An Adriaens

Health related quality of life, physical fitness and physical activity participation in treatment-seeking obese persons with and without binge eating disorder

This study compared the mental and physical health related quality of life (HRQL) of 40 obese persons with BED with 20 age, gender and body mass index (BMI) matched obese persons without BED and 40 age and gender matched non-obese volunteers. Variables contributing to the variability in HRQL were identified. Participants were asked to fill in the MOS 36-item Short Form Health Survey (SF-36), the Symptoms Checklist-90 (SCL-90), the Baecke questionnaire, the bulimia subscale of the Eating Disorder Inventory and the Body Attitude Test. All participants also performed a 6-minute walk test (6MWT). BED patients showed a significant impaired physical and mental HRQL compared with obese and non-obese control groups. In the BED-group female participants showed a significantly more impaired mental HRQL than male participants (40.0±21.2 versus 66.6±10.1). The distance achieved on the 6MWT (512.1±75.8m) explained 22.5% of the variability in physical HRQL in the obese BED-group while gender and the SCL-90 depression score (39.1±12.2) explained 47.1% of the variability in mental HRQL. The present findings suggest that the treatment of obese individuals with BED might benefit by giving more attention to HRQL, depressive symptoms and physical fitness.

Changes in physical activity, physical fitness, self- perception and quality of life following a 6-month physical activity counseling and cognitive behavioral therapy program in outpatients with binge eating disorder

The aim of the current study was to explore the associations between changes in the number of binges, physical activity participation, physical fitness, physical self-perception and quality of life following a 6-month physical activity counseling and cognitive behavioral program in patients with binge eating disorder (BED). In total 34 (31 women) outpatients with BED (38.5±10.7 years) completed a 6-month 1-day per week group-based program. Participants completed the 36-item Short Form Health Survey, the Baecke Physical Activity questionnaire, the Physical Self Perception Profile and performed a 6-min walk test (6MWT) at baseline, after 3 and 6 months. Except for physical activity at work, physical strength and self-worth perception, all parameters significantly improved after 6 months. The effect sizes ranged from -0.33 for the number of binges to 1.67 for participation in sports activities. Significant increases in leisure time physical activity were associated with significant improvements in physical health related quality of life, perceived sports competence and physical fitness and in perceived body attractiveness. The significant reduction in the number of binges was associated with significant improvements in physical health related quality of life. Future research should focus on detailing which techniques can stimulate physical activity participation in patients with BED.

The functional exercise capacity and its correlates in obese treatment-seeking people with binge eating disorder: an exploratory study

Abstract Purpose: The primary aim was to compare the functional exercise capacity between obese treatment-seeking people with and without binge eating disorder (BED) and non-obese controls. The secondary aim was to identify clinical variables including eating and physical activity behaviour, physical complaints, psychopathology and physical self-perception variables in obese people with BED that could explain the variability in functional exercise capacity. Methods: Forty people with BED were compared with 20 age-, gender- and body mass index (BMI)-matched obese persons without BED and 40 age and gender matched non-obese volunteers. A 6-minute walk test (6MWT), the Baecke physical activity questionnaire, the Symptom Checklist-90, the Physical Self-Perception Profile and the Eating Disorder Inventory were administered. Physical complaints before and after the 6MWT were also documented. Results: The distance achieved on the 6MWT was significantly lower in obese participants with BED (512.1 ± 75.8 m versus 682.7 ± 98.4, p < 0.05) compared to non-obese controls. No significant differences were found between obese participants with and without BED. Participants with BED reported significantly (p < 0.05) more musculoskeletal pain and fatigue after the walk test than obese and non-obese controls. A forward stepwise regression analysis demonstrated that sports participation and perceived physical strength explained 41.7% of the variance on the 6MWT in obese participants with BED. Conclusion: Physical activity participation, physical self-perception and perceived physical discomfort during walking should be considered when developing rehabilitation programs for obese people with BED. Implications for Rehabilitation Rehabilitation programmes in people with binge eating disorder should incorporate a functional exercise capacity assessment. Clinicians involved in the rehabilitation of people with binge eating disorder should consider depression and lower self-esteem as potential barriers. Clinicians should take into account the frequently observed physical discomfort when developing rehabilitation programmes for people with binge eating disorder.

