eating disorder (ED) research. In this naturalistic study we included adolescents with AN or subthreshold AN treated in outpatient care, and the overall aim was to examine sample characteristics and treatment outcome. Additional aims were to examine potential factors associated with remission as an outcome variable, and possible differences between three time periods for treatment onset. METHODS Participants were identified through the Swedish national quality register for eating disorder treatment (SwEat), in which patients are registered at treatment onset and followed up once a year until end of treatment (EOT). Inclusion criteria were: medical or self-referral to one of the participating treatment units between 1999 and 2014, 13-19 years of age at initial entry into SwEat and diagnosed with AN or subthreshold AN. The total sample consisted of 3997 patient from 83 different treatment units. RESULTS The results show that 55% of the participants were in remission and approximately 85% were within a healthy weight range at EOT. Of those who ended treatment according to plan, 70% were in remission and 90% within a healthy weight range. The average treatment duration was approximately 15 months. About one third of the patients terminated treatment prematurely, which was associated with a decreased chance of achieving remission. Remission rates and weight recovery increased over time, while treatment duration decreased. Considering treatment outcome, the results did not show any differences between patients with AN or subthreshold AN. CONCLUSIONS The present study shows a relatively good prognosis for adolescent patients with AN or subthreshold AN in routine care and the results indicate that treatment for adolescents with ED in Sweden has become more effective over the past 15 years. The results of the present study contribute to the scope of treatment research and the large-scale naturalistic setting secures the generalizability to a clinical environment. However, more research is needed into different forms of evidence, new research strategies and diversity of treatment approaches. TRIAL REGISTRATION Registered in FOU in Sweden (Researchweb.org) 2014-04-14, ID nr 147301.
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Affiliation(s)
- Katarina Lindstedt
- University Health Care Research Center, Faculty of Medicine and Health, Örebro University, SE-701 82 Örebro, Sweden
| | - Lars Kjellin
- University Health Care Research Center, Faculty of Medicine and Health, Örebro University, SE-701 82 Örebro, Sweden
| | - Sanna Aila Gustafsson
- University Health Care Research Center, Faculty of Medicine and Health, Örebro University, SE-701 82 Örebro, Sweden
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Hill L, Peck SK, Wierenga CE, Kaye WH. Applying neurobiology to the treatment of adults with anorexia nervosa. J Eat Disord 2016; 4:31. [PMID: 27980771 PMCID: PMC5137219 DOI: 10.1186/s40337-016-0119-x] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/07/2016] [Accepted: 08/30/2016] [Indexed: 02/07/2023] Open
Abstract
BACKGROUND Anorexia nervosa is a severe, biologically based brain disorder with significant medical complications. It is critical that new, effective treatments are developed to interrupt the persistent course of the illness due to the medical and psychological sequelae. Several psychosocial, behavioral and pharmacologic interventions have been investigated in adult anorexia nervosa; however, evidence shows that their impact is weak and treatment effects are generally small. METHOD This paper describes a new neurobiological anorexia nervosa model that shifts focus from solely external influences, such as social and family, to include internal influences that integrate genetic and neurobiological contributions, across the age span. The model serves as a theoretical structure for a new, five-day treatment, outlined in this paper, targeting anorexia nervosa temperament, which integrates neurobiological dimensions into evidence-based treatment interventions. The treatment is in two phases. Phase I is a five day, 40 hour treatment for anorexia nervosa adults. Phase II is the follow-up and is currently being developed. RESULTS Preliminary qualitative acceptability data on 37 adults with anorexia nervosa and 60 supports (e.g., spouses, parents, aunts, friends, partners, children of anorexia nervosa adults) are promising from Phase I. Clients with anorexia nervosa and their supports report that learning neurobiological facts improved their understanding of the illness and helped equip them with better tools to manage anorexia nervosa traits and symptoms. In addition, nutritional knowledge changed significantly. CONCLUSIONS This is the first neurobiologically based, five-day treatment for adults with anorexia nervosa and their supports. It is a new model that outlines underlying genetic and neurobiological contributions to anorexia nervosa that serves as a foundation to treat both traits and symptoms. Preliminary qualitative findings are promising, with both clients and supports reporting that the neurobiological treatment approach helped them better understand the illness, while better conceptualizing how to respond to their traits and manage their symptoms. Data in Phase I shows promise as a neurobiologically based intervention for anorexia nervosa, and it serves as a foundation for the development of Phase II. Evidence of ongoing program efficacy will be described as data are reported on Phase II. TRIAL REGISTRATION NCT NCT02852538 Registered 1 August 2016.
