The Tree Is My Anchor: A Pilot Study on the Treatment of BED through Nature-Based Therapy

Abstract

Binge eating disorder (BED), characterized by recurrent episodes of binge eating with a subjective experience of lack of control, is the world’s most common eating disorder. The aim of the present pilot study was to examine the feasibility of implementing nature-based therapy (NBT) in the treatment of BED. The NBT intervention was compared to Support Group Meetings (SGMs), which are the only publicly available form of support for people diagnosed with BED in Denmark. Twenty participants with a BED diagnosis were included in the study, which had a mixed-methods design including Eating Disorder Examination interviews, semi-structured interviews, and questionnaires measuring well-being (The Psychological General Well-Being Index) and self-esteem (Rosenberg’s Self-Esteem Scale). Both the NBT and the SGMs showed positive results on all outcome measures (decreases in binge eating episodes and increases in general psychological well-being and self-esteem). The interviews indicated that the NBT context made the psychotherapeutic content more accessible to the participants and further helped them transfer the therapeutic gains to daily life after completing treatment. However, these results should be interpreted with caution due to the small sample size—ideally, they would need to be tested on a larger, randomized sample.

Embodying Experiences with Nature in Everyday Life Recovery for Persons with Eating Disorders

“…However, although using the dichotomy of mind and body as separate realms to reflect upon their understandings of EDs, the participants in the current study also emphasized the (re)connectedness of their body and mind, as it was precisely moving the body in nature that could help ease the distress in their mind. The sensory awareness embedded in interaction with nature has been emphasized as contributing to a shift in focus away from problematic thoughts and feelings [31]. This is in accordance with reports from the participants in the current study, where the "sense-full" intentionality of the outward perspectives helped put the inward perspectives to rest.…”

“…Being in nature, then, could be seen as a dialogue between feelings and thoughts, and nature [58]. The experienced balance between one's own feelings and the interpretation of nature's expression (e.g., wind, rain, waves) has been highlighted by several studies [31,57,59], and supports the argument that a connection with nature holds the potential to enhance the relationship with one's self [59,60].…”

“…There are several strengths and limitations of the current study that should be noted. First, women were strongly overrepresented in the sample, which seems to be common in studies on EDs in general [67], as well as on EDs and nature [27,31]. A possible explanation for the fact that few men responded with interest during our recruitment process might be that EDs have long been associated with women, and men might still find it difficult to recognize themselves in the ED terminology [67,68].…”

“…In accordance with the shift from a focus on the mind towards the body-and, recently, an integrative focus on body and mind-in experiences with ED recovery, nature has been emphasized as holding great potential [27,31]. In a recent study of nature-based therapy for persons with BED, nature was reported to facilitate several positive processes, including increased wellbeing and enhanced self-esteem [31]. This remains a relatively unexplored field, however.…”

From Evidence to Design Solution—On How to Handle Evidence in the Design Process of Sustainable, Accessible and Health-Promoting Landscapes

“…Increasing numbers of studies indicate the positive health impact of green spaces on various groups of people, for example elderly people [3], teenagers [4], war veterans [5], immigrants [6], and people with eating disorders [7]. However, one group of people has largely been overlooked in the research field of nature and human health relationship [8]-people with disabilities.…”