Department of Psychological and Brain Sciences, University of Louisville, Louisville, KY, USA.
Department of Psychology, Drexel University, Philadelphia, PA, USA.
Eat Weight Disord. 2023 Mar 6;28(1):29. doi: 10.1007/s40519-023-01541-8.
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.
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.
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.
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 II controlled trial without randomization.
对体重增加的恐惧可能在维持饮食失调症（ED）中起着核心作用，但针对暴食症谱系 ED 的认知行为治疗（CBT-E）中对体重增加恐惧的作用的研究却很少。我们研究了在暴食症谱系 ED 的 CBT-E 中对体重增加恐惧的变化。我们调查了对体重增加的恐惧是否可以预测失控（LOC）进食或体重变化。
参与者（N=63）是作为更大规模试验的一部分招募的任何性别的成年人。参与者接受了 12 次 CBT-E，在治疗前、中期和后期进行了诊断评估，并在每次治疗前完成了简短的调查。
对体重增加的恐惧在整个治疗过程中都有所下降，但受到诊断的影响。与暴食症相比，患有神经性贪食症谱系 ED（BN 谱系）的患者在基线时报告的对体重增加的恐惧更高，并且在整个治疗过程中恐惧程度下降更大。在给定的治疗中报告对体重增加恐惧程度更高的人，在接下来的一周内更频繁地经历 LOC 发作。对体重增加的恐惧与 BMI 的治疗期间的变化无关。
CBT-E 可降低对体重增加的恐惧，但在治疗后仍保持高水平，尤其是对 BN 谱系 ED 的患者。未来的干预措施应考虑将对体重增加的恐惧作为 LOC 发作的维持因素。
NCT04076553。
无随机分组的 II 级对照试验。