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Affiliation(s)
- Laura Hill
- The Center for Balanced Living, 8001 Ravines Edge Court, Suite 201, Columbus, OH 43235 USA
| | | | | | - Walter H. Kaye
- Department of Psychiatry, University of California San Diego, San Diego, CA USA
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11
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Metacognitions about desire thinking predict the severity of binge eating in a sample of Italian women. Eat Weight Disord 2016; 21:297-304. [PMID: 26143571 DOI: 10.1007/s40519-015-0205-0] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/20/2015] [Accepted: 06/22/2015] [Indexed: 01/09/2023] Open
Abstract
In this study, our principal aim was to investigate whether metacognitions about desire thinking predict the severity of binge eating in women and, if so, whether this relationship is independent of age, self-reported body mass index (BMI), negative affect, irrational food beliefs and craving. One hundred and four women, consisting of 32 consecutive patients with binge eating disorder undergoing initial assessment for cognitive therapy for eating disorders, 39 moderate binge eaters, and 33 non-binge eaters (both from the general population), completed the following measures: Self-reported BMI, Hospital Anxiety and Depression Scale, Irrational Food Beliefs Scale, General Craving Scale, Metacognitions about Desire Thinking Questionnaire, and Binge Eating Scale. A series of Spearman's rho correlation analyses revealed that self-reported BMI, anxiety, depression, irrational food beliefs, craving, and all three factors of the metacognitions about desire thinking questionnaire were significantly associated with the severity of binge eating. A stepwise regression analysis identified self-reported BMI, craving, and negative metacognitions about desire thinking as significant predictors of the severity of binge eating. These results, taken together, highlight the possible role of metacognitions about desire thinking in predicting the severity of binge eating. The clinical implications of these findings are discussed.
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Knatz S, Wierenga CE, Murray SB, Hill L, Kaye WH. Neurobiologically informed treatment for adults with anorexia nervosa: a novel approach to a chronic disorder. DIALOGUES IN CLINICAL NEUROSCIENCE 2016. [PMID: 26246796 PMCID: PMC4518705 DOI: 10.31887/dcns.2015.17.2/sknatz] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Anorexia nervosa (AN) is a severe and debilitating disorder with significant medical and psychological sequelae. To date, there are no effective treatments for adults, resulting in high rates of chronicity, morbidity, and mortality. Recent advances in brain imaging research have led to an improved understanding of etiology and specific neurobiological mechanisms underlying symptoms. Despite this, there are no treatments focused on targeting symptoms using this empirically supported mechanistic understanding of the illness. Updated treatment approaches focused on targeting neurobiological mechanisms underlying core AN symptomatology are necessary to improve treatment out-comes for this population. Neurobiologically Enhanced With Family Eating Disorder Trait Response Treatment (NEW FED TR) is a neurobiologically informed treatment targeting key temperament constructs associated with the illness through the delivery of psychoeducation and skills training to patients and nominated carers.
