Fear of weight gain during cognitive behavioral therapy for binge-spectrum eating disorders

Eating and Weight Disorders - Studies on Anorexia, Bulimia and Obesity - Tập 28 Số 1
Rachel M. Butler1, Elizabeth W. Lampe2, Claire Trainor2, Stephanie M. Manasse3
1Department of Psychological and Brain Sciences, University of Louisville, Louisville, KY, USA
2Department of Psychology, Drexel University, Philadelphia, PA, USA
3Center for Weight, Eating and Lifestyle Science, Drexel University, Philadelphia, PA, USA

Tóm tắt

Abstract Purpose Fear of weight gain may play a central role in maintaining eating disorders (EDs), but research on the role of fear of weight gain during cognitive behavioral therapy (CBT-E) for binge-spectrum EDs is sparse. We examined changes in fear of weight gain during CBT-E for binge-spectrum EDs. We investigated whether fear of weight gain predicted loss of control (LOC) eating or weight change. Methods Participants (N = 63) were adults of any gender recruited as part of a larger trial. Participants received 12 sessions of CBT-E, completed diagnostic assessments at pre-, mid-, and post-treatment, and completed brief surveys before sessions. Results Fear of weight gain decreased across treatment, moderated by diagnosis. Those with bulimia nervosa spectrum EDs (BN-spectrum), compared to binge eating disorder, reported higher fear of weight gain at baseline and experienced a larger decrease in fear across treatment. Those reporting higher fear of weight gain at a given session experienced more frequent LOC episodes the following week. Fear of weight gain was not associated with session-by-session changes in BMI. Conclusion CBT-E results in decreases in fear of weight gain, but levels remain high at post-treatment, especially for those with BN-spectrum EDs. Future interventions should consider targeting fear of weight gain as a maintaining factor for LOC episodes Trial registration NCT04076553. Level of evidence Level II controlled trial without randomization.

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Tài liệu tham khảo

American Psychiatric Association (2013) Diagnostic and statistical manual of mental disorders, 5th edn. American Psychiatric Association, Washington

Fairburn CG, Marcus MD, Wilson GT (1993) Cognitive-behavioral therapy for binge eating and bulimia nervosa: a comprehensive treatment manual. In: Fairburn CG, Wilson GT (eds) Binge eating: nature, assessment, and treatment. Guilford Press, New York, pp 361–404

Atwood ME, Friedman A (2020) A systematic review of enhanced cognitive behavioral therapy (CBT-E) for eating disorders. Int J Eat Disord 53:311–330. https://doi.org/10.1002/eat.23206

Hay P (2013) A systematic review of evidence for psychological treatments in eating disorders: 2005–2012. Int J Eat Disord 46:462–469. https://doi.org/10.1002/eat.22103

Levinson CA, Williams BM (2020) Eating disorder fear networks: Identification of central eating disorder fears. Int J Eat Disord 53:1960–1973. https://doi.org/10.1002/eat.23382

Linardon J, Phillipou A, Castle D, Newton R, Harrison P, Cistullo LL, Brennan L (2018) The relative associations of shape and weight over-evaluation, preoccupation, dissatisfaction, and fear of weight gain with measures of psychopathology: an extension study in individuals with anorexia nervosa. Eat Behav 29:54–58. https://doi.org/10.1016/j.eatbeh.2018.03.002

Goldschmidt AB, Crosby RD, Cao L, Moessner M, Forbush KT, Accurso EC, Le Grange D (2018) Network analysis of pediatric eating disorder symptoms in a treatment-seeking, transdiagnostic sample. J Abnorm Psychol 127:251–264. https://doi.org/10.1037/abn0000327

Wang SB, Jones PJ, Dreier M, Elliott H, Grilo CM (2019) Core psychopathology of treatment-seeking patients with binge-eating disorder: a network analysis investigation. Psychol Med 49:1923–1928. https://doi.org/10.1017/S0033291718002702

Bullock AJ, Barber J, Barnes RD (2021) Characterizing fear of weight gain and sensitivity to weight gain in individuals seeking weight loss treatment. Eat Weight Dis Stud Anorexia Bulimia Obes 26:385–393. https://doi.org/10.1007/s40519-020-00862-2

Schaumberg K, Reilly EE, Gorrell S, Levinson CA, Farrell NR, Brown TA, Anderson LM (2021) Conceptualizing eating disorder psychopathology using an anxiety disorders framework: evidence and implications for exposure-based clinical research. Clin Psychol Rev 83:101952. https://doi.org/10.1016/j.cpr.2020.101952

Murray SB, Treanor M, Liao B, Loeb KL, Griffiths S, Le Grange D (2016) Extinction theory & anorexia nervosa: deepening therapeutic mechanisms. Behav Res Ther 87:1–10. https://doi.org/10.1016/j.brat.2016.08.017

