Culturally adapted cognitive behavioral guided self-help for binge eating: A feasibility study with Mexican Americans.

Abstract

Objective was to test feasibility and preliminary efficacy of a culturally adapted cognitive-behavioral self-help program to treat binge eating and related problems in Mexican Americans. Participants were 31 women recruited from the Los Angeles area and diagnosed with binge eating disorder, recurrent binge eating or bulimia nervosa. Participants completed a culturally adapted version of a CBT-based self-help program with 8 guidance sessions over a 3-month period. Treatment efficacy was evaluated in terms of binge eating, psychological functioning, and weight loss. Intent-to-treat analyses revealed 35.5% abstinence from binge eating at post-treatment and 38.7% diagnostic remission. Results indicated significant pre-treatment to post-treatment improvement on distress level, BMI, eating disorder psychopathology, and self-esteem. Satisfaction with the program was high. Findings demonstrate that the program is acceptable, feasible, and efficacious in reducing binge eating and associated symptoms for Mexican American women. Study provides “proof of concept” for implementation of culturally adapted forms of evidence-based programs.

Ten‐session cognitive behaviour therapy for eating disorders: Outcomes from a pragmatic pilot study of Australian non‐underweight clients

“…Notably, improvements for most variables were observed at mid-treatment, and posttreatment results were largely maintained at both follow-up points. Abstinence, remission, and good outcome rates were comparable to the initial pilot study and to efficacy and effectiveness studies of CBT-ED and CBT-GSH using both experienced and inexperienced therapists (Banasiak, Paxton, & Hay, 2005;Byrne et al, 2011;Cachelin et al, 2014;Carter & Fairburn, 1998;Fairburn et al, 2009Fairburn et al, , 2015Knott et al, 2015;Rose & Waller, 2017;Signorini et al, 2018;Turner et al, 2015; EDE-Q, Eating disorder examination questionnaire; CIA, clinical impairment assessment; BMI, body mass index; DASS21, depression anxiety and stress scales; ED, eating disorder; OR, odds ratio. Objective bingeing and purging were also analysed using behavioural items from the EDE-Q (where behaviours are assessed over a 4-week period).…”

A pragmatic effectiveness study of 10‐session cognitive behavioural therapy (CBT‐T) for eating disorders: Targeting barriers to treatment provision

“…Byrne et al (), Rose and Waller (), Signorini et al () and Turner et al () samples included participants with BMI < 17.5. Measures: EDE (Banasiak et al, ; Cachelin et al, ; Carter and Fairburn, ; Fairburn et al, ; Fairburn et al, ); EDE‐Q (present study; Byrne et al, ; Knott et al, ; Pellizzer et al, ; Rose & Waller, ; Signorini et al, ; Turner et al, ; Waller et al, ), Eating Disorders Inventory (EDI; Waller et al, ), and a modified version of the EDE‐Q (EDE‐Q‐SF; Zandberg & Wilson, ).. EDE‐Q/EDE/EDE‐Q‐SF global scores not provided in Cachelin et al (), Knott et al (), and Zandberg and Wilson (), subscale effect sizes are presented. Cohen's d presented may differ from those presented in some studies.…”

“…Cachelin et al (): Restraint 0.09 (−0.41, 0.59), Eating Concern 0.33 (−0.17, 0.83), Shape Concern 0.42 (−0.08, 0.92), Weight Concern 0.43 (−0.07, 0.93)…”

Addressing critical gaps in the treatment of eating disorders

“…Participants also reported significant reductions in eating disorder‐specific psychopathology, general psychopathology, and high levels of treatment acceptability, with findings thus strongly suggesting that such task shifting can be done without compromising clinical outcomes. Likewise, nonspecialist “facilitators” with no formal clinical qualifications achieved an outcome of 50% abstinence from binge eating using CBTgsh for individuals with BED (Carter & Fairburn, ), and a culturally adapted version of CBTgsh for Mexican Americans with binge eating, using master's‐level psychology students facilitators providing support sessions over the phone, achieved an outcome of 36% abstinence (Cachelin et al, ). The delivery of group CBT for adolescent girls with recurrent binge eating has also been task‐shifted to master's‐level counselors and health care professionals through use of comprehensive facilitator materials with strong outcomes—100% of participants in the CBT group were abstinent at 6‐month follow‐up vs. 50% in the TAU group (Debar et al, ).…”

“…| 179 binge eating using CBTgsh for individuals with BED (Carter & Fairburn, 1998), and a culturally adapted version of CBTgsh for Mexican Americans with binge eating, using master's-level psychology students facilitators providing support sessions over the phone, achieved an outcome of 36% abstinence (Cachelin et al, 2014). The delivery of group CBT for adolescent girls with recurrent binge eating has also been task-shifted to master's-level counselors and health care professionals through use of comprehensive facilitator materials with strong outcomes-100% of participants in the CBT group were abstinent at 6-month follow-up vs. 50% in the TAU group (Debar et al, 2013).…”