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Affiliation(s)
- Stephanie Knatz
- University of California San Diego, Department of Psychiatry, San Diego, California, USA
| | - Christina E Wierenga
- University of California San Diego, Department of Psychiatry, San Diego, California, USA
| | - Stuart B Murray
- University of California San Diego, Department of Psychiatry, San Diego, California, USA
| | - Laura Hill
- Ohio State University, Department of Psychiatry, Columbus, Ohio, USA
| | - Walter H Kaye
- University of California San Diego, Department of Psychiatry, San Diego, California, USA
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Carral-Fernández L, González-Blanch C, Goddard E, González-Gómez J, Benito-González P, Bustamante-Cruz E, Gómez Del Barrio A. Planning Abilities in Patients with Anorexia Nervosa Compared with Healthy Controls. Clin Neuropsychol 2016; 30:228-42. [PMID: 26959649 DOI: 10.1080/13854046.2016.1147603] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
OBJECTIVE Altered cognitive functioning could have an important role in the development and maintenance of Anorexia Nervosa (AN). The majority of previous research has focused on flexibility and global-detail processing. The aim of this study was to explore planning abilities in women with AN. METHOD Women with AN (n = 32) were compared to healthy controls (n = 42) using two different types of neuropsychological tasks for the assessment of planning abilities: Tower of London (ToL), a classic measure of planning abilities, and Zoo Map test, a more ecologically valid planning measure. Measures of AN psychopathology, anxiety, depression, and obsessive compulsivity were also collected. RESULTS The AN group did not differ from controls in the ToL (all p-values p > .05), although they performed significantly worse than controls in the main score of the Zoo Map (p = .02). A worse performance in the Zoo Map test More was associated with more eating disorders (rho = -.44, p = .018) and depressive (rho = -.42, p = .026) symptoms in the AN group. CONCLUSIONS Our study suggests the presence of subtle planning difficulties in women with AN which might be better detected using tasks with increased ecological validity.
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Affiliation(s)
- Laura Carral-Fernández
- a Marqués de Valdecilla Public Foundation-Research Institute (FMV-IFIMAV) , Santander , Spain.,b Public Health Institute Carlos III, Ministry of Science and Innovation - Government of Spain , Madrid , Spain.,c Eating Disorders Unit, Department of Psychiatry , University Hospital "Marqués de Valdecilla" , Santander , Spain
| | - César González-Blanch
- d Mental Health Centre , University Hospital "Marqués de Valdecilla" , Santander , Spain
| | - Elizabeth Goddard
- e Section of Eating Disorders, Department of Psychological Medicine , King's College London, Institute of Psychiatry , London , UK
| | - Jana González-Gómez
- a Marqués de Valdecilla Public Foundation-Research Institute (FMV-IFIMAV) , Santander , Spain.,c Eating Disorders Unit, Department of Psychiatry , University Hospital "Marqués de Valdecilla" , Santander , Spain
| | - Pilar Benito-González
- c Eating Disorders Unit, Department of Psychiatry , University Hospital "Marqués de Valdecilla" , Santander , Spain
| | - Encarnación Bustamante-Cruz
- c Eating Disorders Unit, Department of Psychiatry , University Hospital "Marqués de Valdecilla" , Santander , Spain
| | - Andrés Gómez Del Barrio
- c Eating Disorders Unit, Department of Psychiatry , University Hospital "Marqués de Valdecilla" , Santander , Spain.,f CIBERSAM, Centro Investigación Biomédica en Red Salud Mental , Madrid , Spain
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Fogelkvist M, Parling T, Kjellin L, Gustafsson SA. A qualitative analysis of participants' reflections on body image during participation in a randomized controlled trial of acceptance and commitment therapy. J Eat Disord 2016; 4:29. [PMID: 27999670 PMCID: PMC5151132 DOI: 10.1186/s40337-016-0120-4] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/08/2016] [Accepted: 10/09/2016] [Indexed: 11/26/2022] Open
Abstract
BACKGROUND Negative body image is a risk factor for development and relapse in eating disorders (ED). Many patients continue to be dissatisfied with their body shape or weight after treatment. This study presents a qualitative analysis of written reflections on body image from patients with an ED and a negative body image before and after an Acceptance and Commitment Therapy group treatment at a specialized ED-unit. METHOD Before and after the treatment participants (n = 47) answered a questionnaire with open ended questions on their thoughts on body image. Data were analyzed through conventional content analysis. RESULTS Body image meant different things for different participants. For some it had to do with how you evaluate your body, whereas others focused on whether their body image was realistic or not. Some emphasized their relationship with their body, while some described body image as strongly related to global self-esteem. These different views on the concept of body image affected the participants' descriptions of their own body image, and how they wanted it to change. Body image was considered a state that fluctuated from day to day. After treatment the participants described changes in their body image, for instance perceiving oneself as less judgmental towards one's body, and a shift in focus to the important things in life. CONCLUSIONS The participants had different views on body image and how they wished it to change. Thus treatment interventions targeting negative body image needs to address various aspects of this complex construct. TRIAL REGISTRATION This study is part of an RCT registered 02/06/2014 in Clinical Trials, registration number: NCT02058121.