Strober M (2004) Pathologic fear conditioning and anorexia nervosa: On the search for novel paradigms. Int J Eat Disord 35:504–508. https://doi.org/10.1002/eat.20029

Brown ML, Levinson CA (2022) Core eating disorder fears: prevalence and differences in eating disorder fears across eating disorder diagnoses. Int J Eat Disord 55:956–965. https://doi.org/10.1002/eat.23728

Levinson CA, Vanzhula IA, Christian C (2019) Development and validation of the eating disorder fear questionnaire and interview: preliminary investigation of eating disorder fears. EaT Behav 35:101320. https://doi.org/10.1016/j.eatbeh.2019.101320

Steinglass JE, Eisen JL, Attia E, Mayer L, Walsh BT (2007) Is anorexia nervosa a delusional disorder? An assessment of eating beliefs in anorexia nervosa. J Psychiatr Pract 13:65–71. https://doi.org/10.1097/01.pra.0000265762.79753.88

Christian C, Levinson CA (2022) An integrated review of fear and avoidance learning in anxiety disorders and application to eating disorders. New Ideas Psychol 67:100964. https://doi.org/10.1016/j.newideapsych.2022.100964

Reilly EE, Anderson LM, Gorrell S, Schaumberg K, Anderson DA (2017) Expanding exposure-based interventions for eating disorders. Int J Eat Disord 50:1137–1141. https://doi.org/10.1002/eat.22761

Essayli JH, Vitousek KM (2020) Cognitive Behavioral therapy with eating disordered youth. Cognitive behavioral therapy in youth: tradition and innovation. Humana, New York, pp 163–187

Fairburn CG (2008) Cognitive behavior therapy and eating disorders. Guilford Press, New York

Waller G, Mountford VA (2015) Weighing patients within cognitive-behavioural therapy for eating disorders: how, when and why. Behav Res Ther 70:1–10. https://doi.org/10.1016/j.brat.2015.04.004

Calugi S, El Ghoch M, Conti M, Dalle Grave R (2018) Preoccupation with shape or weight, fear of weight gain, feeling fat and treatment outcomes in patients with anorexia nervosa: a longitudinal study. Behav Res Ther 105:63–68. https://doi.org/10.1016/j.brat.2018.04.001

Manasse SM, Lampe EW, Gillikin L, Payne-Reichert A, Zhang F, Juarascio AS, Forman EM (2020) The project REBOOT protocol: evaluating a personalized inhibitory control training as an adjunct to cognitive behavioral therapy for bulimia nervosa and binge-eating disorder. Int J Eat Disord 53:1007–1013. https://doi.org/10.1002/eat.23225

Fairburn CG, Cooper Z, O’Connor M. (2008). Eating Disorder Examination (16.0D). In Fairburn CG. Cognitive Behavior Therapy and Eating Disorders. Guilford Press, New York.

Johnson SN, Forbush KT, Swanson TJ, Christensen KA (2021) An empirical evaluation of the diagnostic threshold between full-threshold and sub-threshold bulimia nervosa. Eat Behav 42:101540 https://doi.org/10.1016/j.eatbeh.2021.101540

Goldfarb LA, Dykens EM, Gerrard M (1985) The Goldfarb fear of fat scale. J Pers Assess 49:329–332. https://doi.org/10.1207/s15327752jpa4903_21

Corporation IBM (2019) IBM SPSS statistics for windows version 26.0. IBM Corporation, Armonk

R Core Team (2013). R: A language and environment for statistical computing. R Foundation for Statistical Computing, Vienna, Austria. Retrieved Sep 1, 2022. URL http://www.R-project.org/.

Chernyak Y, Lowe MR (2010) Motivations for dieting: drive for thinness is different from drive for objective thinness. J Abnorm Psychol 119:276–281. https://doi.org/10.1037/a0018398

Butler RM, Heimberg RG (2020) Exposure therapy for eating disorders: a systematic review. Clin Psychol Rev 78:101851. https://doi.org/10.1016/j.cpr.2020.101851

Levinson CA, Christian C, Ram SS, Vanzhula I, Brosof LC, Michelson LP, Williams BM (2020) Eating disorder symptoms and core eating disorder fears decrease during online imaginal exposure therapy for eating disorders. J Affect Disord 276:585–591. https://doi.org/10.1016/j.jad.2020.07.075

Levinson CA, Williams BM, Christian C (2020) What are the emotions underlying feeling fat and fear of weight gain? J Affect Disord 277:146–152. https://doi.org/10.1016/j.jad.2020.08.012

McKenzie SJ, Williamson DA, Cubic BA (1993) Stable and reactive body image disturbances in bulimia nervosa. Behav Ther 24:195–207. https://doi.org/10.1016/S0005-7894(05)80263-1

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Eating and Weight Disorders - Studies on Anorexia, Bulimia and Obesity

Tập 28 Số 1

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