{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,2]],"date-time":"2026-06-02T14:23:31Z","timestamp":1780410211545,"version":"3.54.1"},"reference-count":15,"publisher":"MDPI AG","issue":"11","license":[{"start":{"date-parts":[[2021,11,21]],"date-time":"2021-11-21T00:00:00Z","timestamp":1637452800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"This study was financed in part by the Coordena\u00e7\u00e3o de Aperfei\u00e7oamento de Pessoal de N\u00edvel Superior - Brazil (CAPES) - (with a Visiting Scholarship to Phillipa Hay and a Doctoral Scholarship to Marly Amorim Palavras).","award":["Finance Code 001"],"award-info":[{"award-number":["Finance Code 001"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Nutrients"],"abstract":"<jats:p>Purpose: Understanding the high rate of treatment adherence in trials of people with eating disorders is important as it can compromise the quality of the trials. In clinical practice, it may also contribute to illness chronicity, relapse, and costs. Thus, we investigated factors associated with adherence to a new treatment HAPIFED, which integrates cognitive behavioural therapy having extended sessions with body weight loss therapy compared to cognitive behavioural therapy with extended sessions alone, for individuals with Bulimia Nervosa or Binge Eating Disorder or other eating disorders comorbid with overweight or obesity. Methods: In total, 98 participants having bulimia nervosa, binge eating disorder and other specified and unspecified eating disorders were recruited with 50 randomised to HAPIFED and 48 to the control intervention CBT-E, all administered in groups of up to 10 participants. An investigator external to the site conducted the random allocation, which was concealed from the statistician involved in the analysis, and known only to the therapists until the finalization of the 12-month follow-up after the end of active treatment. Three scenarios in the timeline treatment of a total of 30 sessions were assessed: 33% or 60% or 75% of presence. Mixed-effects logistic regression analysis was performed to find the correlates of adherence after adjusting for clustering by number of group participants. To account for heterogeneity by types of eating disorders in the sample, the latter variable was considered as a control factor in the models. A subgroup analysis was performed for those with binge eating disorder as this was the largest (N = 66) eating disorder group. Results: None of the six variables\u2014frequency of binge eating episodes, purging, eating disorder symptom severity, weight, illness duration and mental health-related quality of life\u2014significantly predicted adherence at 33%, but longer illness duration predicted higher treatment adherence at both 60% and 75% presence of the interventions. Also for 75% presence, higher body weight predicted lower treatment adherence. For the subgroup analysis, those having higher illness duration had significantly higher odds of treatment adherence for 60% and 75% of the sessions. Conclusions: Higher adherence due to late treatment completion was associated with longer binge eating illness length and a lower body weight. More research is needed to recognize factors that may interfere with engagement in treatments aiming to avoid early dropout.<\/jats:p>","DOI":"10.3390\/nu13114171","type":"journal-article","created":{"date-parts":[[2021,11,21]],"date-time":"2021-11-21T21:00:50Z","timestamp":1637528450000},"page":"4171","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["Baseline Predictors of Adherence in a Randomised Controlled Trial of a New Group Psychological Intervention for People with Recurrent Binge Eating Episodes Associated to Overweight or Obesity"],"prefix":"10.3390","volume":"13","author":[{"given":"Haider","family":"Mannan","sequence":"first","affiliation":[{"name":"Translational Health Research Institute, School of Medicine, Western Sydney University, Sydney 2751, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9367-1628","authenticated-orcid":false,"given":"Marly Amorim","family":"Palavras","sequence":"additional","affiliation":[{"name":"Translational Health Research Institute, School of Medicine, Western Sydney University, Sydney 2751, Australia"},{"name":"Eating Disorders Program (PROATA), Department of Psychiatry, Universidade Federal de S\u00e3o Paulo (UNIFESP), S\u00e3o Paulo 04017030, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ang\u00e9lica","family":"Claudino","sequence":"additional","affiliation":[{"name":"Eating Disorders Program (PROATA), Department of Psychiatry, Universidade Federal de S\u00e3o Paulo (UNIFESP), S\u00e3o Paulo 04017030, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0296-6856","authenticated-orcid":false,"given":"Phillipa","family":"Hay","sequence":"additional","affiliation":[{"name":"Translational Health Research Institute, School of Medicine, Western Sydney University, Sydney 2751, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2021,11,21]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","unstructured":"Fassino, S., Pier\u00f3, A., Tomba, E., and Abbate-Daga, G. (2009). Factors associated with dropout from treatment for eating disorders: A comprehensive literature review. BMC Psychiatry, 9.","DOI":"10.1186\/1471-244X-9-67"},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"3","DOI":"10.1002\/erv.2492","article-title":"Predictors, moderators and mediators of treatment outcome following manualised cognitive-behavioral therapy for eating disorders: A systematic review","volume":"25","author":"Linardon","year":"2017","journal-title":"Eur. Eat. Disord. Rev."