Effects of cognitive-behavioural therapy on health-related quality of life in obese subjects with and without binge eating disorder

• Published in: International Journal of Obesity 2002-09, Vol.26 (9), p.1261-1267
• Main Authors: Marchesini, G, Natale, S, Chierici, S, Manini, R, Besteghi, L, Di Domizio, S, Sartini, A, Pasqui, F, Baraldi, L, Forlani, G, Melchionda, N
• Format: Article
• Language: English
• Subjects: Adult and adolescent clinical studies; Behavior modification; Binge eating; binge eating disorder; binging; Biological and medical sciences; Body mass index; Body weight; body weight changes; Bulimia; Cardiovascular disease; Diabetes; Eating behavior; Eating behavior disorders; Eating disorders; females; health status; Hypertension; Medical sciences; mental health; Metabolic diseases; Miscellaneous; Obesity; Overweight; pain; patients; Perceptions; Psychology. Psychoanalysis. Psychiatry; Psychopathology. Psychiatry; Quality of life; Questionnaires; therapeutics; Weight control; weight loss
• ISSN: 0307-0565; 1476-5497
• DOI: 10.1038/sj.ijo.0802073

OBJECTIVE: To measure the effects of cognitive-behavioural therapy on health-related quality of life (HRQL) in obese patients, in relation to binge eating disorder. DESIGN: Longitudinal, clinical intervention study consisting of structured sessions of cognitive-behavioural therapy, preceded by sessions chaired by a psychologist in subjects with binge eating. SUBJECTS: Two groups of obese patients (92 treated by cognitive-behavioural therapy (77 females); 76 untreated controls (67 female), selected from the waiting list (control group)). Of 92 treated patients, 46 had a binge eating disorder at psychometric testing and structured clinical interview. MEASUREMENTS: Health-related quality of life by means of Short-Form 36 questionnaire at baseline and after 3-5 months. RESULTS: Cognitive-behavioural treatment produced an average weight loss of 9.4±7.5 kg, corresponding to a BMI reduction of 3.48±2.70 kg/m2. No changes were observed in the control group. All scales of HRQL improved in treated subjects (by 5-19%). In obese subjects with binge eating weight loss was lower in comparison to non-bingers (7.7±8.1 vs 11.1±6.6; P=0.034). However, the improvement in HRQL was on average larger, and significantly so for Role Limitation -- Physical (P=0.006), Role Limitation -- Emotional (P=0.002), Vitality (P=0.003), Mental Health (P=0.032) and Social Functioning (P=0.034). Bodily Pain was the sole scale whose changes paralleled changes in body weight. CONCLUSIONS: The positive effects of cognitive-behavioural therapy, mainly in subjects with binge eating, largely outweigh the effects on body weight, resulting in a significant change in self-perceived health status.