The effects of cognitive-behavioral therapy for eating disorders on quality of life : A meta-analysis

Journal article

Linardon, Jake and Brennan, Leah. (2017). The effects of cognitive-behavioral therapy for eating disorders on quality of life : A meta-analysis. International Journal of Eating Disorders. 50(7), pp. 715-730. https://doi.org/10.1002/eat.22719
AuthorsLinardon, Jake and Brennan, Leah
Abstract

Objective
Meta‐analyses have documented the efficacy of cognitive‐behavioral therapy (CBT) for reducing symptoms of eating disorders. However, it is not known whether CBT for eating disorders can also improve quality of life (QoL). This meta‐analysis therefore examined the effects of CBT for eating disorders on subjective QoL and health‐related quality of life (QoL).

Method
Studies that assessed QoL before and after CBT for eating disorders were searched in the PsycInfo and Medline database. Thirty‐four articles met inclusion criteria. Pooled within and between‐groups Hedge's g were calculated at post‐treatment and follow‐up for treatment changes on both subjective and HRQoL using a random effects model.

Results
CBT led to significant and modest improvements in subjective QoL and HRQoL from pre to post‐treatment and follow‐up. CBT led to greater subjective QoL improvements than inactive (i.e., wait‐list) and active (i.e., a combination of bona fide therapies, psychoeducation) comparisons. CBT also led to greater HRQoL improvements than inactive, but not active, comparisons. Prepost QoL improvements were larger in studies that delivered CBT individually and by a therapist or according to the cognitive maintenance model of eating disorders (CBT‐BN or CBT‐E); though this was not replicated at follow‐up

Conclusions
Findings provide preliminary evidence that CBT for eating disorders is associated with modest improvements in QOL, and that CBT may be associated with greater improvements in QOL relative to comparison conditions.

Keywordscognitive‐behavioral therapy; eating disorders; quality of life
Year2017
JournalInternational Journal of Eating Disorders
Journal citation50 (7), pp. 715-730
PublisherJohn Wiley & Sons
ISSN0276-3478
Digital Object Identifier (DOI)https://doi.org/10.1002/eat.22719
Scopus EID2-s2.0-85018661186
Open accessPublished as green open access
Research or scholarlyResearch
Page range715-730
Research GroupCentre for Health and Social Research
Author's accepted manuscript
File Access Level
Open
Publisher's version
License
All rights reserved
File Access Level
Controlled
Place of publicationUnited States of America
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Willcox, Kim and Brennan, Leah. (2014). Biopsychosocial outcomes of laparoscopic adjustable gastric banding in adolescents: A systematic review of the literature. Obesity Surgery. 24(9), pp. 1510 - 1519. https://doi.org/10.1007/s11695-014-1273-3
A cluster randomised controlled trial of a telephone-based intervention targeting the home food environment of preschoolers (The Healthy Habits Trial) : The effect on parent fruit and vegetable consumption
Wyse, Rebecca, Brennan, Leah, Wolfenden, Luke and Campbell, Karen. (2014). A cluster randomised controlled trial of a telephone-based intervention targeting the home food environment of preschoolers (The Healthy Habits Trial) : The effect on parent fruit and vegetable consumption. International Journal of Behavioral Nutrition and Physical Activity. 11(144), pp. 1 - 9. https://doi.org/10.1186/s12966-014-0144-6
Biopsychosocial outcomes of laparoscopic adjustable gastric banding in adolescents: A systematic review of the literature
Willcox, Kim and Brennan, Leah. (2014). Biopsychosocial outcomes of laparoscopic adjustable gastric banding in adolescents: A systematic review of the literature. Obesity Surgery. 24(9), pp. 1510 - 1519. https://doi.org/10.1007/s11695-014-1273-3
Physiological and behavioural outcomes of a randomised controlled trial of a cognitive behavioural lifestyle intervention for overweight and obese adolescents
