Effectiveness and acceptability of the physical exercise and dietary therapy in a healthy life center

Abstract

ObjectiveThe high burden of eating disorders (EDs) and limited availability of treatment speaks of a need to explore new avenues for treatment delivery. To understand if new treatment avenues are helpful and acceptable to patients, we investigated the effectiveness of Physical Exercise and Dietary Therapy (PED‐t) in participants with bulimia nervosa or binge‐eating disorder, and acceptability when the PED‐t was implemented in a Healthy Life Center in a municipal primary healthcare service.MethodExercise physiologists and one dietitian were trained in ED literacy and to run PED‐t, before screening women for eligibility. Effectiveness (n = 16) of PED‐t and participants' experiences (n = 8) were evaluated by a mixed methods study design. Results were analyzed by relevant statistics and reflexive thematic analysis.ResultsOf 19 eligible participants, 16 completed treatment. At post‐treatment, the Eating Disorder Examination Questionnaire global score, binge‐eating frequency, and symptoms of depression were lower, and nine (56% of completers) were in remission. Participants' treatment experiences were classified into two overarching themes: “competence” and “emotional support.” Participants reported high acceptance for PED‐t, the local venue and group format, and felt that PED‐t provided them with coping tools and increased mental strength. However, many also spoke of an unmet need to address emotional eating.DiscussionFindings point to a potential for making an effective ED therapy more accessible, and that participants find the local low‐threshold delivery within a group‐format helpful. With small adjustments, the PED‐t could emerge as a promising first‐line treatment for bulimic EDs.Public Significance StatementLimited access to treatment for EDs, patients' high barriers to help‐seeking, and the high rates of limited efficacy from psychotherapy speak of a need to explore new therapies and avenues for delivery. In this study, we build on findings from a controlled ED treatment trial and replicate the beneficial effects and find a high patient acceptance of “physical exercise and diet therapy” implemented in a real, non‐clinical setting.

Expectations of a new eating disorder treatment and its delivery: Perspectives of patients and new therapists

“…This qualitative study was conducted as an implementation study design where the overall aim was to assess the acceptability, feasibility, and effectiveness of PED-t when it is used in a healthcare setting (the HLC), (Mathisen et al, 2023). Women with a diagnosis of BN or BED and between the ages of 18-40 years were included in this study.…”

“…Women with a diagnosis of BN or BED and between the ages of 18-40 years were included in this study. Pregnant women, those with manifested comorbid personality disorders or substance abuse, those outside the BMI range of 17.5-34.0 kg/m 2 , and/or were competing athletes, were excluded from the study (Mathisen et al, 2020(Mathisen et al, , 2023. PED-t is run in a group format of 8-10 participants over 20 weekly sessions for 4 months.…”

“…Each therapy session consists of a supervised exercise session and a dietary psychoeducational session including participants discussions. (Mathisen et al, 2017(Mathisen et al, , 2020(Mathisen et al, , 2023 (see supplementary file 3 for details).…”

“…Patients were recruited to PED-t (n = 10) at one HLC location in 2021 (Mathisen et al, 2023), and were asked verbally or in writing whether they were willing to be interviewed before therapy about their motivations for and expectations of the treatment. All consented to participate.…”