Physical and mental health outcomes of an integrated cognitive behavioural and weight management therapy for people with an eating disorder characterized by binge eating and a high body mass index: a randomized controlled trial.
Binge-eating disorder
Bulimia nervosa
Quality of life
Therapy
Weight loss
Journal
BMC psychiatry
ISSN: 1471-244X
Titre abrégé: BMC Psychiatry
Pays: England
ID NLM: 100968559
Informations de publication
Date de publication:
24 05 2022
24 05 2022
Historique:
received:
28
10
2021
accepted:
17
05
2022
entrez:
24
5
2022
pubmed:
25
5
2022
medline:
27
5
2022
Statut:
epublish
Résumé
Bulimia nervosa (BN) and binge eating disorder (BED) are eating disorders (EDs) characterized by recurrent binge eating. They are associated with medical complications, impaired adaptive function and often a high BMI, for which a multidisciplinary treatment approach may be needed. This study explored the efficacy of a novel intervention integrating Cognitive Behavioural Therapy- Enhanced (CBT-E) and weight management for people with recurrent binge eating episodes and high BMI with respect to physical, psychopathological and quality of life outcomes. Ninety-eight adults diagnosed with BN, BED, or Other Specified/Unspecified Feeding or Eating Disorder (OSFED/UFED) and BMI ≥ 27 to <40 kg/m Both HAPIFED and CBT-E showed statistical significance for the time effect, with reduction in stress (p < 0.001), improvement in mental health-related quality of life (p = 0.032), reduction in binge eating severity (p < 0.001), and also in global ED symptoms scores (p < 0.001), with the significant changes found at end of treatment and sustained at 12-month follow-up. However, no statistical significance was found for differences between the interventions in any of the outcomes measured. Despite a high BMI, most participants (> 75%) had blood test results for glucose, insulin, triglycerides and cholesterol within the normal range, and 52% were within the normal range for the physical component of quality of life at baseline with no change during the trial period. Integrating weight and ED management resulted in comparable outcomes to ED therapy alone. Although adding weight management to an ED intervention had no adverse effects on psychological outcomes, it also had no beneficial effect on metabolic outcomes. Therefore, more intense weight management strategies may be required where indicated to improve metabolic outcomes. Safety will need to be concurrently investigated. US National Institutes of Health clinical trial registration number NCT02464345 , date of registration 08/06/2015. Changes to the present paper from the published protocol paper (Trials 18:578, 2015) and as reported in the Trial registration (clinicaltrials.gov) are reported in Supplementary File 1.
Sections du résumé
BACKGROUND
Bulimia nervosa (BN) and binge eating disorder (BED) are eating disorders (EDs) characterized by recurrent binge eating. They are associated with medical complications, impaired adaptive function and often a high BMI, for which a multidisciplinary treatment approach may be needed. This study explored the efficacy of a novel intervention integrating Cognitive Behavioural Therapy- Enhanced (CBT-E) and weight management for people with recurrent binge eating episodes and high BMI with respect to physical, psychopathological and quality of life outcomes.
METHODS
Ninety-eight adults diagnosed with BN, BED, or Other Specified/Unspecified Feeding or Eating Disorder (OSFED/UFED) and BMI ≥ 27 to <40 kg/m
RESULTS
Both HAPIFED and CBT-E showed statistical significance for the time effect, with reduction in stress (p < 0.001), improvement in mental health-related quality of life (p = 0.032), reduction in binge eating severity (p < 0.001), and also in global ED symptoms scores (p < 0.001), with the significant changes found at end of treatment and sustained at 12-month follow-up. However, no statistical significance was found for differences between the interventions in any of the outcomes measured. Despite a high BMI, most participants (> 75%) had blood test results for glucose, insulin, triglycerides and cholesterol within the normal range, and 52% were within the normal range for the physical component of quality of life at baseline with no change during the trial period.
CONCLUSION
Integrating weight and ED management resulted in comparable outcomes to ED therapy alone. Although adding weight management to an ED intervention had no adverse effects on psychological outcomes, it also had no beneficial effect on metabolic outcomes. Therefore, more intense weight management strategies may be required where indicated to improve metabolic outcomes. Safety will need to be concurrently investigated.
