ORCID Profile
0000-0002-1320-6177
Current Organisations
Pathfinder Psychological Consulting Pty Ltd
,
The University of Newcastle
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Publisher: Frontiers Media SA
Date: 03-11-2021
DOI: 10.3389/FENDO.2021.738856
Abstract: A common challenge among a subgroup of in iduals with obesity is binge eating, that exists on a continuum from mild binge eating episodes to severe binge eating disorder (BED). BED is common among bariatric patients and the prevalence of disordered eating and ED in bariatric surgery populations is well known. Conventional treatments and assessment of obesity seldom address the underlying psychological mechanisms of binge eating and subsequent obesity. This study, titled PnP (People need People) is a psychoeducational group pilot intervention for in iduals with BED and obesity including patients with previous bariatric surgery. Design, feasibility, and a broad description of the study population is reported. A total of 42 patients were from an obesity clinic referred to assessment and treatment with PnP in a psychoeducational group setting (3-hour weekly meetings for 10 weeks). Of these, 6 (14.3%) patients had a previous history of bariatric surgery. Feasibility was assessed by tracking attendance, potentially adverse effects and outcome measures including body mass index (BMI), eating disorder pathology, overvaluation of shape and weight, impairment, self-reported childhood difficulties, alexithymia, internalized shame as well as health related quality of life (HRQoL). All 42 patients completed the intervention, with no adverse effects and a high attendance rate with a median attendance of 10 sessions, 95% CI (8.9,9.6) and 0% attrition. Extent of psychosocial impairment due to eating disorder pathology, body dissatisfaction and severity of ED symptoms were high among the patients at baseline. Additionally, self-reported childhood difficulties, alexithymia, and internalized shame were high among the patients and indicate a need to address underlying psychological mechanisms in in iduals with BED and comorbid obesity. Improvement of HRQoL and reduction of binge eating between baseline and the end of the intervention was observed with a medium effect This feasibility study supports PnP as a potential group psychoeducational intervention for patients living with BED and comorbid obesity. Assessments of BED and delivery of this intervention may optimize selection of candidates and bariatric outcomes. These preliminary results warrant further investigation via a randomized control trial (RCT) to examine the efficacy and effectiveness of PnP.
Publisher: Wiley
Date: 28-01-2020
DOI: 10.1111/OBR.12998
Abstract: Obesity is a leading global epidemic. Bariatric surgery is the only treatment demonstrating substantial long-term weight loss and medical benefits. However, there is limited research on the psychological outcomes following surgery. Therefore, the primary aim of this study was to systematically review depression, anxiety, and binge eating outcomes at different time points following bariatric surgery and identify whether bariatric surgery significantly reduces psychological symptoms over time. These outcomes were also examined among endoscopic bariatric procedures as a secondary aim. Forty-eight studies met inclusion criteria. Findings suggested that most patients experience a short-term reduction in anxiety and depression symptoms from pre-surgery. Over time, however, these symptoms increase and may even return to pre-surgery levels. Furthermore, while binge eating was uncommon after surgery, other disordered eating patterns may emerge. Binge eating may also restart over time as the stomach enlarges again. Overall, the complex psychological difficulties faced by in iduals with obesity continue after surgery and may contribute to longer-term weight reci ism. More comprehensive and standardised psychological assessment procedures, including clinical interviews and longer-term follow-up, may provide insight into the psychological mechanisms maintaining weight management issues, and may serve as a starting point for improving the long-term success of patients with obesity.
Publisher: Springer Science and Business Media LLC
Date: 16-06-2022
DOI: 10.1186/S40337-022-00604-Y
Abstract: Despite being the first validated measure of grazing, the Grazing Questionnaire (GQ) has not been investigated among in iduals with obesity. Therefore, the current study aimed to examine the psychometric properties of the GQ in an obesity s le. Participants ( N = 259) were recruited from community and clinical settings in Australia. The s le comprised adults with normal weight ( n = 77) and obesity ( n = 182). A portion of in iduals with obesity ( n = 102) had binge eating disorder (BED). Data from the obesity group was examined to establish the factor structure, validity, and reliability of the GQ. A one-way ANOVA with planned contrasts was conducted to compare scores on the GQ across groups. Confirmatory factor analysis revealed that the 2-factor model of the GQ was the best model fit for in iduals with obesity. The GQ demonstrated high internal consistency, test–retest reliability over 3 months, and convergent and ergent validity. As hypothesised, the obesity group had significantly higher scores on the GQ than the normal weight group, while the obesity with BED group had significantly higher scores than the obesity without BED group. This was the first study to investigate the psychometric properties of the GQ in an obesity s le. Overall, findings indicated that the GQ is a psychometrically sound measure of grazing among in iduals with obesity. These findings provide further support for two distinct subtypes of grazing and highlight the importance of increased assessment and management of grazing behaviours for in iduals with obesity and eating disorders. Maintaining a healthy weight is one of the greatest challenges for in iduals with obesity. Certain eating patterns such as grazing may contribute to difficulties in weight management. Grazing is the repetitive and unplanned eating of small amounts of food that is not related to feeling hungry. Researchers and clinicians often use self-report questionnaires to measure grazing. However, the first validated questionnaire of grazing has not been investigated among in iduals with obesity. Therefore, the goal of this study was to examine and validate the Grazing Questionnaire in in iduals with obesity. Overall, our results showed that the Grazing Questionnaire is a valid and reliable self-report measure of grazing in in iduals with obesity. Similar to previous research, we found that there are two subtypes of grazing. The first subtype involves continuous, unplanned eating. The second subtype is associated with a sense of loss of control over eating. We also found that people with obesity and binge eating disorder graze more than people with obesity that do not have binge eating disorder, while both groups graze more than in iduals with normal weight. We recommend that clinicians routinely assess and treat unhelpful grazing patterns when working with in iduals with obesity and eating disorders.
