Hostname: page-component-78c5997874-t5tsf Total loading time: 0 Render date: 2024-11-10T19:18:59.523Z Has data issue: false hasContentIssue false

Effectiveness of Rhythmic Movement Therapy for Disordered Eating Behaviors and Obesity

Published online by Cambridge University Press:  10 January 2013

Irina G. Malkina-Pykh*
Affiliation:
Russian Academy of Sciences (Russia)
*
Correspondence concerning this article should be addressed to Irina G. Malkina-Pykh. Research Center for Interdisciplinary Environmental Cooperation, Russian Academy of Sciences (INENCO RAS). St-Petersburg, 191187, nab. Kutuzova, 14 (Russia). E-mail: malkina@mail.admiral.ru

Abstract

The aims of the present study were: a) to examine associations between pre-treatment BMI, body dissatisfaction, perfectionism, alexithymia, and restraint, emotional and external eating behaviour in obese patients; b) to analyze the impact of the pre-treatment measures in psychological variables on the outcome of cognitive-behavioral therapy (CBT) program; c) to test the effectiveness of rhythmic movement therapy (RMT) in the treatment of disordered eating behaviors and obesity with the CBT non-responders. At the first stage of treatment a total of 104 patients (32 males and 72 females, mean age was 37.6±6.7 years) self-referred or referred by professionals to CBT weight management program were selected at random. At the second stage 58 obese CBT-non-responders were randomly divided among the continuing CBT individual treatment group and RMT group. Control group was included. Results revealed that: a) significant associations existed between pre-treatment BMI, external eating and two dimensions of perfectionism, as well as between emotional and external eating and all dimensions of perfectionism, alexithymia and body image dissatisfaction; b) pre-treatment means of psychological variables significantly impacted the CBT program outcome; c). the efficacy of RMT approach for weight reduction as well as for the improvement of psychological status for CBT-non-responders was confirmed.

El estudio plantea: a) examinar relaciones entre IMC pretratamiento e insatisfacción corporal, perfeccionismo, alexitimia, y restricciones; así como patrones de conducta alimentaria emocional y externa en pacientes obesos; b) analizar la influencia de las medidas pretratamiento sobre estas variables psicológicas después de una terapia cognitivo-conductual (TCC); c) probar la eficacia de la terapia de movimientos rítmicos (TMR) en el tratamiento de los desórdenes de conducta alimentaria y obesidad con los participantes que no respondían a la TCC. En la primera fase del tratamiento, participaron 104 pacientes escogidas al azar (32 hombres y 72 mujeres, con una media de edad de 37, 6 ± 6.7 años) autodiagnosticadas o derivadas por profesionales a TCC en un programa de manejo del peso. En la segunda fase, 58 participantes obsesos que no habían respondido a TCC, fueron divididos en dos grupos, unos siguieron TCC individual y otros TMR. Los resultados indicaron: a) relaciones significativas entre el IMC pretratamiento, alimentación externa y dos dimensiones de perfeccionismo, así como entre la conducta alimentaria externa e interna y todas las dimensiones de perfeccionismo, alexitimia e insatisfacción con la imagen corporal; b) modificación significativa de las consecuencias de la TCC en función de las variables psicológicas pretratamiento; c) confirmación de la eficacia de la TMR tanto en la reducción de peso como en la mejora del estado psicológico de los participantes que no respondían a TCC.