Brennan, Leah, Walkley, Jeff, Wilks, Ray, Fraser, Steve and Greenway, Kate. (2013). Physiological and behavioural outcomes of a randomised controlled trial of a cognitive behavioural lifestyle intervention for overweight and obese adolescents. Obesity Research and Clinical Practice. https://doi.org/10.1016/j.orcp.2012.02.010
Psychosocial predictors of 4 year BMI change in overweight and obese children in primary care
Incledon, Emily, Gerner, Bibi, Hay, Margaret, Brennan, Leah and Wake, Melissa. (2013). Psychosocial predictors of 4 year BMI change in overweight and obese children in primary care. Obesity: a resourch journal. https://doi.org/10.1002/oby.20050
Long-term outcomes after bariatric surgery : fifteen-year follow-up of adjustable gastric banding and a systematic review of the bariatric surgical literature
O'Brien, Paul Edmond, MacDonald, Leah, Anderson, Margaret, Brennan, Leah and Brown, Wendy. (2013). Long-term outcomes after bariatric surgery : fifteen-year follow-up of adjustable gastric banding and a systematic review of the bariatric surgical literature. Annals Of Surgery. https://doi.org/10.1056/JC200502110000004
Evaluation of the Recovery Is Possible for Everyone transdiagnostic treatment and support program for adults with eating disorders
Harry, Sarah, Sutherland, Fiona, McCarthy, Bree, Richards, Karen and Brennan, Leah. (2013). Evaluation of the Recovery Is Possible for Everyone transdiagnostic treatment and support program for adults with eating disorders. Journal of Eating Disorders. 1(1). https://doi.org/10.1186/2050-2974-1-S1-O2
Pre-operative weight loss does not predict weight loss following laparoscopic adjustable gastric banding
Brown, Wendy, Moszkowicz, Julia, Brennan, Leah, Burton, Paul, Anderson, Margaret and O'Brien, Paul Edmond. (2013). Pre-operative weight loss does not predict weight loss following laparoscopic adjustable gastric banding. Obesity Surgery. https://doi.org/10.1007/s11695-013-0974-3
Psychosocial outcomes of a non-dieting based positive body image community program for overweight adults : A pilot study
Bloom, Lisa, Shelton, Beth, Bengough, Melissa and Brennan, Leah. (2013). Psychosocial outcomes of a non-dieting based positive body image community program for overweight adults : A pilot study. Journal of Eating Disorders. https://doi.org/10.1186/2050-2974-1-44
Intensive medical weight loss or laparoscopic adjustable gastric banding in the treatment of mild to moderate obesity : long-term follow-up of a prospective randomised trial
O'Brien, Paul Edmond, Brennan, Leah, Laurie, Cheryl and Brown, Wendy. (2013). Intensive medical weight loss or laparoscopic adjustable gastric banding in the treatment of mild to moderate obesity : long-term follow-up of a prospective randomised trial. Obesity Surgery. https://doi.org/10.1007/s11695-013-0990-3
Pre-operative weight loss does not predict weight loss following laparoscopic adjustable gastric banding
Brown, Wendy, Moszkowicz, Julia, Brennan, Leah, Burton, Paul, Anderson, Margaret and O'Brien, Paul Edmond. (2013). Pre-operative weight loss does not predict weight loss following laparoscopic adjustable gastric banding. Obesity Surgery. https://doi.org/10.1007/s11695-013-0974-3
A systematic review of variables associated with the relationship between obesity and depression
Preiss, K, Brennan, Leah and Clarke, David. (2013). A systematic review of variables associated with the relationship between obesity and depression. Obesity Reviews. https://doi.org/10.1111/obr.12052
Defining disordered eating trajectories across adolescence and assessing their impact on psychosocial outcomes using growth mixture modelling
Mitchell, Sarah A., Brennan, Leah, Krug, Isabel and Allen, Nicholas B.. (2013). Defining disordered eating trajectories across adolescence and assessing their impact on psychosocial outcomes using growth mixture modelling. https://doi.org/10.1186/2050-2974-1-S1-O65
Maternal controlling feeding behaviours and child eating in preschool-aged children
Moroshko, Irina and Brennan, Leah. (2013). Maternal controlling feeding behaviours and child eating in preschool-aged children. Nutrition and Dietetics. https://doi.org/10.1111/j.1747-0080.2012.01631.x
