How do women with eating disorders experience a new treatment combining guided physical exercise and dietary therapy? An interview study of women participating in a randomised controlled trial at the Norwegian School of Sport Sciences

Gunn Pettersen, Solveig Sørdal, Jan H Rosenvinge, Tone Skomakerstuen, Therese Fostervold Mathisen, Jorunn Sundgot-Borgen, Gunn Pettersen, Solveig Sørdal, Jan H Rosenvinge, Tone Skomakerstuen, Therese Fostervold Mathisen, Jorunn Sundgot-Borgen

Abstract

Objectives: To investigate how women with bulimia nervosa (BN) and binge eating disorder (BED) experience participating in a new treatment programme for eating disorders, based on guided physical exercise and dietary therapy.

Design and participants: Six women with BN and four with BED were semistructurally interviewed. Transcribed interviews were analysed using a text-condensing analytic approach.

Results: The analysis resulted in four main categories: (1) 'a renewed attitude towards physical activity', (2) 'a new perception of food', (3) 'mixed feelings of being in a heterogeneous treatment group' and (4) 'insight in one's own recovery process', each with 2-4 subcategories to express nuances.

Conclusion: The treatment was experienced as beneficial. Improvements in the implementation of the programme were suggested.

Trial registration number: NCT02079935.

Keywords: eating disorders; mental health; qualitative research.

Conflict of interest statement

Competing interests: None declared.

© Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

References

    1. American Psychiatric Association. Diagnostic and statistical manual of mental disorders. 5th edn Washington DC: American Psychiatric Association, 2013.
    1. Arcelus J, Mitchell AJ, Wales J, et al. . Mortality rates in patients with anorexia nervosa and other eating disorders. A meta-analysis of 36 studies. Arch Gen Psychiatry 2011;68:348–58. 10.1001/archgenpsychiatry.2011.74
    1. Keski-Rahkonen A, Hoek HW, Susser ES, et al. . Epidemiology and course of anorexia nervosa in the community. Am J Psychiatry 2007;164:1259–65. 10.1176/appi.ajp.2007.06081388
    1. Hoek HW, van Hoeken D. Review of the prevalence and incidence of eating disorders. Int J Eat Disord 2003;34:383–96. 10.1002/eat.10222
    1. Wentz E, Gillberg C, Gillberg IC, et al. . Ten-year follow-up of adolescent-onset anorexia nervosa: psychiatric disorders and overall functioning scales. J Child Psychol Psychiatry 2001;42:613–22. 10.1111/1469-7610.00757
    1. Reichborn-Kjennerud T, Bulik CM, Sullivan PF, et al. . Psychiatric and medical symptoms in binge eating in the absence of compensatory behaviors. Obes Res 2004;12:1445–54. 10.1038/oby.2004.181
    1. Rosenvinge JH, Klusmeier AK. Treatment for eating disorders from a patient satisfaction perspective: a Norwegian replication of a British study. Eur Eat Disord Rev 2000;8:293–300. 10.1002/1099-0968(200008)8:4<293::AID-ERV346>;2-4
    1. Rosenvinge JH, Pettersen G. Epidemiology of eating disorders part II: An update with a special reference to the DSM-5. Adv Eat Disord: Theory, Res Pract 2015.
    1. Hay P. A systematic review of evidence for psychological treatments in eating disorders: 2005-2012. Int J Eat Disord 2013;46:462–9. 10.1002/eat.22103
    1. Spielmans GI, Benish SG, Marin C, et al. . Specificity of psychological treatments for bulimia nervosa and binge eating disorder? A meta-analysis of direct comparisons. Clin Psychol Rev 2013;33:460–9. 10.1016/j.cpr.2013.01.008
    1. Vist G. Cognitive behavior therapy compared to other psychotherapy for treatment of bulimia. Oslo: Report from the Norwegian Institute of Public Health, 2016.
    1. Waller G. A ‘trans-transdiagnostic’ model of the eating disorders: a new way to open the egg? Eur Eat Disord Rev 2008;16:165–72. 10.1002/erv.869
    1. Wilson GT, Grilo CM, Vitousek KM. Psychological treatment of eating disorders. Am Psychol 2007;62:199–216. 10.1037/0003-066X.62.3.199
    1. Groff SE. Is enhanced cognitive behavioral therapy an effective intervention in eating disorders? A review. J Evid Inf Soc Work 2015;12:272–88. 10.1080/15433714.2013.835756
    1. Larun L, Nordheim LV, Ekeland E, et al. . Exercise in prevention and treatment of anxiety and depression among children and young people. Cochrane Database Syst Rev 2006;19:CD004691 10.1002/14651858.CD004691.pub2
    1. Cooney GM, Dwan K, Greig CA, et al. . Exercise for depression. Cochr Database Syst Rev 2013;9.
    1. Rosenbaum S, Tiedemann A, Sherrington C, et al. . Physical activity interventions for people with mental illness: a systematic review and meta-analysis. J Clin Psychiatry 2014;75:964–74. 10.4088/JCP.13r08765
    1. Brauhardt A, de Zwaan M, Hilbert A. The therapeutic process in psychological treatments for eating disorders: a systematic review. Int J Eat Disord 2014;47:565–84. 10.1002/eat.22287
    1. Bratland-Sanda S, Rosenvinge JH, Vrabel KA, et al. . Physical activity in treatment units for eating disorders: clinical practice and attitudes. Eat Weight Disord 2009;14:e106–e112. 10.1007/BF03327807
    1. Sundgot-Borgen J, Rosenvinge JH, Bahr R, et al. . The effect of exercise, cognitive therapy, and nutritional counseling in treating bulimia nervosa. Med Sci Sports Exerc 2002;34:190–5. 10.1097/00005768-200202000-00002
    1. Bratland-Sanda S, Sundgot-Borgen J, Rø Ø, et al. . “I’m not physically active - I only go for walks”: physical activity in patients with longstanding eating disorders. Int J Eat Disord 2010;43:88–92. 10.1002/eat.20753
    1. de la Rie S, Noordenbos G, Donker M, et al. . Evaluating the treatment of eating disorders from the patient’s perspective. Int J Eat Disord 2006;39:667–76. 10.1002/eat.20317
    1. Newton JT, Robinson PH, Hartley P. Treatment for eating disorders in the United Kingdom. Part II. Experiences of treatment: A survey of members of the eating disorders association. Eur Eat Disord Rev 1993;1:10–21. 10.1002/erv.2400010104
    1. Clinton D, Björck C, Sohlberg S, et al. . Patient satisfaction with treatment in eating disorders: cause for complacency or concern? Eur Eat Disord Rev 2004;12:240–6. 10.1002/erv.582
    1. Swain-Campbell NR, Surgenor LJ, Snell DL. An analysis of consumer perspectives following contact with an eating-disorders service. Aust N Z J Psychiatry 2001;35:99–103. 10.1046/j.1440-1614.2001.00855.x
    1. Clinton D. Expectations and experiences of treatment in eating disorders. Eat Disord 2001;9:361–71. 10.1080/106402601753454921
    1. Bell L. What can we learn from consumer studies and qualitative research in the treatment of eating disorders? Eat Weight Disord 2003;8:181–7. 10.1007/BF03325011
    1. Poulsen S, Lunn S, Sandros C. Client experience of psychodynamic psychotherapy for bulimia nervosa: An interview study. Psychotherapy: Theory, Research, Practice, Training 2010;47:469–83. 10.1037/a0021178
    1. Krautter T, Lock J. Is manualized family-based treatment for adolescent anorexia nervosa acceptable to patients? Patient satisfaction at the end of treatment. J Fam Ther 2004;26:66–82. 10.1111/j.1467-6427.2004.00267.x
    1. Mathisen TF, Rosenvinge JH, Pettersen G, et al. . The PED-t trial protocol: The effect of physical exercise -and dietary therapy compared with cognitive behavior therapy in treatment of bulimia nervosa and binge eating disorder. BMC Psychiatry 2017;17:180 10.1186/s12888-017-1312-4
    1. Malterud K. Systematic text condensation: a strategy for qualitative analysis. Scand J Public Health 2012;40:795–805. 10.1177/1403494812465030
    1. Pettersen G, Rosenvinge JH, Ytterhus B. Patient experiences with bulimic symptoms in daily life interactions. Eat Disord 2008;16:204–11.
    1. Pettersen G, Thune-Larsen K-B, Wynn R, et al. . Eating disorders: challenges in the later phases of the recovery process. Scand J Caring Sci 2013;27:92–8. 10.1111/j.1471-6712.2012.01006.x
    1. Björk T, Ahlström G. The patient’s perception of having recovered from an eating disorder. Health Care Women Int 2008;29:926–44. 10.1080/07399330802269543
    1. Lindgren BM, Enmark A, Bohman A, et al. . A qualitative study of young women’s experiences of recovery from bulimia nervosa. J Adv Nurs 2015;71:860–9. 10.1111/jan.12554
    1. Rosenvinge JH. Group therapy for anorexic and bulimic patents. Some aspects on the conduction of group therapy and a critical review of some recent studies. Acta Psychiatr Scand 1990;361:38–43.
    1. Pettersen G, Rosenvinge JH, Wynn R. Healing processes in eating disorders related to psychoeducation - patients’ experiences. Scand J Car Sci 2011;25:12–18.
    1. Wanlass J, Kelly Moreno J, Thomson HM. Group therapy for eating disorders: a retrospective case study. J Spec Group Work 2005;30:47–66. 10.1080/01933920590908697
    1. Fassino S, Pierò A, Tomba E, et al. . Factors associated with dropout from treatment for eating disorders: a comprehensive literature review. BMC Psychiatry 2009;9:67 10.1186/1471-244X-9-67
    1. Bell L. What predicts failure to engage in or drop out from treatment for bulimia nervosa and what implications does this have for treatment? Clin Psychol Psychother 2001;8:424–35. 10.1002/cpp.288
    1. Wampold BE. How important are the common factors in psychotherapy? An update. World Psychiatry 2015;14:270–7. 10.1002/wps.20238

Source: PubMed

Sponsorer og samarbejdspartnere

Medicinske tilstande

Narkotikainterventioner

3
Abonner