Reprinted from Eating Disorders Review
May/June 2003 Volume 13, Number 3
©2002 Gürze Books
Obese women with binge eating disorder (BED) may be helped by adding exercise to cognitive behavioral therapy (CBT) and extending the duration of therapy, according to a team of American and Australian researchers (Int J Eat Disord 2002; 31:172).
Dr. John P. Foreyt and colleagues recruited 114 obese binge-eating women through newspaper, television, and radio advertisements announcing a free obesity treatment program. The women had to be at least 30 lb overweight, and to have a history of sedentary lifestyle and occupation and no history of drug abuse. The women were randomly assigned to one of four groups: (1) CBT with exercise and maintenance, (2) CBT with exercise, (3) CBT with maintenance, and (4) CBT only.
Women in all groups received weekly 90-minute group sessions for 4 months, based on CBT treatment for BED outlined in a manual (Telch, Agras, and Rossiter, 1990). Registered dietitians with more than 5 years of training and experience in CBT treatment of obesity led the groups.
In the exercise section, subjects were instructed about how fitness relates to dieting and binge eating and how it helps break the diet-binge cycle. The women were also expected to exercise for at least 45 minutes three times a week at a central exercise department, and required to walk briskly at home once a week. All groups were treated during the first 4 months of the study; the maintenance group then continued for 6 more months.
Exercise enhanced CBT
Women in the CBT, exercise, and maintenance therapy group had significant reductions in binge-eating frequency compared to women who received only CBT. The women in the first group had a 58% abstinence rate at the end of the study and lost an average of 14 lb. (2.2 body mass index, or BMI, units). BMI was significantly reduced in the subjects who were in the exercise and maintenance groups.
Another benefit of exercise was improvement in mood, as measured by the Beck Depression Inventory (BDI). Ten months into the study, there were significant differences in BDI scores between exercisers who had received maintenance treatment and those who had not.
Throughout the study, women who did not exercise had higher BDI scores than did women who exercised several times a week. Those who exercised lost weight throughout the study, while nonexercisers tended to gain weight.