Diet and exercise in addition to psychotherapy, in the treatment of patients suffering from eating disorders with obesity.

Treating patients with eating disorders is often a controversial issue, and obesity adds another difficulty to the treatment regimen. In this study we wanted to evaluate the outcome on body weight in patients suffering from eating disorders with obesity, by adding dietary treatment and exercise to ongoing psychotherapy. The prospective intervention study included 18 obese, female patients in primary health care and outpatient clinic with a BMI > or = 27 kg/m2 with eating disorders, nine of whom were diagnosed with bulimia according to the American Psychiatric Association. The patients had had psychotherapy for at least 2 years in a treatment programme which was chosen by a psychologist. This had had no influence on the patients' weight problem, and an additional diet and exercise regime was added to the ongoing psychotherapy through an eight-week very low calorie diet (VLCD) treatment (Nutrilett), during which the patients also participated in weekly group exercise. The patients were followed-up regularly during a 6-month period. During the 8-week VLCD treatment, which was completed by 16 patients (89%), mean body weight in the group decreased significantly from 98.8 kg to 88.6 kg. Six months after the initial treatment, average weight loss was further significantly reduced to 82.5 kg. The findings of the present study suggest that by combining ongoing psychotherapy with a well-balanced VLCD treatment and exercise it is possible to achieve substantial weight reduction in patients suffering from eating disorders with obesity.