Lifestyle behavioral weight-loss treatment for binge-eating disorder in patients with obesity: where's the harm?

IF 4.7 2区医学 Q1 ENDOCRINOLOGY & METABOLISM

Obesity Pub Date : 2025-05-07 DOI:10.1002/oby.24289

Sydney Yurkow, Valentina Ivezaj, Carlos M. Grilo

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引用次数: 0

Abstract

Objective

Although recent rigorous trials have demonstrated effectiveness of behaviorally based weight-loss treatment (BBWLT) for binge-eating disorder (BED) with coexisting obesity, concerns have been raised that such interventions are contraindicated because they might trigger or exacerbate eating disorder (ED) psychopathology. This secondary analysis of a BBWLT trial examined heterogeneity of outcomes to identify the frequency that individuals experienced increased symptoms.

Methods

One hundred ninety-one participants with BED and obesity in a 6-month BBWLT trial were assessed for binge eating, ED psychopathology, and weight at baseline, at posttreatment, and at a 12-month follow-up after treatment (i.e., 18 months after baseline). Changes were examined at the individual level to identify cases of any increased features.

Results

At posttreatment, 95.3% (n = 162) of participants reported decreased binge-eating frequency, and 87.6% (n = 149) reported decreased ED psychopathology scores. At the 12-month follow-up, 97.1% (n = 135) reported decreased binge-eating frequency, and 93.0% (n = 120) reported decreased ED psychopathology scores. Inspection of the few instances of any increases revealed mostly small magnitudes.

Conclusions

Frequency of cases with any increased symptoms of binge eating and/or ED psychopathology was quite low at posttreatment and at 1 year after ending BBWLT for BED and obesity. These participant-level findings add important clinical context regarding overall improvements with BBWLT for BED with obesity (large effect sizes) and challenge concerns that BBWLT exacerbates ED psychopathology.

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生活方式行为减肥治疗肥胖患者暴食症：危害在哪里？

目的：尽管最近严格的试验已经证明了基于行为的减肥治疗（BBWLT）对暴饮暴食症（BED）合并肥胖的有效性，但人们担心这种干预措施是禁忌的，因为它们可能引发或加剧饮食失调（ED）的精神病理。这项对BBWLT试验的二次分析检查了结果的异质性，以确定个体经历症状增加的频率。方法：在一项为期6个月的BBWLT试验中，对191名BED和肥胖症患者在基线、治疗后和治疗后12个月（即基线后18个月）的暴食、ED精神病理和体重进行评估。在个体水平上检查变化，以确定任何增加的特征。结果：在治疗后，95.3% （n = 162）的参与者报告暴食频率下降，87.6% （n = 149）的参与者报告ED精神病理评分下降。在12个月的随访中，97.1% （n = 135）报告暴食频率下降，93.0% （n = 120）报告ED精神病理评分下降。对少数几个增加的实例的检查显示，幅度大多很小。结论：暴饮暴食和/或ED精神病理症状增加的病例在治疗后和结束BBWLT治疗BED和肥胖1年后的频率相当低。这些参与者水平的研究结果为BBWLT对BED合并肥胖的总体改善（大效应量）提供了重要的临床背景，并挑战了BBWLT加重ED精神病理的担忧。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Obesity 医学-内分泌学与代谢

CiteScore

11.70

自引率

1.40%

发文量

261

审稿时长

2-4 weeks

期刊介绍： Obesity is the official journal of The Obesity Society and is the premier source of information for increasing knowledge, fostering translational research from basic to population science, and promoting better treatment for people with obesity. Obesity publishes important peer-reviewed research and cutting-edge reviews, commentaries, and public health and medical developments.