{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,9]],"date-time":"2026-01-09T20:19:29Z","timestamp":1767989969718,"version":"3.49.0"},"reference-count":38,"publisher":"MDPI AG","issue":"8","license":[{"start":{"date-parts":[[2023,8,3]],"date-time":"2023-08-03T00:00:00Z","timestamp":1691020800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"National Health and Medical Research Council (NHMRC) Australia","award":["634922"],"award-info":[{"award-number":["634922"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Behavioral Sciences"],"abstract":"<jats:p>Anorexia nervosa (AN) is a mental health disorder that has serious physical, emotional and social consequences. Whilst cognitive behavioural therapy for AN (CBT-AN) has demonstrated efficacy, there remains a global need to improve AN treatment. Compulsive exercise activity therapy (LEAP) is an active therapy consisting of the addition to CBT-AN of eight specific sessions that focus on exercise and motivation for behavioural change. This paper presents a secondary analysis of 74 female participants in a randomised control trial of LEAP plus CBT-AN versus CBT-AN alone. The main aim of this study was to explore putative predictors and to estimate the magnitude of changes due to LEAP for specific outcome measures. Participants (LEAP: n = 36; CBT-AN: n = 38) were assessed at three successive surveys: baseline, end of therapy, and 6 months post-therapy. The overall effect sizes for changes between baseline to end of therapy and baseline to 6-month follow-up assessment showed large effect sizes (Cohen\u2019s d &gt; = 0.80) for mental-health-related quality of life (MHRQoL), weight concern, dietary restraint, eating concern, AN stage change, and psychological distress (all p &lt; 0.05). The results also indicated that several pre-treatment characteristics, including body mass index (BMI), level of eating disorder (ED) symptoms, and MHRQoL are important for identifying whether a treatment is likely to be effective. Future treatment programs should aim to optimise early improvements in BMI, ED symptoms, and MHRQoL.<\/jats:p>","DOI":"10.3390\/bs13080651","type":"journal-article","created":{"date-parts":[[2023,8,3]],"date-time":"2023-08-03T11:23:03Z","timestamp":1691061783000},"page":"651","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":4,"title":["Impact of LEAP and CBT-AN Therapy on Improving Outcomes in Women with Anorexia Nervosa"],"prefix":"10.3390","volume":"13","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-0296-6856","authenticated-orcid":false,"given":"Phillipa","family":"Hay","sequence":"first","affiliation":[{"name":"Mental Health Research Unit, Liverpool Hospital, South Western Sydney Local Health District, NSW Health, Liverpool, NSW 2170, Australia"},{"name":"Translational Health Research Institute, School of Medicine, Western Sydney University, Campbelltown, NSW 2560, Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2483-3798","authenticated-orcid":false,"given":"Mohammed","family":"Mohsin","sequence":"additional","affiliation":[{"name":"Mental Health Research Unit, Liverpool Hospital, South Western Sydney Local Health District, NSW Health, Liverpool, NSW 2170, Australia"},{"name":"Faculty of Medicine & Health, School of Clinical Medicine, University of New South Wales, Sydney, NSW 2052, Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8671-5098","authenticated-orcid":false,"given":"Liquan","family":"Liu","sequence":"additional","affiliation":[{"name":"School of Psychology, Western Sydney University, Sydney, NSW 2560, Australia"},{"name":"The MARCS Institute for Brain, Behaviour and Development, Western Sydney University, Sydney, NSW 2560, Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1290-6243","authenticated-orcid":false,"given":"Stephen","family":"Touyz","sequence":"additional","affiliation":[{"name":"Inside Out Institute, University of Sydney, Sydney, NSW 2006, Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Caroline","family":"Meyer","sequence":"additional","affiliation":[{"name":"International Digital Laboratory, The University of Warwick, Coventry CV4 7AL, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3805-0180","authenticated-orcid":false,"given":"Jon","family":"Arcelus","sequence":"additional","affiliation":[{"name":"Institute of Mental Health, University of Nottingham, Nottingham NG7 2TU, UK"},{"name":"Psychoneurobiology of Eating and Addictive Behaviors Group, Bellvitge Biomedical Research Institute (IDIBELL), Bellvitge University Hospital, University of Barcelona, 08908 Barcelona, Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5903-6647","authenticated-orcid":false,"given":"Sloane","family":"Madden","sequence":"additional","affiliation":[{"name":"The Sydney Children\u2019s Hospitals Network, Westmead, Sydney, NSW 2145, Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Evelyn","family":"Attia","sequence":"additional","affiliation":[{"name":"The New York State Psychiatric Institute, Columbia University, New York, NY 10032, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kathleen M.","family":"Pike","sequence":"additional","affiliation":[{"name":"World Health Organization Collaborating Centre for Capacity Building and Training in Global Mental Health, Columbia University Medical Center, New York, NY 10032, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5064-8003","authenticated-orcid":false,"given":"Janet","family":"Conti","sequence":"additional","affiliation":[{"name":"Translational Health Research Institute, School of Medicine, Western Sydney University, Campbelltown, NSW 2560, Australia"},{"name":"School of Psychology, Western Sydney University, Sydney, NSW 2560, Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2023,8,3]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","unstructured":"American Psychiatric Association (2013). 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