Intensive medical weight loss or laparoscopic adjustable gastric banding in the treatment of mild to moderate obesity : long-term follow-up of a prospective randomised trial
O'Brien, Paul Edmond, Brennan, Leah, Laurie, Cheryl and Brown, Wendy. (2013). Intensive medical weight loss or laparoscopic adjustable gastric banding in the treatment of mild to moderate obesity : long-term follow-up of a prospective randomised trial. Obesity Surgery. https://doi.org/10.1007/s11695-013-0990-3
Physiological and behavioural outcomes of a randomised controlled trial of a cognitive behavioural lifestyle intervention for overweight and obese adolescents
Brennan, Leah, Walkley, Jeff, Wilks, Ray, Fraser, Steve and Greenway, Kate. (2013). Physiological and behavioural outcomes of a randomised controlled trial of a cognitive behavioural lifestyle intervention for overweight and obese adolescents. Obesity Research and Clinical Practice. https://doi.org/10.1016/j.orcp.2012.02.010
A cluster randomised controlled trial of a telephone-based parent intervention to increase preschoolers' fruit and vegetable consumption
Wyse, Rebecca, Wolfenden, Luke, Campbell, Elizabeth, Campbell, Karen, Wiggers, John, Brennan, Leah, Fletcher, Amanda, Bowman, Jenny and Heard, Todd. (2012). A cluster randomised controlled trial of a telephone-based parent intervention to increase preschoolers' fruit and vegetable consumption. American Journal of Clinical Nutrition: A journal reporting the practical application of our world-wide knowledge of nutrition. 96(1), pp. 102 - 110. https://doi.org/10.3945/ajcn.111.030585
Predictors of attrition in bariatric aftercare : a systematic review of the literature
Moroshko, Irina, Brennan, Leah and O'Brien, Paul. (2012). Predictors of attrition in bariatric aftercare : a systematic review of the literature. Obesity Surgery. 22(10), pp. 1640 - 1647. https://doi.org/10.1007/s11695-012-0691-3
Promoting protective factors for young adolescents : ABCD Parenting Young Adolescents Program randomised controlled trial
Burke, Kylie, Brennan, Leah and Cann, Warren. (2012). Promoting protective factors for young adolescents : ABCD Parenting Young Adolescents Program randomised controlled trial. Journal of Adolescence. 35(5), pp. 1315 - 1328. https://doi.org/10.1016/j.adolescence.2012.05.002
Parenting styles, communication and child/adolescent diets andweight status : let's talk about it
Parletta, Natalie, Peters, Jacqueline, Owen, Amber, Tsiros, Margarita and Brennan, Leah. (2012). Parenting styles, communication and child/adolescent diets andweight status : let's talk about it. Early Child Development and Care. 182(8), pp. 1089 - 1103. https://doi.org/10.1080/03004430.2012.678597
Does exercise improve weight loss after bariatric surgery? : A systematic review
Egberts, Kristine, Brown, Wendy, Brennan, Leah and O'Brien, Paul. (2012). Does exercise improve weight loss after bariatric surgery? : A systematic review. Obesity Surgery. 22(2), pp. 335 - 341. https://doi.org/10.1007/s11695-011-0544-5
Treatment acceptability and psychosocial outcomes of a randomised controlled trial of a cognitive behavioural lifestyle intervention for overweight and obese adolescents
Brennan, Leah, Wilks, Ray, Walkley, Jeff, Fraser, Steve and Greenway, Kate. (2012). Treatment acceptability and psychosocial outcomes of a randomised controlled trial of a cognitive behavioural lifestyle intervention for overweight and obese adolescents. Behaviour Change. 29(1), pp. 36 - 62. https://doi.org/10.1017/bec.2012.5
Parent- and adolescent-reported barriers to participation in an adolescent overweight and obesity intervention
Brennan, Leah, Walkley, Jeff and Wilks, Ray. (2012). Parent- and adolescent-reported barriers to participation in an adolescent overweight and obesity intervention. Obesity: a resourch journal. 20(6), pp. 1319 - 1324. https://doi.org/10.1038/oby.2011.358
Validity of the beck depression inventory as a screening tool for a clinical mood disorder in bariatric surgery candidates