Type
Research Article
Copyright
Copyright © Cambridge University Press 2012

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

American Psichiatric Association (1994). American Psychiatric Association: Diagnostic and Statistical Manual of Mental Disorders: DSM- IV. Washington, DC: American Psichiatric Association.Google Scholar
Baer, R. A., Fischer, S., & Huss, D. B. (2005). Mindfulness and acceptance in the treatment of disordered eating. Journal of Rational-Emotive & Cognitive-Behavior Therapy, 23, 281299. http://dx.doi.org/10.1007/s10942-005-0015-9CrossRefGoogle Scholar
Bardone-Cone, A. M., Wonderlich, S. A., Frost, R. O., Bulik, C. M., Mitchell, J. E., Uppala, S., & Simonichal, H. (2007). Perfectionism and eating disorders: Current status and future directions. Clinical Psychology Review, 27, 384405. http://dx.doi.org/10.1016/j.cpr.2006.12.005CrossRefGoogle ScholarPubMed
Bardone-Cone, A. M., Sturm, K., Lawson, M. A., Robinson, P., & Smith, R. (2010). Perfectionism across stages of recovery from eating disorders. International Journal of Eating Disorders, 43, 139148. http://dx.doi.org/10.1002/eat.20674CrossRefGoogle ScholarPubMed
Brownell, K. D. (2000). The LEAR program for weight management 2000. Dallas, TX: American Health Publishers Co.Google Scholar
Bruch, H. (1973). Eating disorders: Obesity, anorexia nervosa, and the person within. New York, NY: Basic Books.Google Scholar
Byrne, S. M. (2002). Psychological aspects of weight maintenance and relapse in obesity. Journal of Psychosomatic Research, 53, 10291036. http://dx.doi.org/10.1016/S0022-3999(02)00487-7CrossRefGoogle ScholarPubMed
Byrne, S. M., Cooper, Z., & Fairburn, C. G. (2004). Psychological predictors of weight regain in obesity. Behaviour Research and Therapy, 42, 13411356. http://dx.doi.org/10.1016/j.brat.2003.09.004CrossRefGoogle ScholarPubMed
Carano, A., Berardis, D. De, Gambi, F., Paolo, C. D., Campanella, D., Pelusi, L., … Ferroet, F. M. (2006). Alexithymia and body image in adult outpatients with binge eating disorder. International Journal of Eating Disorders, 39, 332340. http://dx.doi.org/10.1002/eat.20238CrossRefGoogle ScholarPubMed
Cash, T. F., & Pruzinsky, T. (Eds). (2002). Body image: a handbook of theory, research and clinical practice. New York, NY: Guilford Publications.Google Scholar
Chodorow, J. (1991). Dance therapy and depth psychology. The moving imagination. London-New-York, Routledge.Google Scholar
Clerici, M., Albonetti, S., Papa, R., Penati, G., & Invernizzi, G. (1992). Alexithymia and obesity. Study of the impaired symbolic function by the Rorschach test. Psychotherapy and Psychosomatics, 57, 8893. http://dx.doi.org/10.1159/000288580CrossRefGoogle ScholarPubMed
Cohen, J. (1988). Statistical power analysis for the behavioral sciences (2nd Ed.). Hillsdale, NJ: Erlbaum.Google Scholar
Cooper, Z., & Fairburn, C. G. (2001). A new cognitive behavioral approach to the treatment of obesity. Behaviour Research and Therapy, 39, 499511. http://dx.doi.org/10.1016/S0005-7967(00)00065-6CrossRefGoogle Scholar
Daubenmier, J. J. (2005). The relationship of Yoga, body awareness, and body responsiveness to self-objectification and disordered eating. Psychology of Women Quarterly, 29, 207219. http://dx.doi.org/10.1111/j.1471-6402.2005.00183.xCrossRefGoogle Scholar
