Abstract
PurposeA 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.Material and MethodsA 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).ResultsAll 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 effectConclusionThis 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 via a randomized control trial (RCT) to examine the efficacy and effectiveness of PnP.
Highlights
One common condition among a subgroup of individuals within the obesity1 population is a type of disordered eating behavior called binge eating
The results indicate that the PnP program is feasible for patients with patients with obesity and comorbid binge eating disorder (BED), including patients with past bariatric surgery who do not meet the diagnostic criteria for BED
The current study provides initial support for the feasability of a brief 10‐session psychoeducational group intervention for patients with obesity and comorbid BED. It appears that emphasis on creating a safe context to explore underlying mechanisms and responses to internal and external stressors such as weight stigma, shame and poor body image may have contributed to the feasability of the study and the high attendance
Summary
One common condition among a subgroup of individuals within the obesity population is a type of disordered eating behavior called binge eating. BED is a psychiatric disorder that is characterized by recurrent episodes of binge eating, in the absence of compensatory behaviors and accompanied by a sense of loss of control [2]. Whilst the condition has only recently been recognized by the Diagnostic and Statistical Manual fifth edition [7] as its own defined category, BED represents the most common eating disorder (ED) with prevalence rates ranging from 0.2% to 6.6% of the worldwide population [8,9,10]. In a recent health survey from England, individuals with obesity were more likely to screen positive for a possible ED, compared with those in lower BMI categories [23].
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