A Timely Update: An Umbrella Review and Meta-Meta-Analysis of Psychotherapy for Non-Underweight Eating Disorders.

IF 4.3 2区医学 Q1 NUTRITION & DIETETICS

International Journal of Eating Disorders Pub Date : 2025-10-09 DOI:10.1002/eat.24567

Mia L Pellizzer, Yuan Zhou, Madelaine K de Valle, Jake Linardon, Tracey D Wade

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引用次数: 0

Abstract

Objective: This umbrella review and meta-analysis synthesized recent evidence on the efficacy of psychotherapy for adults with non-underweight eating disorders (EDs).

Method: PsycINFO, Scopus, PubMed, and ProQuest Dissertations and Theses Global were searched for meta-analyses of randomized controlled trials comparing psychotherapy to treatment as usual (TAU) or control conditions in non-underweight adults with EDs (published January 2020-September 2025). Standardized mean differences (SMDs) for ED psychopathology and objective binge episode (OBE) frequency were pooled using second-order random-effects models. Subgroup analyses examined specific diagnoses and delivery format. Quality was assessed with the A MeaSurement Tool to Assess systematic Review (AMSTAR 2). Data were synthesized with Covidence and analyzed using R.

Results: Ten meta-analyses (71 RCTs) were included. Most participants were female, White, and diagnosed with bulimia nervosa or binge eating disorder. Psychotherapy yielded significant medium-to-large improvements in ED psychopathology (SMD = 0.74, 95% CI: 0.67-0.82, Q_p = 0.79, I² = 0.0% [95% CI: 0.0%- 56.6%]) and OBE frequency (SMD = 0.64, 95% CI: 0.52-0.77, Q_p = 0.40, I² = 4.5% [95% CI: 0.0%- 66.4%]) relative to TAU/control, with low heterogeneity. Effects were comparable across sub-group analyses. Nine of 10 meta-analyses were rated as critically low regarding confidence in results, as per the AMSTAR 2.

Discussion: Psychotherapy is efficacious for non-underweight adults with eating disorders, including when delivered using program-led focused interventions. The use of the AMSTAR-2 tool is encouraged to guide high-quality, transparent reporting of future meta-analyses in our field.

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及时更新：非体重过轻饮食失调心理治疗的总体回顾和元-元分析。

目的：本综述和荟萃分析综合了最近关于心理治疗对成人非体重过轻饮食失调（EDs）疗效的证据。方法：检索PsycINFO、Scopus、PubMed和ProQuest Dissertations and Theses Global，对非体重不足的成年ed患者（发表于2020年1月- 2025年9月）进行心理治疗、常规治疗（TAU）或对照条件的随机对照试验进行meta分析。采用二阶随机效应模型对ED精神病理和客观暴食发作频率的标准化平均差异（SMDs）进行汇总。亚组分析检查了特定的诊断和分娩形式。用评估系统评价的测量工具（AMSTAR 2）评估质量。结果：纳入10项meta分析（71项随机对照试验）。大多数参与者是女性，白人，被诊断为神经性贪食症或暴食症。与TAU/对照组相比，心理治疗在ED精神病理（SMD = 0.74, 95% CI: 0.67-0.82, Qp = 0.79, I2 = 0.0% [95% CI: 0.0%- 56.6%]）和出窍频率（SMD = 0.64, 95% CI: 0.52-0.77, Qp = 0.40, I2 = 4.5% [95% CI: 0.0%- 66.4%]）方面取得了显著的中大型改善，异质性较低。亚组分析的效果具有可比性。根据AMSTAR 2, 10个元分析中有9个在结果的可信度方面被评为极低。讨论：心理治疗对患有饮食失调的非体重过轻的成年人有效，包括采用以项目为主导的重点干预措施。鼓励使用AMSTAR-2工具来指导本领域未来元分析的高质量、透明报告。

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

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.