Davis, C. (1997). Normal and neurotic perfectionism in eating disorders: An interactive model. International Journal of Eating Disorders, 22, 421426. http://dx.doi.org/10.1002/(SICI)1098-108X(199712)22:4<421::AID-EAT7>3.0.CO;2-O3.0.CO;2-O>CrossRefGoogle ScholarPubMed
de Berardis, D., Carano, A., Gambi, F., Campanella, D., Giannetti, P., Ceci, A., … Ferro, F. M. (2007). Alexithymia and its relationships with body checking and body image in a nonclinical female sample. Eating Behaviors, 8, 296304. http://dx.doi.org/10.1016/j.eatbeh.2006.11.005CrossRefGoogle Scholar
De Panfilis, C., Cero, S., Dall'Aglio, E., Salvatore, P., Torre, M., & Maggini, C. (2007). Psychopathological predictors of compliance and outcome in weight-loss obesity treatment. Acta Bio Medica, 78, 2228.Google ScholarPubMed
De Panfilis, C., Rabbaglio, P., Rossi, C., Zita, G., & Maggini, C. (2003). Body image disturbance, parental bonding and alexithymia in patients with eating disorders. Psychopathology, 36, 239246. http://dx.doi.org/10.1159/000073449CrossRefGoogle ScholarPubMed
de Sousa, P. M. L. (2008). Body-image and obesity in adolescence: A comparative study of social-demographic, psychological, and behavioural aspects. The Spanish Journal of Psychology, 11, 551563.CrossRefGoogle Scholar
de Zwaan, M., Bach, M., Mitchell, J. E., Ackard, D., Specker, S. M., Pyle, R. L., & Pakesch, G. (1995). Alexithymia, obesity, and binge eating disorder. International Journal of Eating Disorders, 17, 135140. http://dx.doi.org/10.1002/1098-108X(199503)17:2<135::AID-EAT2260170205>3.0.CO;2-73.0.CO;2-7>CrossRefGoogle ScholarPubMed
Fairburn, C. G. (1997). Interpersonal psychotherapy for bulimia nervosa. In Garner, D. M. & Garfinkel, P. E. (Eds.), Handbook of Treatment for Eating Disorders (2nd Ed., pp. 278294). New York, NY: Guilford.Google Scholar
Fairburn, C. G. (2008). Cognitive behavior therapy and eating disorders. New York, NY: Guilford Press.Google ScholarPubMed
Fairburn, C. G., Cooper, Z., & Shafran, R. (2003). Cognitive behaviour therapy for eating disorders: A ‘transdiagnostic’ theory and treatment. Behaviour Research and Therapy, 41, 509528. http://dx.doi.org/10.1016/S0005-7967(02)00088-8CrossRefGoogle ScholarPubMed
Fairburn, C., & Brownell, K. (Eds). (2003). Eating disorders and obesity: A comprehensive handbook. New York, NY: Guilford press.Google Scholar
Foreyt, J. P., Goodrick, G. K., & Gotto, A. M. (1981). Limitations of behavioral treatment of obesity: Review and analysis. Journal of Behavioral Medicine, 4, 159174. http://dx.doi.org/10.1007/BF00844268CrossRefGoogle Scholar
Foster, G. D., Wadden, T. A., Vogt, R. A., & Brewer, G. (1997). What is a reasonable weight loss? Patients' expectations and evaluations of obesity treatment outcomes. Journal of Consulting and Clinical Psychology, 65, 7985. http://dx.doi.org/10.1037/0022-006X.65.1.79CrossRefGoogle ScholarPubMed
Foster, G. D., Markis, A. P., & Bailer, B. A. (2005). Behavioral treatment of obesity. The American Journal of Clinical Nutrition, 82, 230235.CrossRefGoogle ScholarPubMed
Franko, D. L., & Orosan-Weine, P. (1998). The prevention of eating disorders: Empirical, methodological and conceptual considerations. Clinical Psychology: Science and Practice, 5, 459477. http://dx.doi.org/10.1111/j.1468-2850.1998.tb00167.xGoogle Scholar
Freyberger, H. (1977). Supportive psychotherapeutic techniques in primary and secondary alexithymia. Psychotherapy and Psychosomatics, 28, 337345. http://dx.doi.org/10.1159/000287080CrossRefGoogle ScholarPubMed