Publisher: Elsevier BV
Date: 12-2016
DOI: 10.1016/J.EATBEH.2016.07.010
Abstract: Obesity and binge eating disorder (BED) are both associated with deficiencies in executive function. The Behaviour Rating Inventory of Executive Function - Adult Version (BRIEF-A) is a self-report measure that assesses executive function. This study aimed to examine the psychometric properties of the BRIEF-A in an obese population, with and without BED, and to explore the differences on the BRIEF-A in the obese, with and without BED, compared to normative s le. 98 obese participants (70 BED) completed the BRIEF-A, DASS-21 and several performance-based measures of executive function. 30 participants completed a repeat assessment two months later. There was evidence of good internal consistency and test-retest reliability, however evidence for construct and convergent validity was mixed. Additionally, it was found that obese in iduals report significantly more executive function difficulties on the BRIEF-A than the normative s le. Further, obese with BED report more executive function difficulties than those without. This study shows some evidence of sound psychometric properties of the BRIEF-A in an obese s le, however more research is required to understand the nature of executive function being measured.
Publisher: Wiley
Date: 08-07-2022
DOI: 10.1002/ERV.2936
Abstract: Emerging evidence suggests that loss of control (LOC) may present as a common feature across disordered eating behaviours. However, there has been limited research on the transdiagnostic nature of LOC in this area. The primary aim of this study was to systematically review disordered eating behaviours and measures of LOC in clinical and non‐clinical populations. Electronic searches of the relevant databases were conducted. Selected articles were screened for eligibility and assessed for methodological quality. Thirty‐four studies met inclusion criteria. Findings demonstrated that LOC was associated with disordered eating behaviours across bariatric populations, eating disorder populations, and community populations. Specifically, LOC was associated with binge eating (subjective and objective episodes), grazing, night eating, and emotional or stress eating. Findings also revealed that LOC was inconsistently operationalised across studies, with varied approaches to measuring the construct. Overall, the findings from this review provide support for LOC as a transdiagnostic feature of disordered eating behaviours. Future studies should utilise robust multi‐method assessments to measure the severity of LOC, which may provide greater insight into how LOC manifests across different eating disorder presentations.
Publisher: Springer Science and Business Media LLC
Date: 17-10-2021
DOI: 10.1007/S40519-020-01034-Y
Abstract: Theoretical research on the psychological underpinnings of weight management is limited. Recently, the clinical obesity maintenance model (COMM) proposed a theoretical conceptualisation of salient psychological and neuropsychological mechanisms maintaining weight management issues. The current study aimed to empirically test the COMM and elucidate the results in the context of recent empirical findings. Participants (N = 165) were recruited from university and community settings in Australia. The s le consisted of adults with normal weight (n = 41), overweight (n = 40), and obesity (n = 84). Participants completed self-report questionnaires and a brief neuropsychological test. Structural equation modelling was used to estimate the associations between the hypothesised variables of the COMM and evaluate the model fit. Findings suggested acceptable to good model fit. Furthermore, several direct effects were found. First, cognitive flexibility directly affected eating habit strength. Second, eating habit strength directly affected eating beliefs. Third, eating beliefs directly affected emotion dysregulation. Fourth, emotion dysregulation directly affected depression and binge eating with depression partially mediating this relationship. Finally, depression directly affected binge eating. This was the first study to empirically test the COMM. Overall, findings provide preliminary support for the COMM as a psychological model of weight management and highlight the underlying psychological and neuropsychological mechanisms that may contribute to weight management issues. As this study examined a simplified version of the COMM, future research should continue evaluating this model and consider incorporating these components into more holistic weight management models to improve long-term treatment outcomes. V, cross-sectional descriptive study.
