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. 2021 Oct 28;64(1):e67.
doi: 10.1192/j.eurpsy.2021.2242.

Mindfulness-based cognitive therapy added to usual care improves eating behaviors in patients with bulimia nervosa and binge eating disorder by decreasing the cognitive load of words related to body shape, weight, and food

L Sala  1 , P Gorwood  1   2 , C Vindreau  1 , P Duriez  1   2
Affiliations

Mindfulness-based cognitive therapy added to usual care improves eating behaviors in patients with bulimia nervosa and binge eating disorder by decreasing the cognitive load of words related to body shape, weight, and food

L Sala et al. Eur Psychiatry. .

Abstract

Background: This study aimed to investigate the effectiveness of mindfulness-based cognitive therapy (MBCT) as a complementary approach in patients with bulimia nervosa (BN) or binge eating disorder (BED), and to assess how the reduction of the cognitive load of words related to eating disorders (ED) could constitute an intermediate factor explaining its global efficacy.

Methods: Eighty-eight women and men participated in clinical assessments upon inscription, prior to and following 8-week group MBCT. Mindfulness skills were assessed using the five facet mindfulness questionnaire; eating behaviors were assessed using the Three Factor Eating Questionnaire (TFEQ); comorbid pathologies were assessed using the beck depression index and the state-trait anxiety inventory. The cognitive load of words associated with ED was assessed through a modified version of the Stroop color naming task.

Results: Mindfulness skills improved significantly (p < .05) after group MBCT. The improvement of TFEQ scores was accompanied by reduced levels of depressive mood and trait anxiety. The positive impact of MBCT on TFEQ score was directly related to an improvement of the performance in the Stroop task.

Conclusions: MBCT represents an interesting complementary therapy for patients with either BN or BED, at least when cognitive and behavioral domains are concerned. Such efficacy seems to be mediated by the reduction of the cognitive load associated with ED stimuli, which offers a possible explanation of how MBCT could reduce binge-eating behaviors. Other studies are needed, in independent centers, to focus more directly on core symptoms and long-term outcome.

Keywords: binge eating disorder; bulimia nervosa; eating disorders; mindfulness-based cognitive therapy.

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Figures

Figure 1.
Figure 1.
Path analysis of the impact of the “waiting list” on “TFEQ” score, directly, and through its impact on the “Stroop ED” test (for words related to eating disorders). Changes for both TFEQ score and performance in the emotional Stroop task associated with the waiting list correspond to the difference between timepoints T0 and T1. Bold arrows indicate significant paths (p<.05). There was no direct effect of the waiting list neither on the TFEQ score nor on emotional Stroop performance for ED-related words. ED symptoms improvement was significantly predicted by emotional Stroop performance.
Figure 2.
Figure 2.
Path analysis of the impact of the mindfulness-based cognitive therapy (“MBCT”) on “TFEQ” score, directly, and through its impact on the “Stroop ED” test (for words related to eating disorders). Changes for both TFEQ score and performance in the emotional Stroop task associated with MBCT correspond to the difference between timepoints T1 and T2. Bold arrows indicate significant paths (p<.05). There was no direct effect of MBCT on the TFEQ score but a strong effect on emotional Stroop performance for ED-related words. ED symptoms improvement was significantly predicted by emotional Stroop performance.
See this image and copyright information in PMC

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