Is physical exercise and dietary therapy a feasible alternative to cognitive behavior therapy in treatment of eating disorders? A randomized controlled trial of two group therapies

Abstract

Objective: To compare effects of physical exercise and dietary therapy (PED-t) to cognitive behavioral therapy (CBT) in treatment of bulimia nervosa (BN) and bingeeating disorder (BED). Method:The active sample (18-40 years of age) consisted of 76 women in the PEDt condition and 73 in the CBT condition. Participants who chose not to initiate treatment immediately (n = 23) were put on a waiting list. Outcome measures were the eating disorder examination questionnaire (EDE-Q), Clinical Impairment Assessment (CIA), Satisfaction with Life Scale (SWLS), Beck Depression Inventory (BDI), and numbers in remission at posttreatment, and at 6-, 12-, and 24-months follow-up.Results: Both treatment conditions produced medium to strong significant improvements on all outcomes with long-term effect. The PED-t produced a faster improvement in EDE-Q and CIA, but these differences vanished at follow-ups. Only PED-t provided improvements in BDI, still with no between-group difference. Totally, 30-50% of participants responded favorable to treatments, with no statistical between-group difference.Discussion: Both treatments shared a focus on normalizing eating patterns, correcting basic self-regulatory processes and reducing idealized aesthetic evaluations of self-worth. The results point to the PED-t as an alternative to CBT for BN and BED, although results are limited due to compliance and dropout rates. Replications are needed by independent research groups as well as in more clinical settings. K E Y W O R D S affect regulation, binge-eating disorder, bulimia nervosa, dietary therapy, exercise therapy, physical activity, self-regulation Trial registration: Prospectively registered in Norwegian

The neurostructural and neurocognitive effects of physical activity: A potential benefit to promote eating disorder recovery

“…In women with BN, physical activity as therapy had superior long-term effects in reduction of drive for thinness, bulimic cognitions, and bulimic behavior compared with cognitive-behavior therapy (Sundgot-Borgen, Rosenvinge, Bahr, & Schneider, 2002). We have also found comparable remission rates with long-term effects in women with BN and BED treated with supervised physical exercise and dietary therapy (PED-t) compared with cognitive behavior therapy (Mathisen et al, 2020).…”

Treatment of eating disorders: voices from a ward

“…Nevertheless, physical activity can for some be a method for reducing/ managing challenging thoughts/feelings (Trangsrud et al, 2020). A new study shows that patients with ED experienced the same treatment-effect by receiving training-and diet guidance, as they did by cognitive therapy after 6-12 months (Mathisen et al, 2020). Bratland and Skogmo (2011) argue for a focus on the joy of motion, and not on the burning of calories.…”

Benefits of Exercise in Multidisciplinary Treatment of Binge Eating Disorder in Adolescents with Obesity

“…The paucity and heterogeneity of available studies limit overall conclusions of this systematic review and highlight the need for further research. In light of these promising results, Mathisen et al compared the effects of physical exercise and dietary therapy (PED-t) to CBT in the treatment of bulimia nervosa and BED in young adults and the adult population [ 115 , 116 ]. Specifically, the exercise program proposed consisted of three weekly exercise sessions, each of 40–60 min duration.…”