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Affiliation(s)
- Maria Fogelkvist
- University Health Care Research Center, Faculty of Medicine and Health, Örebro University, S-huset, vån 2, Box 1613, 701 16 Örebro, Sweden
| | - Thomas Parling
- Department of Psychology, Uppsala University, Uppsala, Sweden
| | - Lars Kjellin
- University Health Care Research Center, Faculty of Medicine and Health, Örebro University, S-huset, vån 2, Box 1613, 701 16 Örebro, Sweden
| | - Sanna Aila Gustafsson
- University Health Care Research Center, Faculty of Medicine and Health, Örebro University, S-huset, vån 2, Box 1613, 701 16 Örebro, Sweden
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15
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Sheng M, Lu H, Liu P, Thomas BP, McAdams CJ. Cerebral perfusion differences in women currently with and recovered from anorexia nervosa. Psychiatry Res 2015; 232:175-83. [PMID: 25795596 PMCID: PMC4417098 DOI: 10.1016/j.pscychresns.2015.02.008] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/19/2014] [Revised: 12/19/2014] [Accepted: 02/19/2015] [Indexed: 12/26/2022]
Abstract
Anorexia nervosa is a serious psychiatric disorder characterized by restricted eating, a pursuit of thinness, and altered perceptions of body shape and size. Neuroimaging in anorexia nervosa has revealed morphological and functional alterations in the brain. A better understanding of physiological changes in anorexia nervosa could provide a brain-specific health marker relevant to treatment and outcomes. In this study, we applied several advanced magnetic resonance imaging (MRI) techniques to quantify regional and global cerebral blood flow (CBF) in 25 healthy women (HC), 23 patients currently with anorexia (AN-C) and 19 patients in long-term weight recovery following anorexia (AN-WR). Specifically, CBF was measured with pseudo-continuous arterial spin labeling (pCASL) MRI and then verified by a different technique, phase contrast (PC) MRI. Venous T2 values were determined by T2 relaxation under spin tagging (TRUST) MRI, and were used to corroborate the CBF results. These novel techniques were implemented on a standard 3T MRI scanner without any exogenous tracers, and the total scan duration was less than 10min. Voxel-wise comparison revealed that the AN-WR group showed lower CBF in bilateral temporal and frontal lobes than the AN-C group. Compared with the HC group, the AN-C group also showed higher CBF in the right temporal lobe. Whole-brain-averaged CBF was significantly decreased in the AN-WR group compared with the AN-C group, consistent with the PC-MRI results. Venous T2 values were lower in the AN-WR group than in the AN-C group, consistent with the CBF results. A review of prior work examining CBF in anorexia nervosa is included in the discussion. This study identifies several differences in the cerebral physiological alterations in anorexia nervosa, and finds specific differences relevant to the current state of the disorder.