Frost, R., Marten, P., Lahart, C., & Rosenblate, R. (1990). The dimensions of perfectionism. Cognitive Therapy and Research, 14, 449468. http://dx.doi.org/10.1007/BF01172967CrossRefGoogle Scholar
Gupta, M., Gupta, A. K., Schork, N. J., & Watteel, G. N. (1995). Perceived touch deprivation and body image: Some observations among eating disordered and non-clinical subjects. Journal of Psychosomatic Research, 39, 459464. http://dx.doi.org/10.1016/0022-3999(94)00146-VCrossRefGoogle ScholarPubMed
Hewitt, P. L., Flett, G. L., & Ediger, E. (1995). Perfectionism traits and perfectionistic self-presentation in eating disorder attitudes, characteristics, and symptoms. International Journal of Eating Disorders, 18, 317326. http://dx.doi.org/10.1002/1098-108X(199512)18:4<317::AID-EAT2260180404>3.0.CO;2-23.0.CO;2-2>CrossRefGoogle ScholarPubMed
Hudson, C. L. F. (2008). The relationship of body image, body mass index and self-esteem to eating attitudes in a normal sample. (Unpublished master's thesis). University of Canterbury, Canterbury.Google Scholar
Hutchinson, M. G. (1985). Transforming body image: Learning to love the body you have. Freedom, CA: The Crossing Press.Google Scholar
Jade, D. (2002). How good is your body image? Retrieved from http://www2.netdoctor.co.uk/testyourself/facts/body_image.asp.Google Scholar
Jeffery, R. W., Wing, R. R., & Mayer, R. R. (1998). Are smaller weight losses or moreachievable weight loss goals better in the long term for obese patients? Journal of Consulting and Clinical Psychology, 66, 641645. http://dx.doi.org/10.1037/0022-006X.66.4.641CrossRefGoogle ScholarPubMed
Kabat-Zinn, J. (1990). Full catastrophe living: Using the wisdom of your body and mind to face stress, pain, and illness. New York, NY: Delacorte.Google Scholar
Kristeller, J. L., & Hallett, C. B. (1999). An exploratory study of a meditationbased intervention for binge eating disorder. Journal of Health Psychology, 4, 357363. http://dx.doi.org/10.1177/135910539900400305CrossRefGoogle ScholarPubMed
Kuller, L. H., Simkin-Silverman, L. R., Wing, R. R., Meilahn., E. N., & Ives, D. G. (2001). Women's Healthy Lifestyle Project: A randomized clinical trial—results at 54 months. Circulation, 103, 3237. http://dx.doi.org/10.1161/01.CIR.103.1.32CrossRefGoogle Scholar
Latner, J. D., Stunkard, A. J., Wilson, G. T., Jackson, M. L., Zelitch, D. S., & Labouvie, E. (2000). Effective long-term treatment of obesity: A continuing care model. International Journal of Obesity, 24, 893898. http://dx.doi.org/10.1038/sj.ijo.0801249CrossRefGoogle ScholarPubMed
Laumer, U., Bauer, M., Fichter, V., & Milz, H. (2004). Therapeutic effects of the Feldenkrais Method (Awareness Through Movement) in eating disorders. Feldenkrais Research Journal, 1, 1727.Google Scholar
Legorreta, G., Bull, R., & Kiely, M. (1988). Alexithymia and symbolic function in the obese. Psychotherapy and Psychosomatics, 50, 8894. http://dx.doi.org/10.1159/000288105CrossRefGoogle ScholarPubMed
Lowen, A. (1975). Bioenergetics. New York, NY: Penguin.Google Scholar
Malkina-Pykh, I. G. (2001). Rhythmic movement psychotherapy. St.-Petersburg, Russia: Center INENCO RAS.Google Scholar
Malkina-Pykh, I. G. (2007). Terapiya pishcevogo povedeniya [Therapy of eating behavior]. Moscow, Russia: EKSMO.Google Scholar