Publisher: Springer Science and Business Media LLC
Date: 19-10-2022
DOI: 10.1007/S40519-021-01299-X
Abstract: To explore the perceived barriers and facilitators to healthy eating and physical activity in in iduals opting for endoscopic bariatric procedures. A total of 55 participants were recruited from a metropolitan bariatric clinic in Australia. Participants were interviewed at one of two stages of treatment: pre-procedure (n = 34) or 5-6 months post-procedure (n = 18). Interviews were transcribed and analyzed using content analysis. Five themes emerged from analysis of participant responses in both groups including lifestyle, psychological, physiological, social, and eating behaviors. Each theme consisted of subthemes which were either perceived barriers, or facilitators, to healthy eating and physical activity. Perceived barriers consisted of factors such as time constraints, low motivation, unhealthy habits and portion control, low priority of personal health, emotional difficulties, and pain/mobility issues. Facilitators included subthemes such as planning/organization, high motivation, seeing results, improved self-esteem, increased energy, improved mobility, and changing mindset about portions. The results highlight the importance of delivering in idualized and targeted treatment plans for in iduals opting for bariatric procedures. Level III: Evidence obtained from cohort or case-control analytic studies.
Publisher: SAGE Publications
Date: 12-04-2022
DOI: 10.1177/02692155221091509
Abstract: To establish the effectiveness of relaxation and related therapies in treating Multiple Sclerosis related symptoms and sequelae. PsycINFO, PubMed, Embase, CINAHL, ProQuest Dissertations and Theses Global databases were searched. We included studies from database inception until 31 December 2021 involving adult participants diagnosed with multiple sclerosis or disseminated sclerosis, which featured quantitative data regarding the impact of relaxation interventions on multiple sclerosis-related symptoms and sequelae. Studies which examined multi-modal therapies - relaxation delivered in combination with non-relaxation interventions - were excluded. Risk of bias was assessed using the Revised Risk of Bias tool for randomised trials - ROB2, Risk of Bias in Non-Randomised Studies of Interventions ROBINS-I), and within and between-group effects were calculated (Hedges' Twenty-eight studies met inclusion criteria. Twenty-three of these were randomised controlled trials, with 1246 total participants. This review reports on this data, with non-randomised study data reported in supplemental material. Post -intervention relaxation was associated with medium to large effect-size improvement for depression, anxiety, stress and fatigue. The effects of relaxation were superior to wait-list or no treatment control conditions however, comparisons with established psychological or physical therapies were mixed. In idual studies reported sustained effects (≤ 6 months) with relaxation for stress, pain and quality of life. Most studies were rated as having a high/serious risk of bias. There is emerging evidence that relaxation therapies can improve outcomes for persons with multiple sclerosis. Given the high risk of bias found for included studies, stronger conclusions cannot be drawn.
Publisher: Springer Science and Business Media LLC
Date: 03-12-2021
DOI: 10.1007/S40519-019-00823-4
Abstract: Despite varied treatment effects, weight reci ism is common and typically associated with the abandonment of prescribed weight management strategies. Literature suggests that difficulty with weight management is associated with deficits in executive functioning, in particular cognitive flexibility and response inhibition, the neurocognitive processes that are involved in goal-directed behaviours, such as dietary adherence. These processes are overlooked by mainstream weight loss programmes. The aim of the study was to assess the effectiveness of a cognitive remediation-enabled cognitive behaviour therapy (CR-CBT) in addressing the neurocognitive, psychological and behavioural correlates of weight loss. It was hypothesised that CR-CBT would improve cognitive flexibility and response inhibition, reduce binge eating, aid weight loss and improve metabolic health. Four adults with obesity (body mass index > 30 kg/m Cognitive remediation-enabled cognitive behaviour therapy produced improvements in response inhibition and cognitive flexibility, and reductions in binge eating frequency, weight, and metabolic health readings between baseline and 3-month follow-up. This is the first study to assess the effectiveness of CR-CBT in the treatment of obesity. Preliminary indications of treatment success are discussed with respect to study limitations. In light of these results, we recommend further investigation via a randomised control trial (RCT). Level IV, case series.