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Affiliation(s)
- Min Sheng
- Advanced Imaging Research Center, The University of Texas Southwestern Medical Center, Dallas, TX 75390, United States
| | - Hanzhang Lu
- Advanced Imaging Research Center, The University of Texas Southwestern Medical Center, Dallas, TX 75390, United States,Department of Psychiatry, The University of Texas Southwestern Medical Center, Dallas, TX 75390, United States
| | - Peiying Liu
- Advanced Imaging Research Center, The University of Texas Southwestern Medical Center, Dallas, TX 75390, United States,Department of Psychiatry, The University of Texas Southwestern Medical Center, Dallas, TX 75390, United States
| | - Binu P. Thomas
- Advanced Imaging Research Center, The University of Texas Southwestern Medical Center, Dallas, TX 75390, United States
| | - Carrie J. McAdams
- Department of Psychiatry, The University of Texas Southwestern Medical Center, Dallas, TX 75390, United States,Corresponding author. Tel: +1 214 648 4145; fax: +1 214 648 5321. (C.J.McAdams)
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16
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Abstract
A significant number of adults with eating disorders fail to achieve relief from the disorder, with many dropping out of treatment or relapsing. The standard treatment remains individual therapy despite partners being negatively affected and typically wanting to help in an effective and loving way. We propose that couple-based interventions, which leverage the support of a partner and the relationship in treatment, may improve outcome and recovery rates for adults with eating disorders. In this article, we survey the empirical literature supporting the treatment of adults in a couple context and describe our existing and emerging couple-based interventions for eating disorders.
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Affiliation(s)
- Jennifer S Kirby
- a Department of Psychiatry , University of North Carolina at Chapel Hill , Chapel Hill , North Carolina , USA
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17
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Groff SE. Is Enhanced Cognitive Behavioral Therapy an Effective Intervention in Eating Disorders? A Review. ACTA ACUST UNITED AC 2015; 12:272-88. [DOI: 10.1080/15433714.2013.835756] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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18
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Wright DR, Austin SB, LeAnn Noh H, Jiang Y, Sonneville KR. The cost-effectiveness of school-based eating disorder screening. Am J Public Health 2014; 104:1774-82. [PMID: 25033131 DOI: 10.2105/ajph.2014.302018] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
OBJECTIVES We aimed to assess the value of school-based eating disorder (ED) screening for a hypothetical cohort of US public school students. METHODS We used a decision-analytic microsimulation model to model the effectiveness (life-years with ED and quality-adjusted life-years [QALYs]), total direct costs, and cost-effectiveness (cost per QALY gained) of screening relative to current practice. RESULTS The screening strategy cost $2260 (95% confidence interval [CI] = $1892, $2668) per student and resulted in a per capita gain of 0.25 fewer life-years with ED (95% CI = 0.21, 0.30) and 0.04 QALYs (95% CI = 0.03, 0.05) relative to current practice. The base case cost-effectiveness of the intervention was $9041 per life-year with ED avoided (95% CI = $6617, $12,344) and $56,500 per QALY gained (95% CI = $38,805, $71,250). CONCLUSIONS At willingness-to-pay thresholds of $50,000 and $100,000 per QALY gained, school-based ED screening is 41% and 100% likely to be cost-effective, respectively. The cost-effectiveness of ED screening is comparable to many other accepted pediatric health interventions, including hypertension screening.