Matz, P. E., Foster, G. D., Faith, M. S., & Wadden, T. A. (2002). Correlates of body image dissatisfaction among overweight women seeking weight loss. Journal of Consulting and Clinical Psychology, 70, 10401044. http://dx.doi.org/10.1037/0022-006X.70.4.1040CrossRefGoogle ScholarPubMed
Mehling, W. T., Wrubell, J., Daubenmier, J. J., Price, C. J., Kerr, K. E., Silow, T., … Stewart, A. L. (2011). Body awareness: A phenomenological inquiry into the common ground of mind-body therapies Philosophy, Ethics, and Humanities in Medicine, 6, 6. http://dx.doi.org/10.1186/1747-5341-6-6CrossRefGoogle ScholarPubMed
Morosin, A., & Riva, G. (1997). Alexithymia in a clinical sample of obese women. Psychological Report, 80, 387394. http://dx.doi.org/10.2466/pr0.1997.80.2.387CrossRefGoogle Scholar
Neumark-Sztainer, D., Levine, M. P., Paxton, S. J., Smolak, L., Piran, N., & Wertheim, E. H. (2006). Prevention of body dissatisfaction and disordered eating: What next? Eating Disorders, 14, 265285. http://dx.doi.org/10.1080/10640260600796184CrossRefGoogle ScholarPubMed
Ogrodniczuk, J. S., Piper, W. E., & Joyce, A. S. (2005). The negative effect of alexithymia on the outcome of group therapy for complicated grief: What role might the therapy play? Comprehensive Psychiatry, 46, 206213. http://dx.doi.org/10.1016/j.comppsych.2004.08.005CrossRefGoogle Scholar
Raney, T. J., Shapiro, J., & Bulik, C. M. (2009). Evidence-based psychotherapies for eating disorders. US Psychiatry Review, 2, 2931.Google Scholar
Rapoport, L., Clark, M., & Wardle, J. (2000). Evaluation of a modified cognitive-behavioral programme for weight management. International Journal of Obesity, 24, 17261737. http://dx.doi.org/10.1038/sj.ijo.0801465CrossRefGoogle Scholar
Reich, W. (1949). Character Analysis, 3rd Ed. New York, NY: Farrar, Straus, and Giroux.Google Scholar
Ricca, V., Mannucci, E., Zucchi, T., Rotella, C. M., & Faravelli, C. (2000). Cognitive-behavioural therapy for bulimia nervosa and binge eating disorder: A review. Psychotherapy and Psychosomatics, 69, 287295. http://dx.doi.org/10.1159/000012410CrossRefGoogle ScholarPubMed
Rosenberger, P. H., Henderson, K. E., & Grilo, K. M. (2006). Correlates of body image dissatisfaction in extremely obese female bariatric surgery candidates. Obesity Surgery, 16, 13311336. http://dx.doi.org/10.1381/096089206778663788CrossRefGoogle ScholarPubMed
Roth, G. (1997). The practice. Sweat your prayers: Movement a spiritual practice. New York, NY: Penguin Putnam Inc.Google Scholar
Sarwer, D. B., & Thompson, J. K. (2002). Obesity and body image disturbance. In Wadden, T. A. & Stunkard, A. J. (Eds.), Handbook of obesity treatment. New York, NY: Gilford Press.Google Scholar
Schilder, P. (1935). Image and appearance of human body. London, England: Kagan, Paul, Trench, Trubner, & Company.Google Scholar
Schwartz, M. B., & Brownell, K. D. (2004). Obesity and body image. Body Image, 1(1), 4356. http://dx.doi.org/10.1016/S1740-1445(03)00007-XCrossRefGoogle ScholarPubMed
Sherry, S. B. (2006). The perfectionism model of binge eating: Idiographic and nomothetic tests of an integrative model. (Unpublished doctoral dissertation). University of Saskatchewan, Saskatoon, Canada.Google Scholar
Shisslak, C. M., & Crago, M. (2001). Risk and protective factors in the development of eating disorders. In Thompson, K. J. & Smolak, L. (Eds.), Body image, eating disorders, and obesity in youth (pp. 103125). Washington, DC: American Psychological Association.Google Scholar