TRIAL REGISTRATION
US National Institutes of Health clinical trial registration number NCT02464345 , date of registration 08/06/2015. Changes to the present paper from the published protocol paper (Trials 18:578, 2015) and as reported in the Trial registration (clinicaltrials.gov) are reported in Supplementary File 1.
Identifiants
pubmed: 35610603
doi: 10.1186/s12888-022-04005-y
pii: 10.1186/s12888-022-04005-y
pmc: PMC9131673
doi:
Banques de données
ClinicalTrials.gov
['NCT02464345']
Types de publication
Journal Article
Randomized Controlled Trial
Research Support, Non-U.S. Gov't
Langues
eng
Sous-ensembles de citation
IM
Pagination
355Informations de copyright
© 2022. The Author(s).
Références
J Consult Clin Psychol. 2017 Nov;85(11):1080-1094
pubmed: 29083223
Int J Eat Disord. 2019 Jan;52(1):42-50
pubmed: 30756422
Psychiatr Clin North Am. 2019 Jun;42(2):263-274
pubmed: 31046928
Addict Behav. 1982;7(1):47-55
pubmed: 7080884
Obes Facts. 2018;11(2):144-156
pubmed: 29631275
Biometrics. 1986 Mar;42(1):121-30
pubmed: 3719049
Circulation. 2002 Dec 17;106(25):3143-421
pubmed: 12485966
J Consult Clin Psychol. 2019 Jan;87(1):91-105
pubmed: 30570304
Med Care. 1996 Mar;34(3):220-33
pubmed: 8628042
J Clin Psychiatry. 1998;59 Suppl 20:22-33;quiz 34-57
pubmed: 9881538
Medicine (Baltimore). 2015 Dec;94(52):e2098
pubmed: 26717356
Stat Med. 2011 Feb 20;30(4):377-99
pubmed: 21225900
Int J Obes (Lond). 2017 Jul;41(7):1148-1153
pubmed: 28337025
Behav Res Ther. 1995 Mar;33(3):335-43
pubmed: 7726811
Aust N Z J Psychiatry. 2014 Nov;48(11):977-1008
pubmed: 25351912
Eat Weight Disord. 2021 Feb;26(1):249-262
pubmed: 31983019
Lancet Psychiatry. 2021 Apr;8(4):320-328
pubmed: 33675688
BMC Med. 2019 May 14;17(1):93
pubmed: 31084617
Med Clin North Am. 2019 Jul;103(4):669-680
pubmed: 31078199
Int J Eat Disord. 2017 Aug;50(8):863-872
pubmed: 28489288
Eat Weight Disord. 2020 Aug;25(4):1105-1109
pubmed: 31214963
Psychiatry Res. 1992 Dec;44(3):191-201
pubmed: 1289917
Psychiatr Clin North Am. 2019 Jun;42(2):275-286
pubmed: 31046929
Eat Weight Disord. 2016 Sep;21(3):353-364
pubmed: 26942768
J Gen Intern Med. 2018 Aug;33(8):1337-1343
pubmed: 29948810
Am J Clin Nutr. 2019 May 1;109(5):1402-1413
pubmed: 31051507
Curr Opin Psychiatry. 2017 Nov;30(6):423-437
pubmed: 28777107
Am J Hematol. 2020 Apr;95(4):E98-E101
pubmed: 31944357
Cien Saude Colet. 2013 Jul;18(7):1923-31
pubmed: 23827896
Soc Psychiatry Psychiatr Epidemiol. 2022 Jul;57(7):1491-1503
pubmed: 35044479
J Eat Disord. 2017 Aug 16;5:29
pubmed: 28824810
Trials. 2015 Dec 18;16:578
pubmed: 26683478
Psychol Med. 2014 Aug;44(11):2241-54
pubmed: 24238470
J Eat Disord. 2017 May 1;5:15
pubmed: 28469914
J Affect Disord. 2014 Feb;155:104-9
pubmed: 24238871
Br J Clin Psychol. 2005 Jun;44(Pt 2):227-39
pubmed: 16004657