Een cognitief-gedragstherapeutisch programma voor patiënten met obesitas en binge eating disorder: kortetermijnresultaten

SamenvattingDit artikel beschrijft een nieuwe cognitief-gedragstherapeutische behandeling voor patiënten met obesitas en binge eating disorder. Het programma loopt één dag per week gedurende zes maanden (24 sessies). De specifieke therapeutische doelen zijn onder meer: het normaliseren van het eetgedrag en stoppen van de eetbuien; het bevorderen van lichaamsbeweging en een positieve lichaamsbeleving; het aanleren van sociale vaardigheden, zoals assertiviteit; het installeren van een functioneel zelfevaluatiesysteem; het leren identificeren, verdragen en uitdrukken van negatieve emoties; het bevorderen van zelfvertrouwen; het voorkomen van terugval en het bevorderen van de algemene levenskwaliteit. We beschrijven enkele onderzoeksgegevens over de effectiviteit van dit programma op korte termijn. Ondanks een vrij beperkt gewichtsverlies, daalde het aantal eetbuien per week aanzienlijk. Daarmee werd onze belangrijkste doelstelling gehaald. Daarnaast tonen de resultaten enkele veelbelovende verbeteringen wat betreft psychologisch welzijn, zoals significant minder depressieve klachten en angstklachten. Follow-up op langere termijn is nodig om het nut van dit programma te bevestigen.AbstractThis article describes an innovative cognitive-behavioural therapeutic program for patients with binge eating disorder and obesity. The program runs one day a week during six months (24 sessions). The most important therapeutic goals are: normalization of eating behaviour and stopping of the binges; promoting physical exercise and a positive body experience; learning social skills such as assertivity, installing a functional self-evaluation system, promoting self-esteem and the prevention of relapse. Overall, the program aims at improving the general physical and psychological well being. Some preliminary results of the efficacy of this program are described. Not withstanding a limited loss of weight, the program resulted in an important reduction of the number of binge episodes, a major goal of the program. Moreover, the results show that the psychological well being of the patients improved significantly.

De psychotherapeutische behandeling van patiënten met de eetbuistoornis: een literatuuroverzicht

SamenvattingDe eetbuistoornis wordt in de DSM-IV-TR beschreven onder de categorie EDNOS (eating disorder not otherwise specified). Vaak resulteert de eetbuistoornis in obesitas. Als je de grote hoeveelheid studies over medicamenteuze behandelingen van de eetbuistoornis in ogenschouw neemt, kun je stellen dat er weinig onderzoek is verricht naar de effecten van een psychotherapeutische aanpak. In deze bijdrage vatten we ‘de state of the art’ samen omtrent de psychotherapeutische aanpak (met en zonder medicatie) van de eetbuistoornis en obesitas. Onderzoek geeft aan dat er matige evidentie bestaat voor een cognitieve gedragstherapeutische behandeling, aangeboden via een stapsgewijs protocol. Een hele reeks andere behandelingen lijkt erg beloftevol, maar méér en gecontroleerd onderzoek omtrent deze andere behandelingen blijft aangewezen om uitspraken over de evidentie ervan te kunnen doen.AbstractBinge Eating Disorder (BED) is described within the DSM-IV-TR under the category of EDNOS (Eating Disorder Not Otherwise Specified). Often BED is associated with obesity. Compared to the many studies on the use of medications in the treatment of BED, little research has been done on the effects of a psychotherapeutic approach. In this contribution we summarize the ‘state of the art’ of the research on the psychotherapeutic approach of BED. Studies of a purely psychotherapy approach will be discussed together with studies combining psychotherapy and medication. Research indicates that there is moderate evidence for a cognitive behavioral therapeutic approach, offered through a stepwise protocol as an effective treatment for BED. Several other treatment approaches seem to be very promising, but more controlled studies on larger samples are needed before any conclusions about the evidence can be drawn.