Hayden, Melissa J., Brown, Wendy A., Brennan, Leah and O'Brien, Paul Edmond. (2012). Validity of the beck depression inventory as a screening tool for a clinical mood disorder in bariatric surgery candidates. Obesity Surgery. 22(11), pp. 1666 - 1675. https://doi.org/10.1007/s11695-012-0682-4
In people with poorly controlled type 2 diabetes, cognitive behaviour therapy combined with motivational enhancement therapy reduces HbA1c after 12 months
Brennan, Leah. (2011). In people with poorly controlled type 2 diabetes, cognitive behaviour therapy combined with motivational enhancement therapy reduces HbA1c after 12 months. Worldviews on Evidence-Based Nursing. 14(3), pp. 72 - 73. https://doi.org/10.1136/ebn1164
In people with poorly controlled type 2 diabetes, cognitive behaviour therapy combined with motivational enhancement therapy reduces HbA1c after 12 months
Brennan, Leah. (2011). In people with poorly controlled type 2 diabetes, cognitive behaviour therapy combined with motivational enhancement therapy reduces HbA1c after 12 months. Worldviews on Evidence-Based Nursing. 14(3), pp. 72 - 73. https://doi.org/10.1136/ebn1164
Predictors of dropout in weight loss interventions :a systematic review of the literature
Moroshko, Irina, Brennan, Leah and O'Brien, Paul Edmond. (2011). Predictors of dropout in weight loss interventions :a systematic review of the literature. Obesity Reviews. 12(11), pp. 912 - 934. https://doi.org/10.1111/j.1467-789X.2011.00915.x
Primary Goals for Weight Loss Questionnaire (PGWLQ) :Development and Psychometric Evaluation in Overweight and Obese Adults
Murphy, Kylie, Brennan, Leah, Walkley, Jeff, Reece, John and Little, Emma. (2011). Primary Goals for Weight Loss Questionnaire (PGWLQ) :Development and Psychometric Evaluation in Overweight and Obese Adults. Behaviour Change. 28(1), pp. 29 - 43. https://doi.org/10.1375/bech.28.1.29
Self-Monitoring in the Treatment of Overweight Adolescents
Sandilands, Mary, Brennan, Leah, Walkley, Jeff, Fraser, Steve and Greenway, Kate. (2011). Self-Monitoring in the Treatment of Overweight Adolescents. Behaviour Change. 28(2), pp. 97 - 109. https://doi.org/10.1375/bech.28.2.97
Predicting treatment initiation in a family-based adolescent overweight and obesity intervention
Dhingra, Akshay, Brennan, Leah and Walkley, Jeff. (2011). Predicting treatment initiation in a family-based adolescent overweight and obesity intervention. Obesity: a resourch journal. 19(6), pp. 1307 - 1310. https://doi.org/10.1038/oby.2010.289
Psychosocial predictors of eating disorder risk in overweight and obese treatment seeking adolescents
Russo, Jade, Brennan, Leah, Walkley, Jeff, Fraser, Steve and Greenway, Kate. (2011). Psychosocial predictors of eating disorder risk in overweight and obese treatment seeking adolescents. Behaviour Change. 28(3), pp. 111 - 127. https://doi.org/10.1375/bech.28.3.111
A pilot study of a telephone-based parental intervention to increase fruit and vegetable consumption in 3 to 5 year old children
Wyse, Rebecca, Wolfenden, Luke, Campbell, Elizabeth, Campbell, Karen, Brennan, Leah, Fletcher, Amanda, Bowman, Jenny, Heard, Todd and Wiggers, John. (2011). A pilot study of a telephone-based parental intervention to increase fruit and vegetable consumption in 3 to 5 year old children. Public Health Nutrition. 14(12), pp. 2245 - 2253. https://doi.org/10.1017/S1368980011001170
Reliability of the school food checklist for in-school audits and photograph analysis of children's school lunches
Mitchell, Sarah, Miles, Cara, Brennan, Leah and Matthews, Jan. (2010). Reliability of the school food checklist for in-school audits and photograph analysis of children's school lunches. Journal of Human Nutrition and Dietetics. 23(1), pp. 48 - 53. https://doi.org/10.1111/j.1365-277X.2009.00996.x
A randomised controlled trial of the efficacy of the ABCD Parenting Young Adolescents Program : rationale and methodology
Burke, Kylie, Brennan, Leah and Roney, Sarah. (2010). A randomised controlled trial of the efficacy of the ABCD Parenting Young Adolescents Program : rationale and methodology. Child and Adolescent Psychiatry and Mental Health. 4(22), pp. 1 - 14. https://doi.org/10.1186/1753-2000-4-22