Speranza, M., Loas, G., Wallier, J., & Corcos, M. (2007). Predictive value of alexithymia in patients with eating disorders: A 3-year prospective study. Journal of Psychosomatic Research, 63, 365371. http://dx.doi.org/10.1016/j.jpsychores.2007.03.008CrossRefGoogle ScholarPubMed
Stark, A. (1987). American Dance Therapy Association, a kinesthetic approach. Dance Magazine, 61, 5657.Google Scholar
Stice, E. (2002). Risk and maintenance factors for eating pathology: A meta-analytic review. Psychological Bulletin, 128, 825848. http://dx.doi.org/10.1037/0033-2909.128.5.825CrossRefGoogle Scholar
Stotland, S. C., & Larocque, M. (2004). Convergent validity of the Larocque Obesity Questionnaire and self-reported behavioural observations during obesity treatment. Psychological Report, 95, 10311042. http://dx.doi.org/10.2466/PR0.95.7.1031-1042CrossRefGoogle Scholar
Stotland, S. C., Larocque, M., & Kronick, I. (2006). Selfregulation of weight: Basic processes and treatment implications. In Prescott, A. E. (Ed.), The concept of self in medicine and health care. New-York, NY: Nova Science Publishers.Google Scholar
Taylor, G., Ryan, D., & Bagby, R. (1985). Toward the development of a new self-report alexithymia scale. Psychotherapy and Psychosomatics, 44, 191199. http://dx.doi.org/10.1159/000287912CrossRefGoogle ScholarPubMed
Teixeira, P. J., Going, S. B., Sardinha, L. B., & Lohman, T. G. (2005). A review of psychosocial pre-treatment predictors of weight control. Obesity Reviews, 6, 4365. http://dx.doi.org/10.1111/j.1467-789X.2005.00166.xCrossRefGoogle ScholarPubMed
van Strien, T., Frijters, J. E. R., Bergers, G. P. A., & Defares, P. B. (1986). The Dutch Eating Behavior Questionnaire (DEBQ) for assessment of restrained, emotional, and external eating behaviour. International Journal of Eating Disorders, 5, 295315. http://dx.doi.org/10.1002/1098-108X(198602)5:2<295::AID-EAT2260050209>3.0.CO;2-T3.0.CO;2-T>CrossRefGoogle Scholar
Vitousek, K., & Manke, F. (1994). Personality variables and disorders in anorexia nervosa and bulimia nervosa. Journal of Abnormal Psychology, 103, 137147. http://dx.doi.org/10.1037/0021-843X.103.1.137CrossRefGoogle ScholarPubMed
Wadden, T. A., & Stunkard, A. J. (Eds) (2000). Handbook of obesity treatment. New York, NY: Gilford Press.Google Scholar
Wardle, J. (2005). Dietary restraint, body dissatisfaction, and psychological distress: A prospective analysis. Journal of Abnormal Psychology, 114, 119125. http://dx.doi.org/10.1037/0021-843X.114.1.119Google Scholar
Wardle, J., Waller, J., & Rapoport, L. (2001). Body dissatisfaction and binge eating in obese women: The role of restraint and depression. Obesity Research, 9, 778787. http://dx.doi.org/10.1038/oby.2001.107CrossRefGoogle ScholarPubMed
Weiss, F. (2004). Group psychotherapy with obese disordered-eating adults with body-image disturbances: An integrated model. American Journal of Psychotherapy, 58, 281303.CrossRefGoogle ScholarPubMed
World Health Organization (2000). Obesity: Preventing and managing of global epidemic. Report of a WHO consultation. WHO Technical Report Series 894. Geneva, Switzerland: World Health Organization.Google Scholar
Wilson, G. T. (1996). Acceptance and change in the treatment of eating disorders and obesity. Behavior Therapy, 27, 417439. http://dx.doi.org/10.1016/S0005-7894(96)80025-6CrossRefGoogle Scholar