Randomized trial of a dissonance-based group treatment for eating disorders versus a supportive mindfulness group treatment.

Abstract

Objective: Evaluate a dissonance-based group eating disorder treatment designed to be a cost-effective front-line transdiagnostic treatment that could be more widely implemented than extant treatments that are more intensive and expensive relative to a supportive mindfulness group treatment typical of that offered at colleges. Method: Young women with eating disorders (N = 84) were randomized to 8-week dissonance-based Body Project Treatment (BPT) or supportive mindfulness treatment, completing diagnostic interviews and questionnaires at pretest, posttest, and 6-month follow-up. Results: Regarding primary outcomes, by 6-month follow-up 77% of BPT participants no longer met diagnosis for an eating disorder versus 60% of supportive mindfulness participants (relative risk ratio = 2.22; 95% CI = 1.01–4.93), though groups did not differ on eating disorder symptom change. Regarding secondary outcomes, BPT versus supportive mindfulness participants showed significantly lower dissonance about affirming the thin ideal at posttest and 6-month follow-up (d = .38 & .32), body dissatisfaction at posttest and 6-month follow-up (d = .62 & .62), negative affect at posttest and 6-month follow-up (d = .49 & .48), and functional impairment (d = .36) at 6-month follow-up; differences in thin-ideal internalization and abstinence from binge eating and compensatory behaviors were not significant. Conclusions: Whereas both treatments appeared effective, BPT produced larger effects and significantly greater remission of eating disorder diagnoses than a credible alternative treatment, which is very rare for trials that have compared active eating disorder treatments. Results suggest it would be useful to refine BPT and conduct target engagement research and efficacy trials.

Randomized trial of a dissonance-based transdiagnostic group treatment for eating disorders: An evaluation of target engagement.

“…We thus recommend that future trials use the older version of the BPT. Results from this trial, and the previous trials of BPT (Stice, Rohde, et al, 2015, 2019) imply that the new dissonance-based eating disorder treatment produces clinically meaningful reductions in outcomes and is more cost-effective than 20-session individually administered treatments for eating disorders. It will be important to conduct fully powered efficacy and effectiveness trials of this novel frontline transdiagnostic eating disorder treatment that could be more broadly implemented than more intensive individual therapies for eating disorders.…”

“…In a second trial, 84 young women with any threshold or subthreshold DSM–5 eating disorder were randomized to BPT or a supportive mindfulness group treatment typical of that offered at US colleges (Stice, Rohde, Shaw, & Gau, 2019). By 6-month follow-up, 77% of BPT participants no longer met diagnosis for an eating disorder versus 60% of supportive mindfulness participants (relative risk ratio = 2.22; p < .05), though there were no differences in eating disorder symptom change.…”

Mindfulness como terapêutica nos distúrbios alimentares: uma revisão integrativa de literatura / Mindfulness as therapeutic in eating disorders: an integrative literature review

“…Sabe-se que existem diversos fatores que contribuem para a eficácia da atenção plena, entre eles destacam-se o senso de controle e escolha, o sentimento em relação ao "eu" e a relação entre pensamentos e sentimentos, tudo isso a partir do controle pela aceitação, conscientização e compreensão (OMIWOLE et al, 2019). Elmiquist et al STICE et al, 2019). Outro benefício desta prática é a redução da frequência de idas a hospitais e necessidade da equipe de psicologia e psiquiatria, por se tratar de uma terapia que pode ser realizada de forma individual e sem a ajuda de um profissional (RUFFAULT et al, 2017).…”

Traumatic stress, body shame, and internalized weight stigma as mediators of change in disordered eating: a single-arm pilot study of the Body Trust® framework

“…In two recent meta-analyses, Hilbert et al (2019Hilbert et al ( , 2020 established multiple forms of treatment (including guided/structured self-help) as successful for decreasing symptoms of binge eating. Even with more empirically supported treatments available however, it is important to recognize that clear superiority of one form of treatment over another is rarely found in head-to-head trials (e.g., Crow, 2003;Kristeller et al, 2014;Stice et al, 2019;Wonderlich et al, 2014). Accordingly, research efforts have turned to a more intentional focus on mechanisms and moderators to help guide decisions about treatment targets and for whom certain modalities may be better suited (e.g., Barney et al, 2019;Linardon et al, 2017).…”