Exploring Dietary Restraint as a Mediator of Behavioral and Cognitive-Behavioral Treatments on Outcomes for Patients With Binge-Eating Disorder With Obesity

IF 4.7 2区医学 Q1 NUTRITION & DIETETICS

International Journal of Eating Disorders Pub Date : 2024-09-09 DOI:10.1002/eat.24288

Carlos M. Grilo, Brian Pittman

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引用次数: 0

Abstract

Objective

To explore dietary-restraint as a mediator of binge eating and weight-loss outcomes within a randomized controlled trial comparing cognitive-behavioral therapy (CBT) and behavioral weight loss (BWL) for binge-eating disorder (BED) with obesity.

Methods

Ninety participants were randomly assigned to CBT or BWL and assessed by evaluators blinded to conditions at pretreatment, throughout-, and post-treatment (6 months). Three dietary-restraint measures (Eating Disorder Examination-Questionnaire [EDE-Q]-Restraint, Three-Factor Flexible-Restraint and Rigid-Restraint) were administered at pretreatment and after 2 months of treatment. Regression models examined whether changes at 2-months in the restraint scales mediated the effects of treatment (CBT versus BWL) on binge eating and weight-loss outcomes at post-treatment.

Results

CBT and BWL had similar binge-eating outcomes and similar changes in EDE-Q-restraint and flexible-restraint. BWL had greater 2-month increases in rigid-restraint and greater weight-loss at posttreatment than CBT, with results suggesting 2-month changes in rigid-restraint mediated the greater difference (>7 pounds) in weight-loss. The observed mediation effect of 2.92 suggests 39% of total treatment-effect on weight-loss was mediated through 2-month increases in rigid-restraint.

Discussion

This secondary analysis within a trial comparing CBT and BWL for BED suggests early-change in rigid-restraint has a mediating effect of BWL on weight-loss. Findings indicate that BWL improves binge eating and challenge views that dietary-restraint might exacerbate binge eating in BED with obesity. Findings require confirmation using hypothesis-testing in future trials.

Trial Registration: Clinicaltrials.gov: NCT00537758 (“Treatment for Obesity and Binge Eating Disorder”)

Abstract Image

查看原文本刊更多论文

探索饮食限制作为行为疗法和认知行为疗法对暴食症合并肥胖症患者疗效的中介作用。

目的在一项随机对照试验中，比较认知行为疗法（CBT）和行为减肥法（BWL）对暴饮暴食症（BED）和肥胖症的治疗效果，探讨饮食限制对暴饮暴食和减肥效果的中介作用：90名参与者被随机分配到CBT或BWL治疗中，并在治疗前、治疗中和治疗后（6个月）由盲人评估员进行评估。在治疗前和治疗 2 个月后进行了三种饮食限制测量（饮食紊乱检查-问卷[EDE-Q]-限制、三因素灵活限制和刚性限制）。回归模型检验了两个月后约束量表的变化是否对治疗（CBT 与 BWL）对治疗后暴食和体重减轻结果的影响起中介作用：结果：CBT 和 BWL 的暴饮暴食结果相似，EDE-Q-克制量表和灵活克制量表的变化相似。与 CBT 相比，BWL 在 2 个月内刚性约束的增加幅度更大，治疗后的体重减轻幅度更大，结果表明 2 个月内刚性约束的变化介导了体重减轻方面更大的差异（大于 7 磅）。观察到的中介效应为 2.92，表明治疗对体重减轻总效果的 39% 是通过 2 个月刚性约束的增加来中介的：讨论：在一项比较 CBT 和 BWL 治疗 BED 的试验中进行的二次分析表明，刚性约束的早期改变对 BWL 的减肥效果具有中介作用。研究结果表明，BWL 可以改善暴饮暴食，并对饮食限制可能会加剧肥胖性暴饮暴食的观点提出了质疑。研究结果需要在未来的试验中通过假设检验加以证实：试验注册：Clinicaltrials.gov：试验注册：Clinicaltrials.gov：NCT00537758（"肥胖和暴食症治疗"）。

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来源期刊

International Journal of Eating Disorders 医学-精神病学

CiteScore

10.00

自引率

12.70%

发文量

204

审稿时长

4-8 weeks

期刊介绍： Articles featured in the journal describe state-of-the-art scientific research on theory, methodology, etiology, clinical practice, and policy related to eating disorders, as well as contributions that facilitate scholarly critique and discussion of science and practice in the field. Theoretical and empirical work on obesity or healthy eating falls within the journal’s scope inasmuch as it facilitates the advancement of efforts to describe and understand, prevent, or treat eating disorders. IJED welcomes submissions from all regions of the world and representing all levels of inquiry (including basic science, clinical trials, implementation research, and dissemination studies), and across a full range of scientific methods, disciplines, and approaches.