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

Lauren B. Shomaker, Marian Tanofsky-Kraff, Camden E. Matherne, Rim D. Mehari, Cara H. Olsen, Shannon E. Marwitz, Jennifer L. Bakalar, Lisa M. Ranzenhofer, Nichole R. Kelly, Natasha A. Schvey, Natasha L. Burke, Omni Cassidy, Sheila M. Brady, Laura J. Dietz, Denise E. Wilfley, Susan Z. Yanovski, Jack A. Yanovski

Research output: Contribution to journalArticlepeer-review

14 Scopus citations

Abstract

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.

Original languageEnglish
Pages (from-to)1084-1094
Number of pages11
JournalInternational Journal of Eating Disorders
Volume50
Issue number9
DOIs
StatePublished - Sep 2017

Keywords

  • interpersonal psychotherapy
  • loss-of-control eating
  • obesity
  • overweight
  • preadolescents

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