Eating disorder risk during behavioral weight management in adults with overweight or obesity: A systematic review with meta‐analysis

Abstract

This systematic review examined change in eating disorder risk during weight management interventions. Four databases and clinical trials registries were searched in March and May 2022, respectively, to identify behavioral weight management intervention trials in adults with overweight/obesity measuring eating disorder symptoms at pre-and post-intervention or follow-up. Random effects meta-analyses were conducted examining within group change in risk. Of 12,023 screened, 49 were eligible (n = 6337, mean age range 22.1 to 59.9 years, mean (SD) 81(20.4)% female).Interventions ranged from 4 weeks to 18 months, with follow-up of 10 weeks to 36 months post-intervention. There was a within group reduction in global eating disorder scores (20 intervention arms; Hedges' g = À0.27; 95% CI À0.36, À0.17; I 2 67.1%) and binge eating (49 intervention arms; À0.66; 95% CI À0.76, À0.56; I 2 82.7%) post-intervention, both maintained at follow-up. Of 14 studies reporting prevalence or episodes of binge eating, all reported a reduction. Four studies reported

Real‐world data of a digitally enabled, time‐restricted eating weight management program in public sector workers living with overweight and obesity in the United Kingdom: A service evaluation of the Roczen program

“…This would show the idea that eating disorder risk is not impacted within behavioral weight management interventions offered alongside healthcare support, and that such clinically supervised program may in fact may be of benefit. 56 Our service evaluation has several strengths. Firstly, a large proportion of the members were public service workers, with this representing a novel intervention in this population and offering a novel and deliverable intervention to improve workplace health for this population.…”

Naltrexone/bupropion for binge‐eating disorder: A randomized, double‐blind, placebo‐controlled trial

“…Cardel and colleagues [13, 42], in their evidence‐based commentaries, cogently addressed the “false dichotomy” between reducing eating‐disorder risk and treating obesity. In contrast to concerns that addressing obesity might serve only to stigmatize people with higher BMIs and to foster eating disorders, systematic reviews of the evidence base indicate that reductions in eating‐disorder psychopathology occur during and following behavioral weight‐management interventions with few instances of eating‐disorder symptoms developing [43]. The present study testing naltrexone/bupropion and the recent RCT testing naltrexone/bupropion and behavioral therapy for BED [26] converge with previous rigorous trials testing behavioral weight loss for BED [10, 41, 44] in documenting reductions in binge eating and associated eating‐disorder psychopathology.…”

Distinguishing probable atypical anorexia nervosa from weight loss alone in a national sample of U.S. Military Veterans: Disentangling the roles of weight suppression and cognitive concerns

“…This is also noteworthy because there has been longstanding tension between the ED and obesity fields regarding the question of whether weight loss is attainable and sustainable without the presence of ED symptomatology (Cardel et al, 2022, 2023; Steinberg & Bohon, 2023). Although there is evidence to suggest WS is positively correlated with ED symptomatology (Gorrell et al, 2019; Lowe et al, 2018), and dieting is frequently cited as an antecedent to ED development (Bodell et al, 2017; Keel et al, 2007), there is also contradictory evidence (Jebeile et al, 2023). Results of the current study suggest weight loss is attainable without concurrent ED cognitive symptoms.…”