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A randomized, comparative pilot trial of family‐based interpersonal psychotherapy for reducing psychosocial symptoms, disordered‐eating, and excess weight gain in at‐risk preadolescents with loss‐of‐control‐eating
Author(s) -
Shomaker Lauren B.,
TanofskyKraff Marian,
Matherne Camden E.,
Mehari Rim D.,
Olsen Cara H.,
Marwitz Shan E.,
Bakalar Jennifer L.,
Ranzenhofer Lisa M.,
Kelly Nichole R.,
Schvey Natasha A.,
Burke Natasha L.,
Cassidy Omni,
Brady Sheila M.,
Dietz Laura J.,
Wilfley Denise E.,
Yanovski Susan Z.,
Yanovski Jack A.
Publication year - 2017
Publication title -
international journal of eating disorders
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.785
H-Index - 138
eISSN - 1098-108X
pISSN - 0276-3478
DOI - 10.1002/eat.22741
Subject(s) - interpersonal psychotherapy , binge eating , psychosocial , overweight , eating disorders , disordered eating , psychology , randomized controlled trial , binge eating disorder , anxiety , psychiatry , medicine , body mass index , clinical psychology , bulimia nervosa
Objective Preadolescent loss‐of‐control‐eating (LOC‐eating) is a risk factor for excess weight gain and binge‐eating‐disorder. We evaluated feasibility and acceptability of a preventive family‐based interpersonal psychotherapy (FB‐IPT) program. FB‐IPT was compared to family‐based health education (FB‐HE) to evaluate changes in children's psychosocial functioning, LOC‐eating, and body mass. Method A randomized, controlled pilot trial was conducted with 29 children, 8 to 13 years who had overweight/obesity and LOC‐eating. Youth‐parent dyads were randomized to 12‐week FB‐IPT ( n = 15) or FB‐HE ( n = 14) and evaluated at post‐treatment, six‐months, and one‐year. Changes in child psychosocial functioning, LOC‐eating, BMI, and adiposity by dual‐energy‐X‐ray‐absorptiometry were assessed. Missing follow‐up data were multiply imputed. Results FB‐IPT feasibility and acceptability were indicated by good attendance (83%) and perceived benefits to social interactions and eating. Follow‐up assessments were completed by 73% FB‐IPT and 86% FB‐HE at post‐treatment, 60% and 64% at six‐months, and 47% and 57% at one‐year. At post‐treatment, children in FB‐IPT reported greater decreases in depression (95% CI −7.23, −2.01, Cohen's d = 1.23) and anxiety (95% CI −6.08, −0.70, Cohen's d = .79) and less odds of LOC‐eating (95% CI −3.93, −0.03, Cohen's d = .38) than FB‐HE. At six‐months, children in FB‐IPT had greater reductions in disordered‐eating attitudes (95% CI −0.72, −0.05, Cohen's d = .66) and at one‐year, tended to have greater decreases in depressive symptoms (95% CI −8.82, 0.44, Cohen's d = .69) than FB‐HE. There was no difference in BMI gain between the groups. Discussion Family‐based approaches that address interpersonal and emotional underpinnings of LOC‐eating in preadolescents with overweight/obesity show preliminary promise, particularly for reducing internalizing symptoms. Whether observed psychological benefits translate into sustained prevention of disordered‐eating or excess weight gain requires further study.