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控制暴饮暴食与体重:一种值得研究的暴食症治疗方法?

Controlling binge eating and weight: a treatment for binge eating disorder worth researching?

作者信息

Cooper Zafra, Calugi Simona, Dalle Grave Riccardo

机构信息

Department of Psychiatry, Yale School of Medicine, 34 Park Street, New Haven, CT, 06519, USA.

Department of Eating and Weight Disorders, Villa Garda Hospital, Via Montebaldo 89, 1-37016, Garda, VR, Italy.

出版信息

Eat Weight Disord. 2020 Aug;25(4):1105-1109. doi: 10.1007/s40519-019-00734-4. Epub 2019 Jun 18.

Abstract

PURPOSE

The majority of those who seek treatment for binge eating disorder also have accompanying obesity or overweight. The best available psychological treatments for binge eating disorder produce good and lasting outcomes with regard to control over eating but virtually no weight loss, yet control over eating and weight loss are both important and valued goals of those who seek treatment.

METHODS

We have devised a model of the processes maintaining both the binge eating and the overweight or obesity that occurs in many patients with binge eating disorder who seek treatment. The model draws on previous research findings to highlight and integrate the factors maintaining both the disordered eating and the accompanying overweight or obesity.

RESULTS

We outline a new treatment based on the proposed model that explicitly addresses the twin goals of cessation of binge eating and weight loss in an integrated fashion. The proposed treatment incorporates and integrates elements from two previously tested evidence-based interventions, enhanced cognitive behavioural therapy for eating disorders shown to reduce binge eating and cognitive behaviour therapy of obesity, which produces weight loss.

CONCLUSION

To meet a major challenge for the treatment of binge eating disorder (BED), we have proposed that an integrated treatment with the goals of addressing both binge eating and overweight or obesity is worth researching further. Should this treatment be successful, the goals of many patients who seek treatment for BED are more likely to be met.

LEVEL OF EVIDENCE

This brief report proposes a new approach to clinical practice to be researched further. The evidence on the basis of which the case is made is derived from Level 1: evidence obtained from at least one properly designed randomized controlled trial; systematic reviews and meta-analyses; and experimental studies.

摘要

目的

大多数寻求暴食症治疗的人同时伴有肥胖或超重。现有的针对暴食症的最佳心理治疗方法在控制饮食方面能产生良好且持久的效果,但几乎不会导致体重减轻,然而控制饮食和体重减轻都是寻求治疗者重视的重要目标。

方法

我们设计了一个模型,用于解释在许多寻求治疗的暴食症患者中维持暴食行为以及超重或肥胖状态的过程。该模型借鉴了以往的研究结果,以突出并整合维持饮食紊乱以及伴随的超重或肥胖状态的因素。

结果

我们基于所提出的模型概述了一种新的治疗方法,该方法以综合的方式明确解决了停止暴食和体重减轻这两个双重目标。所提议的治疗方法纳入并整合了两种先前经过测试的循证干预措施的要素,即已被证明可减少暴食行为的饮食失调强化认知行为疗法,以及能实现体重减轻的肥胖认知行为疗法。

结论

为应对暴食症(BED)治疗中的一项重大挑战,我们提议对以解决暴食行为和超重或肥胖为目标的综合治疗方法进行进一步研究。如果这种治疗方法取得成功,许多寻求BED治疗的患者的目标更有可能实现。

证据水平

本简要报告提出了一种有待进一步研究的临床实践新方法。提出该方法所依据的证据来源于1级证据:至少一项设计合理的随机对照试验、系统评价和荟萃分析以及实验研究中获得的证据。

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