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Affiliation(s)
- Davene R Wright
- Davene R. Wright is with the Department of Pediatrics, University of Washington School of Medicine, and the Center for Child Health, Behavior, and Development, Seattle Children's Research Institute, Seattle. S. Bryn Austin is with the Department of Social and Behavioral Sciences, Harvard School of Public Health, and the Division of Adolescent and Young Adult Medicine, Boston Children's Hospital, Boston. Kendrin R. Sonneville is with the Department of Pediatrics, Harvard Medical School, and the Division of Adolescent and Young Adult Medicine, Boston Children's Hospital, Boston. H. LeAnn Noh is with the Department of Social and Behavioral Sciences, Harvard School of Public Health, Boston. Yushan Jiang is with the Department of Global Health and Population, Harvard School of Public Health, Boston
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19
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Clausen L, Jones A. A systematic review of the frequency, duration, type and effect of involuntary treatment for people with anorexia nervosa, and an analysis of patient characteristics. J Eat Disord 2014; 2:29. [PMID: 25414793 PMCID: PMC4237771 DOI: 10.1186/s40337-014-0029-8] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/13/2014] [Accepted: 10/12/2014] [Indexed: 11/10/2022] Open
Abstract
OBJECTIVE Involuntary treatment of anorexia nervosa is controversial and costly. A better understanding of the conditions that determine involuntary treatment, as well as the effect of such treatment is needed in order to adequately assess the legitimacy of this model of care. The aim of the present study was to investigate the frequency and duration of involuntary treatment, the characteristics of this group of patients, the kind of involuntary actions that are applied and the effect of such actions. REVIEW Relevant databases were systematically searched for studies investigating the involuntary treatment of individuals diagnosed with anorexia nervosa. RESULTS The studies included in the review contained people treated in an inpatient setting for severe or severe and enduring anorexia nervosa. People that were treated involuntarily were characterised by a more severe psychiatric load. The levels of eating disorder pathology between involuntary and voluntary groups were similar and the outcome of involuntary treatment was comparable in terms of symptom reduction to that of voluntary treatment. CONCLUSION Despite inconsistent findings, the comparable levels of eating disorder pathology observed between involuntary and voluntary patient-groups together with findings of higher co-morbidity, more preadmissions, longer duration of illness and more incidences of self-harm for involuntary patients suggest that involuntary treatment is not a reaction to the severity of eating disorder symptoms alone, but is most likely a response to the complexity of the patient's situation as a whole.
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Affiliation(s)
- Loa Clausen
- Centre of Child- and Adolescent Psychiatry, Aarhus University Hospital, Skovagervej 2, DK-8240 Risskov, Denmark
| | - Allan Jones
- Institute of Psychology, University of Southern Denmark, Campusvej 55, DK-5230 Odense M, Denmark
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20
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Klabunde M, Acheson D, Boutelle K, Matthews S, Kaye W. Interoceptive sensitivity deficits in women recovered from bulimia nervosa. Eat Behav 2013; 14:488-92. [PMID: 24183142 PMCID: PMC3817494 DOI: 10.1016/j.eatbeh.2013.08.002] [Citation(s) in RCA: 69] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/17/2013] [Revised: 07/16/2013] [Accepted: 08/07/2013] [Indexed: 10/26/2022]
Abstract
Self-report studies suggest that patients with bulimia nervosa (BN) evidence difficulties with interoceptive awareness. Indeed, interoceptive deficits may persist after recovery of BN and may be a biological trait that predisposes symptom development in BN. However, no studies to date have directly assessed interoceptive sensitivity, or accuracy in detecting and perceiving internal body cues, in patients with or recovered from BN. Nine women who had recovered from BN and 10 healthy control women completed the Heart Beat Perception Task (HBPT) in which individuals were required to estimate the number of heartbeats between intervals of time. Accuracy scores were compared between groups. Significant differences were found between the groups on the HBPT ((F1,19) = 7.78, p = .013, Cohen's d = 1.16) when controlling for age. These results suggest that deficits in interoceptive sensitivity are present in individuals recovered from BN. Thus interoceptive deficits may be one factor that bridges the gap between brain dysfunction and symptom presentation in BN.
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Affiliation(s)
- Megan Klabunde
- Department of Psychiatry, Stanford University, Stanford, CA, United States.