Parental use of restrictive feeding practices and child BMI z-score. A 3-year prospective cohort study
Campbell, Karen, Andrianopoulos, Nick, Hesketh, Kylie, Ball, Kylie, Crawford, David, Brennan, Leah, Corsini, Nadia and Timperio, Anna. (2010). Parental use of restrictive feeding practices and child BMI z-score. A 3-year prospective cohort study. Appetite. 55(1), pp. 84 - 88. https://doi.org/10.1016/j.appet.2010.04.006
A cluster randomised trial of a telephone-based intervention for parents to increase fruit and vegetable consumption in their 3- to 5-year-old children: Study protocol
Wyse, Rebecca, Wolfenden, Luke, Campbell, Elizabeth, Brennan, Leah, Campbell, Karen, Fletcher, Amanda, Bowman, Jenny, Heard, Todd and Wiggers, John. (2010). A cluster randomised trial of a telephone-based intervention for parents to increase fruit and vegetable consumption in their 3- to 5-year-old children: Study protocol. BMC Public Health. 10(216), pp. 1 - 12. https://doi.org/10.1186/1471-2458-10-216
Adolescent and parent content preferences and predictors of intention to use an online healthy weight website for adolescents
Baulch, Jacqueline, Chester, Andrea and Brennan, Leah. (2010). Adolescent and parent content preferences and predictors of intention to use an online healthy weight website for adolescents. E - Journal of Applied Psychology. 6(1), pp. 19 - 26. https://doi.org/10.7790/ejap.v6i1.173
Changes in the content of children's school lunches across the school week
Brennan, Leah, Miles, Cara, Mitchell, Sarah and Matthews, Jan. (2010). Changes in the content of children's school lunches across the school week. Health Promotion Journal of Australia. 21(3), pp. 196 - 201.
Maternal psychosocial predictors of controlling parental feeding styles and practices
Mitchell, Sarah, Brennan, Leah, Hayes, Louise and Miles, Cara L.. (2009). Maternal psychosocial predictors of controlling parental feeding styles and practices. Appetite. 53(3), pp. 384 - 389. https://doi.org/10.1016/j.appet.2009.08.001
Health-related quality of life in obese children and adolescents
Tsiros, Margarita D., Olds, Timothy S., Buckley, Jonathan David, Grimshaw, Paul, Brennan, Leah, Walkley, Jeff, Hills, Andrew Peter, Howe, Peter and Coates, Alison M.. (2009). Health-related quality of life in obese children and adolescents. International Journal of Obesity. 33(4), pp. 387 - 400. https://doi.org/10.1038/ijo.2009.42
A cognitive behavioural intervention for overweight and obese adolescents illustrated by four case studies
Brennan, Leah, Walkley, Jeff, Lukeis, Sarah, Risteska, Anica, Archer, Lisa, Digre, Ellen, Fraser, Steve F. and Greenway, Kate. (2009). A cognitive behavioural intervention for overweight and obese adolescents illustrated by four case studies. Behaviour Change. 26(3), pp. 190 - 213. https://doi.org/10.1375/bech.26.3.190
Treatment alternatives for overweight and obesity: The role of online interventions
Baulch, Jacqueline, Chester, Andrea and Brennan, Leah. (2008). Treatment alternatives for overweight and obesity: The role of online interventions. Behaviour Change. 25(1), pp. 1 - 14. https://doi.org/10.1375/bech.25.1.1
Motivational interviewing and cognitive behaviour therapy in the treatment of adolescent overweight and obesity: Study design and methodology
Brennan, Leah, Walkley, Jeff, Fraser, Steve F., Greenway, Kate and Wilks, Ray. (2008). Motivational interviewing and cognitive behaviour therapy in the treatment of adolescent overweight and obesity: Study design and methodology. Contemporary Clinical Trials. 29(3), pp. 359 - 375. https://doi.org/10.1016/j.cct.2007.09.001
Cognitive behavioural therapy improves diet and body composition in overweight and obese adolescents
Tsiros, Margarita D., Parletta, Natalie, Brennan, Leah, Coates, Alison M., Walkley, Jeff, Petkov, John, Howe, Peter, David and Buckley, Jonathan David. (2008). Cognitive behavioural therapy improves diet and body composition in overweight and obese adolescents. American Journal of Clinical Nutrition. 87(5), pp. 1134 - 1140.