Ricarda Schmidt, Danielle Schewe, Stephan Herpertz, Stephan Zipfel, Brunna Tuschen-Caffier, Hans-Christoph Friederich, Andreas Mayr, Martina de Zwaan, Anja Hilbert
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引用次数: 0
Abstract
Objective: Cognitive-behavioral therapy (CBT) is the most well-established treatment for binge-eating disorder (BED), but the mechanisms of change remain poorly understood. This study investigated in CBT for BED the effects of overvaluation of shape and weight and dietary restraint on subsequent objective binge-eating episodes (OBEs).
Method: In a multicenter randomized-controlled trial, 84 patients diagnosed with full- or subsyndromal BED were offered 20 individual sessions of CBT over 4 months. Dynamic structural equation modeling (DSEM) was used to disentangle within- and between-patient associations of overvaluation of shape and weight, dietary restraint, and OBEs.
Results: Between the first and last week of therapy, there were significant reductions in overvaluation of shape and weight, dietary restraint, and OBEs. DSEM showed significant within-patient effects of overvaluation of shape and weight on the subsequent number of OBEs. Weeks with lower overvaluation of shape and weight levels were followed by weeks with fewer OBEs. Although no within-patient effect of dietary restraint on OBEs was found, within-patient dietary restraint levels positively predicted subsequent overvaluation of shape and weight levels.
Discussion: The findings suggest that reductions in overvaluation of shape and weight may precede improvements in binge eating during CBT for BED, supporting its role as a potential mechanism of change. While dietary restraint did not show a direct temporal link to binge eating, its association with overvaluation points to a potential indirect role. These results underscore the value of targeting cognitive features of BED in CBT and highlight the need for more temporally sensitive assessments in mechanisms research.
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.
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