Hostname: page-component-745bb68f8f-v2bm5 Total loading time: 0 Render date: 2025-02-06T04:38:39.794Z Has data issue: false hasContentIssue false
  • English
  • Français

Effectiveness of Rhythmic Movement Therapy for Disordered Eating Behaviors and Obesity

Published online by Cambridge University Press:  10 January 2013

Irina G. Malkina-Pykh
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
Rights & Permissions [Opens in a new window]

Abstract

Core share and HTML view are not available for this content. However, as you have access to this content, a full PDF is available via the ‘Save PDF’ action button.

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.

Keywords

disordered eating behaviorsobesitypersonality traitsweight reduction programrhythmic movement therapytrastornos de alimentaciónobesidadrasgos de personalidadprograma de reducción de pesoterapia de movimiento rítmico
Type
Research Article
Information
The Spanish Journal of Psychology , Volume 15 , Issue 3 , November 2012 , pp. 1371 - 1387
Copyright
Copyright © Cambridge University Press 2012

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, 281–299. 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, 384–405. 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, 139–148. 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, 1029–1036. 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, 1341–1356. 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, 332–340. 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, 88–93. 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, 499–511. 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, 207–219. 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, 421–426. 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, 296–304. 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, 22–28.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, 239–246. 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, 551–563.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, 135–140. 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. 278–294). 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, 509–528. 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, 159–174. 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, 79–85. 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, 230–235.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, 459–477. 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, 337–345. 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, 449–468. 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, 459–464. 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, 317–326. 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, 641–645. 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, 357–363. 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, 32–37. 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, 893–898. 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, 17–27.Google Scholar
Legorreta, G., Bull, R., & Kiely, M. (1988). Alexithymia and symbolic function in the obese. Psychotherapy and Psychosomatics, 50, 88–94. 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, 1040–1044. 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, 387–394. 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, 265–285. 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, 206–213. 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, 29–31.Google Scholar
Rapoport, L., Clark, M., & Wardle, J. (2000). Evaluation of a modified cognitive-behavioral programme for weight management. International Journal of Obesity, 24, 1726–1737. 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, 287–295. 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, 1331–1336. 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), 43–56. 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. 103–125). 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, 365–371. 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, 56–57.Google Scholar
Stice, E. (2002). Risk and maintenance factors for eating pathology: A meta-analytic review. Psychological Bulletin, 128, 825–848. 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, 1031–1042. 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, 191–199. 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, 43–65. 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, 295–315. 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, 137–147. 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, 119–125. 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, 778–787. 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, 281–303.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, 417–439. http://dx.doi.org/10.1016/S0005-7894(96)80025-6CrossRefGoogle Scholar