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Int J Eat Disord. 2018 Aug;51(8):999-1004. doi: 10.1002/eat.22920. Epub 2018 Jul 26.

A randomized controlled trial of the compuLsive Exercise Activity TheraPy (LEAP): A new approach to compulsive exercise in anorexia nervosa.

Author information

1
Discipline of Mental Health, Translational Health Research Institute (THRI), School of Medicine, Western Sydney University, Campbelltown, Australia.
2
Department of Clinical Psychology, School of Psychology, University of Sydney, Sydney, Australia.
3
Faculty of Medicine & Health Sciences, Institute of Mental Health, University of Nottingham, Nottingham, United Kingdom.
4
Department of Psychiatry, Leicestershire Adult Eating Disorders Service, Leicestershire Partnership NHS Trust, Bennion Centre, Glenfield Hospital, Leicester, United Kingdom.
5
Division of Behavioral Health Services and Policy Research, Columbia University, New York, New York.
6
Department of Psychiatry, College of Physicians and Surgeons of Columbia University, New York, New York.
7
Neuropsychiatric Research Institute, Fargo, University of North Dakota School of Medicine and Health Sciences, Fargo, North Dakota.
8
Department of Psychiatry, Eating Disorders Service at the Sydney Children's Hospitals Network, Sydney, Australia.
9
Jeffery & Ree Clinical Psychologists, Subiaco, Perth Australia.
10
Discipline of Behavioural Psychology, WMG and Warwick Medical School, University of Warwick, Coventry, United Kingdom.
11
Discipline of Psychology, University Hospitals Coventry and Warwickshire NHS Trust, Coventry, United Kingdom.

Abstract

OBJECTIVE:

To compare the efficacy of the compuLsive Exercise Activity theraPy (LEAP) programme integrated with manualized cognitive behavioral therapy for anorexia nervosa (CBT-AN) compared to CBT-AN alone.

METHOD:

Seventy-eight adults were randomized to CBT-AN, delivered with or without eight embedded sessions of LEAP, for a total of 34 individual outpatient sessions. Participants were assessed at baseline, the end of the first phase of CBT-AN (which included LEAP), mid-therapy, end of therapy, and at 3 and 6 months follow-up. Linear mixed effects modelling was used for comparing trajectories over time by group in primary outcomes of pathological exercise cognitions and secondary outcomes of exercise frequency, BMI, eating disorder (ED) symptoms, AN stage of change, anxiety/depression, and health related quality of life.

RESULTS:

There were significant improvements over time in all outcomes. There were no significant differences between treatment groups in primary outcome measures. Fidelity and end-of-treatment participant satisfaction were satisfactory across both conditions.

DISCUSSION:

CBT-AN and LEAP added to CBT-AN resulted in improved attitudes and beliefs toward exercise and general improvements in BMI and ED psychopathology in people with AN.

KEYWORDS:

anorexia nervosa; cognitive-behavioral; double-blinded; driven exercise; psychotherapy; therapy

PMID:
30051623
DOI:
10.1002/eat.22920
[Indexed for MEDLINE]

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