Department of Psychiatry, Washington University School of Medicine, Mailstop 8134-29-2100, 660 S. Euclid Ave., St. Louis, MO 63110, USA.
Department of Psychology, Cardinal Glennon Children's Hospital, 1465 S Grand Blvd, St. Louis, MO 63104, USA.
Eat Behav. 2023 Aug;50:101789. doi: 10.1016/j.eatbeh.2023.101789. Epub 2023 Jul 24.
Binge-type eating disorders (EDs; i.e., bulimia nervosa, binge eating disorder) are common among young adults with high body weight, yet few interventions target both conditions. This study tested an online guided self-help intervention that provided cognitive behavioral therapy (CBT) tools for EDs and behavioral weight loss (BWL) content to young adults with binge-type EDs and high body weight.
60 adults aged 18-39 with clinical/subclinical binge-type EDs and high body weight were randomized to a combined condition or a CBT-only condition. Participants received self-help content for 8 weeks and self-reported ED attitudes, frequency of binge eating and compensatory behaviors, and weight at baseline, 4-weeks, and 8-weeks. Linear mixed models and negative binomial models compared changes between conditions in ED attitudes, ED behaviors, and weight at each timepoint. Chi-square test and independent samples t-test compared program completion and session engagement between conditions.
No significant differences in weight change or ED symptom change emerged between the conditions. Both conditions achieved significant reductions in ED attitudes, binge episodes, and compensatory behaviors from baseline to 8-weeks (ps < .05). Neither condition demonstrated significant weight loss from baseline to 8-weeks. Program completion (47 %) and session engagement (57 %) were equally high across conditions.
Both conditions achieved ED symptom change; however, neither condition was associated with weight change. Research is needed to identify the types of strategies and doses of BWL that promote clinically significant weight and ED symptom change in young adults.
狂欢型进食障碍（ED；即神经性贪食症、暴食障碍）在体重较高的年轻成年人中较为常见，但很少有干预措施同时针对这两种疾病。本研究测试了一种在线指导自助干预措施，该措施为有狂欢型 ED 和高体重的年轻成年人提供了 ED 的认知行为疗法（CBT）工具和行为体重管理（BWL）内容。
60 名年龄在 18-39 岁之间、患有临床/亚临床狂欢型 ED 和高体重的成年人被随机分配到联合组或 CBT 组。参与者接受了 8 周的自助内容，并在基线、4 周和 8 周时自我报告 ED 态度、暴食发作和补偿行为的频率以及体重。线性混合模型和负二项式模型比较了每个时间点条件之间 ED 态度、ED 行为和体重变化的差异。卡方检验和独立样本 t 检验比较了条件之间的项目完成和课程参与情况。
条件之间的体重变化或 ED 症状变化没有显著差异。两种条件在基线到 8 周时，ED 态度、暴食发作和补偿行为均显著减少（ps<0.05）。两种条件在基线到 8 周时均未显示出显著的体重减轻。项目完成率（47%）和课程参与率（57%）在两个条件中均相同。
两种条件均实现了 ED 症状的变化；然而，没有一种条件与体重变化有关。需要研究确定促进年轻成年人体重和 ED 症状发生有临床意义的改变的 BWL 策略类型和剂量。
