Department of Neuromedicine and Movement Science, Norwegian University of Science and Technology, Trondheim, Norway.
Stjørdal Community Mental Health Centre, Levanger Hospital, Levanger, Norway.
Front Endocrinol (Lausanne). 2021 Nov 3;12:738856. doi: 10.3389/fendo.2021.738856. eCollection 2021.
A common challenge among a subgroup of individuals with obesity is binge eating, that exists on a continuum from mild binge eating episodes to severe binge eating disorder (BED). BED is common among bariatric patients and the prevalence of disordered eating and ED in bariatric surgery populations is well known. Conventional treatments and assessment of obesity seldom address the underlying psychological mechanisms of binge eating and subsequent obesity. This study, titled PnP (People need People) is a psychoeducational group pilot intervention for individuals with BED and obesity including patients with previous bariatric surgery. Design, feasibility, and a broad description of the study population is reported.
A total of 42 patients were from an obesity clinic referred to assessment and treatment with PnP in a psychoeducational group setting (3-hour weekly meetings for 10 weeks). Of these, 6 (14.3%) patients had a previous history of bariatric surgery. Feasibility was assessed by tracking attendance, potentially adverse effects and outcome measures including body mass index (BMI), eating disorder pathology, overvaluation of shape and weight, impairment, self-reported childhood difficulties, alexithymia, internalized shame as well as health related quality of life (HRQoL).
All 42 patients completed the intervention, with no adverse effects and a high attendance rate with a median attendance of 10 sessions, 95% CI (8.9,9.6) and 0% attrition. Extent of psychosocial impairment due to eating disorder pathology, body dissatisfaction and severity of ED symptoms were high among the patients at baseline. Additionally, self-reported childhood difficulties, alexithymia, and internalized shame were high among the patients and indicate a need to address underlying psychological mechanisms in individuals with BED and comorbid obesity. Improvement of HRQoL and reduction of binge eating between baseline and the end of the intervention was observed with a medium effect.
This feasibility study supports PnP as a potential group psychoeducational intervention for patients living with BED and comorbid obesity. Assessments of BED and delivery of this intervention may optimize selection of candidates and bariatric outcomes. These preliminary results warrant further investigation a randomized control trial (RCT) to examine the efficacy and effectiveness of PnP.
肥胖亚组人群中存在一个常见的问题,即暴食症,其表现形式从轻度暴食发作到严重暴食障碍(BED)。BED 在肥胖症患者中较为常见,且在肥胖症手术人群中,饮食失调和 ED 的患病率是众所周知的。传统的治疗方法和肥胖症评估很少涉及暴食和随后肥胖的潜在心理机制。本研究题为 PnP(人需要人),是针对 BED 和肥胖症患者(包括之前接受过减肥手术的患者)的一种心理教育团体干预。报告了设计、可行性和研究人群的广泛描述。
共有 42 名患者来自肥胖症诊所,他们被转诊到 PnP 进行评估和治疗,采用心理教育团体设置(每周 3 小时,共 10 周)。其中,有 6 名患者(14.3%)有之前的减肥手术史。通过跟踪出勤率、潜在的不良反应和结局测量来评估可行性,包括体重指数(BMI)、饮食失调病理、对体型和体重的过度评价、损伤、自我报告的童年困难、述情障碍、内化的羞耻感以及健康相关生活质量(HRQoL)。
所有 42 名患者均完成了干预,无不良反应,出勤率高,中位数为 10 次,95%CI(8.9,9.6),无患者退出。患者在基线时的饮食失调病理、身体不满和 ED 症状严重程度方面存在较高的心理社会损伤程度。此外,患者的自我报告的童年困难、述情障碍和内化的羞耻感较高,表明需要解决 BED 和合并肥胖症患者的潜在心理机制。在干预结束时,观察到 HRQoL 的改善和暴食发作的减少,具有中等效果。
这项可行性研究支持 PnP 作为一种潜在的针对 BED 和合并肥胖症患者的团体心理教育干预。BED 的评估和干预的提供可能会优化候选者的选择和减肥手术的结果。这些初步结果值得进一步研究,开展一项随机对照试验(RCT)来检验 PnP 的疗效和有效性。