Publisher: Springer Science and Business Media LLC
Date: 04-11-2014
Publisher: Springer Science and Business Media LLC
Date: 03-07-2017
Publisher: Springer Science and Business Media LLC
Date: 16-04-2018
Publisher: Frontiers Media SA
Date: 14-08-2020
Publisher: Springer Science and Business Media LLC
Date: 2019
Publisher: Hindawi Limited
Date: 2013
DOI: 10.1155/2013/240128
Abstract: Psychological distress and deficits in executive functioning are likely to be important barriers to effective weight loss maintenance. The purpose of this paper is twofold. First, in the light of recent evidence in the fields of neuropsychology and obesity, particularly on the deficits in the executive function in overweight and obese in iduals, a conceptual and theoretical framework of obesity maintenance is introduced by way of a clinical obesity maintenance model (COMM). It is argued that psychological variables, that of habitual cluster Behaviors, emotional dysregulation, mood, and health literacy, interact with executive functioning and impact on the overeating/binge eating behaviors of obese in iduals. Second, cognizant of this model, it is argued that the focus of obesity management should be extended to include a broader range of maintaining mechanisms, including but not limited to cognitive deficits. Finally, a discussion on potential future directions in research and practice using the COMM is provided.
Publisher: Wiley
Date: 16-08-2019
DOI: 10.1111/OBR.12919
Abstract: Bariatric surgery is the most effective treatment for weight loss in in iduals with severe and complex obesity. While the extant literature has mostly explored clinical outcomes of surgery, recent research has also examined patients' experiences prior to treatment. This systematic review synthesized findings from qualitative studies investigating patients' motives and expectations prior to undergoing bariatric surgery for weight loss. Twenty-eight studies published in English involving 580 participants were identified for inclusion. Data extraction and thematic synthesis yielded four global themes: physiological, emotional, cognitive, and interpersonal/environmental. These represented seven subthemes describing patients' presurgery experiences: relationship with food, physical health, activities of living, personal identity, social relations, presurgery information, and beliefs about surgery. In addition to improving physical and medical comorbidities associated with obesity, participants believed that postsurgery weight loss would produce positive psychosocial impacts by strengthening their personal identities, their relationships, and improving their engagement in public and professional life. The complex and widespread nature of the changes patients expected would result from bariatric surgery highlights the importance of providing pretreatment education focused on psychosocial well-being, as well as concurrent psychological support alongside surgery, to best inform in idual treatment selection and clinical practice.
Publisher: Elsevier BV
Date: 04-2018
DOI: 10.1016/J.APPET.2017.12.023
Abstract: Research has indicated that in iduals with obesity have neurocognitive deficits, especially in cognitive flexibility that may in turn impact on their weight loss and maintenance. Consequently, we examined the efficacy of a manualised face-to-face cognitive remediation therapy for obesity (CRT-O) within a randomised controlled trial, in terms of improving cognitive flexibility, reducing binge eating behaviour, improving quality of life and helping with weight loss. 80 adults with obesity (body mass index >30 kg/m Mixed-effects model analyses revealed that the CRT-O group had a significant improvement in their cognitive flexibility at post-treatment and 3-month follow-up compared to the control group (Cohen's d = 0.96 to 2.1). 68% of those in the CRT-O group achieved a weight loss of 5% or more at follow-up compared to only 15% of the controls (Cohen's d = 1.3). Changes in set-shifting predicted changes in weight (p < .05). Binge eating reduced in the CRT-O group compared to the control (Cohen's d = 0.80). This is the first study showing the efficacy of CRT-O for obesity. Future CRT-O studies with longer follow-ups and pairing it with longer BWL programs are needed. 12613000537752. 14 May 2013.
Publisher: Elsevier BV
Date: 05-2019
DOI: 10.1016/J.SOARD.2019.01.009
Abstract: The demand and the utilization of intensive treatments of obesity have been increased tremendously. This study aimed to investigate trends in interest related to the intensive treatments of obesity in both academic research and the public domain, and assess whether they match each other. The BMI Clinic, Double Bay, New South Wales, Australia. Intensive treatment of obesity is defined as meal replacement, pharmacologic treatments, and surgical or endoscopic bariatric procedures identified by the national guidelines. To identify the academic research interests, the number of academic research publications for each search topic was identified as converted into relative popularity. To identify the public's interests, Google Trends relative search volume and Twitter message relative intensity for each topic was mined to identify the most recent interests in intensive obesity treatment among the public. There was an increase in academic publications in all treatment domains between 2007 and 2017, but that the research emphasis correlated poorly with public interest. Between 2007 and 2017, the most popular and increasing academic research interest in the intensive treatment of obesity was bariatric surgery, followed by weight loss medication. In 2007, the most popular public-interest treatment was weight loss medication followed by bariatric surgery. In contrast, in 2017, meal replacement and bariatric surgery were equally popular, while the interests in weight loss medication declined. Significant seasonal patterns were also recognized for the public's interests. Academic research and public interest are not currently sufficiently aligned in the area of obesity treatment.
Start Date: 2014
End Date: 2014
Funder: Diabetes Australia Research Trust: ACT, ACT, AU
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