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"946","DOI":"10.1002\/eat.22411","article-title":"Predictors of treatment outcome in individuals with eating disorders: A systematic review and meta-analysis","volume":"48","author":"Vall","year":"2015","journal-title":"Int. J. Eat. Disord."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"123","DOI":"10.4236\/ojmp.2020.93010","article-title":"Premature Termination of Treatment among Adults Attending Treatment for Eating Disorders: A Critical Review","volume":"9","author":"Malta","year":"2020","journal-title":"Open J. Med Psychol."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"2026","DOI":"10.1002\/eat.23384","article-title":"Effectiveness of internet-based guided self-help for binge-eating disorder and characteristics of completers versus noncompleters","volume":"53","author":"Jensen","year":"2020","journal-title":"Int. J. Eat. Disord."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1186\/s13063-015-1079-1","article-title":"Comparing cognitive behavioral therapy for eating disorders integrated with behavioral weight loss therapy to cognitive behavioral therapy-enhanced alone in overweight or obese people with bulimia nervosa or binge eating disorder: Study protocol for a randomised controlled trial","volume":"16","author":"Palavras","year":"2015","journal-title":"Trials"},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"249","DOI":"10.1007\/s40519-020-00846-2","article-title":"Integrated weight loss and cognitive behavioral therapy (CBT) for the treatment of recurrent binge eating and high body mass index: A randomized controlled trial","volume":"26","author":"Palavras","year":"2021","journal-title":"Eat. Weight. Disord.\u2014Stud. Anorex. Bulim. Obesity"},{"key":"ref_8","doi-asserted-by":"crossref","unstructured":"Abd El-Baky, G.B., Hay, P.J., le Grange, D., Lacey, H., Crossby, R.D., and Touyz, S. (2014). Pre-treatment predictors of attrition in a randomized controlled trial of psychological trial for severe and enduring anorexia nervosa. BMC Psychiatry, 14, Available online: http:\/\/www.biomedcentral.com\/1471-244X\/1469.","DOI":"10.1186\/1471-244X-14-69"},{"key":"ref_9","doi-asserted-by":"crossref","unstructured":"American Psychiatric Association (APA) (2013). Diagnostic and Statistical Manual of Mental Disorders, American Psychiatric Publishing. [5th ed.].","DOI":"10.1176\/appi.books.9780890425596"},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"80","DOI":"10.1016\/j.wpsyc.2012.05.005","article-title":"Classification of feeding and eating disorders: Review of evidence and proposals for ICD-11","volume":"11","author":"Uher","year":"2012","journal-title":"World Psychiatry"},{"key":"ref_11","unstructured":"Fairburn, C.G., Cooper, Z., and O\u2019Connor, M. The Eating Disorder Examination, The Centre for Research on Eating Disorders at Oxford. [17th ed.]. Available online: www.credo-oxford.com\/pdfs\/EDE170D.pdf."},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"220","DOI":"10.1097\/00005650-199603000-00003","article-title":"A 12-item short-form health survey: Construction of scales and preliminary tests of reliability and validity","volume":"34","author":"Ware","year":"1996","journal-title":"Med. Care"},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"127","DOI":"10.1016\/j.tree.2008.10.008","article-title":"Generalized linear mixed models: A practical guide for ecology and evolution","volume":"24","author":"Bolker","year":"2009","journal-title":"Trends Ecol. Evol."},{"key":"ref_14","unstructured":"(2013). SAS, Version 9, SAS Institute."},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"161","DOI":"10.1007\/s12529-010-9092-y","article-title":"The association between rate of initial weight loss and long-term success in obesity treatment: Does slow and steady win the race?","volume":"17","author":"Nackers","year":"2010","journal-title":"Int. J. Behav. Med."}],"container-title":["Nutrients"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2072-6643\/13\/11\/4171\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,11]],"date-time":"2025-10-11T07:33:39Z","timestamp":1760168019000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2072-6643\/13\/11\/4171"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2021,11,21]]},"references-count":15,"journal-issue":{"issue":"11","published-online":{"date-parts":[[2021,11]]}},"alternative-id":["nu13114171"],"URL":"https:\/\/doi.org\/10.3390\/nu13114171","relation":{},"ISSN":["2072-6643"],"issn-type":[{"value":"2072-6643","type":"electronic"}],"subject":[],"published":{"date-parts":[[2021,11,21]]}}}