Department of Clinical Psychological Science, Faculty of Psychology and Neuroscience, Maastricht University, P.O. Box 616, 6200 MD, Maastricht, the Netherlands.
Department of Clinical Psychological Science, Faculty of Psychology and Neuroscience, Maastricht University, P.O. Box 616, 6200 MD, Maastricht, the Netherlands.
J Behav Ther Exp Psychiatry. 2020 Jun;67:101453. doi: 10.1016/j.jbtep.2019.01.005. Epub 2019 Jan 24.
Learning models of overeating predict that exposure therapy is effective in reducing food cue reactivity and overeating. This pilot study tested an eight-session exposure therapy aimed at inhibitory learning vs. an active control condition aimed at lifestyle improvement for obesity (treatment-as-usual). Main outcomes are snacking behavior, eating psychopathology, food cue reactivity, and weight loss. Change in overeating expectancies was assessed as mediator for outcomes, and the associations between habituation of eating desires and outcomes were investigated in the exposure condition. Sleep quality was investigated as moderator for outcomes.
45 overweight women were randomly assigned to the exposure intervention or control condition. The main outcomes, overeating expectancies and sleep quality were re-assessed at post-treatment and three-month follow-up. Habituation of eating desires was measured during exposure sessions.
Compared to the control intervention, exposure led to a significantly stronger reduction in snacking behavior of exposed foods, though this effect did not generalize to non-exposed foods, and stronger binge eating frequency. The exposure condition lost significantly more weight at post-treatment and follow-up than the lifestyle condition. Changes of expectancies mediated the effect of condition on kcal consumption of exposed foods, while habituation during exposure was not related to better treatment outcome. Sleep quality did not moderate the effect of condition on treatment outcome.
Small sample size and limited follow-up period.
This short exposure therapy reduced snacking behavior, binge eating and weight more than a lifestyle intervention and is therefore a recommendable intervention for obesity and overeating disorders.
暴食学习模型预测暴露疗法可有效降低食物线索反应性和暴食。本初步研究测试了一种八次疗程的暴露疗法，旨在进行抑制性学习，另一种为主动对照组，旨在改善肥胖的生活方式（常规治疗）。主要结局是零食行为、进食心理病理学、食物线索反应性和体重减轻。暴食预期的变化被评估为结局的中介，在暴露条件下研究了进食欲望习惯化与结局之间的关联。睡眠质量被研究为结局的调节因素。
45 名超重女性被随机分配到暴露干预组或对照组。主要结局（暴食预期和睡眠质量）在治疗后和三个月随访时重新评估。在暴露治疗期间测量进食欲望的习惯化。
与对照组相比，暴露治疗导致暴露食物的零食行为明显减少，但这种效果并未推广到非暴露食物，并且暴食频率明显增加。暴露组在治疗后和随访时体重减轻的幅度明显大于生活方式组。期望的变化介导了条件对暴露食物热量摄入的影响，而暴露期间的习惯化与更好的治疗效果无关。睡眠质量没有调节条件对治疗结果的影响。
样本量小和随访时间有限。
这种短期暴露疗法可减少零食行为、暴食和体重，比生活方式干预更有效，因此是肥胖和暴食障碍的推荐干预措施。
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