Relapse prevention for eating disorders: a randomized controlled trial targeting weight-related self-esteem
Bibliographic record
Abstract
A high level of weight-related self-esteem (WRSE) at the end of eating disorder treatment is predictive of relapse. The first goal of this project was to develop a cognitive-behavioural intervention to target WRSE in partially remitted eating disorder clients to prevent relapse (WRSE protocol). The second goal (Study 1) was to conduct a pilot study to assess whether receiving the WRSE protocol leads to improvements in WRSE and related variables. The final goal of this project (Study 2) was to conduct a randomized controlled trial to determine whether the individual-based treatment added to treatment as usual (TAU) provided additional benefits to eating disorder clients, with respect to WRSE, eating disorder symptoms, and relapse. After the treatment manual was developed, 16 clients were recruited and administered the treatment protocol in Study 1. The results indicated that participants had significant improvements in levels of WRSE and related variables following treatment. For Study 2, 47 participants who had achieved behavioural symptom interruption were randomly assigned to either 1) TAU + WRSE protocol or 2) TAU. Results were mainly consistent across Complete Case and Last Observation Carried Forward procedures where participants who received the additional WRSE protocol had greater improvements in WRSE, body checking behaviour, and self-esteem. Groups did not differ with respect to body avoidance, general avoidance, fat talk, and other variables compared to participants who received TAU only. Multiple imputation procedures, which accounted for missing data, indicated no significant differences for all measured variables. Participants who completed the WRSE protocol had significantly greater adherence to their meal plan (i.e., less dietary restriction) compared to participants who only received TAU. Groups did not differ regarding level of binge eating and/or vomiting after the intervention period, and there were no differences in relapse between groups at 3-month follow-up. Overall, the newly developed treatment provided some benefit to eating disorder clients above and beyond TAU. However, the data appear to have been sensitive to attrition. Future research should include further refinement of the treatment protocol and evaluation across a longer follow-up period to assess its impact on relapse rates.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.003 | 0.005 |
| Meta-epidemiology (narrow) | 0.002 | 0.001 |
| Meta-epidemiology (broad) | 0.005 | 0.002 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.001 | 0.002 |
| Scholarly communication | 0.001 | 0.001 |
| Open science | 0.002 | 0.001 |
| Research integrity | 0.003 | 0.004 |
| Insufficient payload (model declined to judge) | 0.008 | 0.001 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".