| | - Dean Acheson
- Department of Psychiatry, University of California, San Diego, La Jolla, CA
| | - Kerri Boutelle
- Department of Psychiatry, University of California, San Diego, La Jolla, CA
| | - Scott Matthews
- Department of Psychiatry, University of California, San Diego, La Jolla, CA
,Research Service, VA San Diego Healthcare System, San Diego, CA
| | - Walter Kaye
- Department of Psychiatry, University of California, San Diego, La Jolla, CA
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21
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Abstract
PURPOSE OF REVIEW This review summarizes recent evidence on psychological treatments for eating disorders. RECENT FINDINGS Eating disorders are serious psychiatric conditions requiring evidence-based intervention. Treatments have been evaluated within each eating disorder diagnosis and across diagnoses. For adults with anorexia nervosa, no one specialist treatment has been shown to be superior. Cognitive behavioral therapy and interpersonal psychotherapy remain the most established treatments for bulimia nervosa and binge eating disorder, with stepped-care approaches showing promise and new behavioral treatments under study. Enhanced cognitive behavioral therapy has improved symptoms in adults and youth. Maudsley family-based therapy is the most established treatment for youth with anorexia nervosa and may be efficacious for youth with bulimia nervosa. Interpersonal psychotherapy for the prevention of excess weight gain may be efficacious for reducing loss of control eating and weight gain in overweight youth. SUMMARY Significant advances in treatments have been made, including evaluation of long-term outcomes, novel approaches, and tailored extension for specific patient profiles. However, widespread access to effective eating disorder treatments remains limited. Increasing the potency and expanding the implementation of psychological treatments beyond research settings into clinical practice has strong potential to increase access to care, thereby reducing the burden of eating disorders.
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Affiliation(s)
- Andrea E. Kass
- Department of Psychology, Washington University in St. Louis, St. Louis, Missouri, USA
| | - Rachel P. Kolko
- Department of Psychology, Washington University in St. Louis, St. Louis, Missouri, USA
| | - Denise E. Wilfley
- Department of Psychology, Washington University in St. Louis, St. Louis, Missouri, USA
- Department of Psychiatry, Washington University School of Medicine, St. Louis, Missouri, USA
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22
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Hilbert A. Cognitive-behavioral therapy for binge eating disorder in adolescents: study protocol for a randomized controlled trial. Trials 2013; 14:312. [PMID: 24066704 PMCID: PMC3850645 DOI: 10.1186/1745-6215-14-312] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2013] [Accepted: 09/11/2013] [Indexed: 12/04/2022] Open
Abstract
BACKGROUND Binge eating disorder is a prevalent adolescent disorder, associated with increased eating disorder and general psychopathology as well as an increased risk for overweight and obesity. As opposed to binge eating disorder in adults, there is a lack of validated psychological treatments for this condition in adolescents. The goal of this research project is therefore to determine the efficacy of age-adapted cognitive-behavioral therapy in adolescents with binge eating disorder - the gold standard treatment for adults with binge eating disorder. METHODS/DESIGN In a single-center efficacy trial, 60 12- to 20-year-old adolescents meeting diagnostic criteria of binge eating disorder (full-syndrome or subthreshold) according to the Diagnostic and Statistical Manual of Mental Disorders 4th or 5th Edition, will be centrally randomized to 4 months of cognitive-behavioral therapy (n = 30) or a waiting-list control condition (n = 30). Using an observer-blind design, patients are assessed at baseline, mid-treatment, post-treatment, and at 6- and 12-month follow-ups after the end of treatment. In 20 individual outpatient sessions, cognitive-behavioral therapy for adolescents focuses on eating behavior, body image, and stress; parents receive psychoeducation on these topics. Primary endpoint is the number of episodes with binge eating over the previous 28 days at post-treatment using a state-of-the art clinical interview. Secondary outcome measures address the specific eating disorder psychopathology, general psychopathology, mental comorbidity, self-esteem, quality of life, and body weight. DISCUSSION This trial will allow us to determine the short- and long-term efficacy of cognitive-behavioral therapy in adolescent binge eating disorder, to determine cost-effectiveness, and to identify predictors of treatment outcome. Evidence will be gathered regarding whether this treatment will help to prevent excessive weight gain. If efficacy can be demonstrated, the results from this trial will enhance availability of evidence-based treatment of adolescent binge eating disorder. TRIAL REGISTRATION German Clinical Trials Register: DRKS00000542.
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Affiliation(s)
- Anja Hilbert
- Department of Medical Psychology and Medical Sociology, Integrated Research and Treatment Center AdiposityDiseases, University of Leipzig Medical Center, Philipp-Rosenthal-Strasse 27, Leipzig, 04103 Germany.
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