OBJECTIVE Effective treatments exist for binge-eating disorder (BED), although roughly 50% of patients fail to attain binge-eating abstinence. Evidence on how to refine treatments is lacking. Conceptualizing BED as arising from a network of symptom-to-symptom interactions allows for the identification of the most strongly connected symptoms, which could inform intervention targets. This study assessed how BED symptom centrality changed with behaviorally based weight-loss treatments (BBWLTs). METHODS Participants were 191 adult patients (71% female, 79% White) with BED with comorbid obesity participating in a randomized controlled trial testing 6-month BBWLTs for BED. Independent assessments of BED symptoms were performed at pretreatment, posttreatment, and 12 months after treatment. Strength centrality indicated how strongly and frequently symptoms were associated with each other in the network. Significant changes in centrality between timepoints were determined using permutation tests. RESULTS At pretreatment, overvaluation of shape/weight and preoccupation with shape/weight and food/eating had the highest strength centrality. At posttreatment and 12-month follow-up, dissatisfaction with shape/weight had the highest centrality, which significantly increased from pretreatment. CONCLUSIONS The relations among symptoms of BED are not static and change over time with treatment. BBWLTs do not appear to reduce connectivity of overvaluation of shape/weight (the most central BED symptom prior to treatment), but instead increase connectivity of dissatisfaction with shape/weight with other symptoms following treatment. The observed network structure of symptoms following BBWLTs resembles network analyses of people without eating disorders. Findings highlight the importance of understanding how treatments impact symptom relationships, not just symptom intensities. (PsycInfo Database Record (c) 2022 APA, all rights reserved).

中文翻译：

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暴食症患者饮食失调精神病理学网络结构的变化：12 个月随访治疗试验的结果。

目标 暴食症 (BED) 存在有效的治疗方法，尽管大约 50% 的患者未能戒除暴食症。缺乏关于如何改进治疗的证据。将 BED 概念化为由症状到症状相互作用的网络产生，可以识别最密切相关的症状，这可以为干预目标提供信息。本研究评估了 BED 症状中心性如何随着基于行为的减肥治疗 (BBWLT) 发生变化。方法参与者是 191 名 BED 成年患者（71% 女性，79% 白人）并伴有肥胖症，他们参加了一项随机对照试验，测试 6 个月的 BBWLTs BED。在治疗前、治疗后和治疗后 12 个月对 BED 症状进行独立评估。强度中心性表明症状在网络中相互关联的强度和频率。使用排列测试确定时间点之间中心性的显着变化。结果 在治疗前，对体型/体重的高估以及对体型/体重和食物/饮食的关注具有最高的强度中心性。在治疗后和 12 个月的随访中，对体型/体重的不满具有最高的中心性，与治疗前相比显着增加。结论 BED 症状之间的关系不是静态的，而是随着治疗的时间而改变。BBWLT 似乎并没有降低体型/体重高估（治疗前最核心的 BED 症状）之间的联系，而是增加了对体型/体重的不满与治疗后其他症状的联系。BBWLT 后观察到的症状网络结构类似于对没有进食障碍的人的网络分析。研究结果强调了理解治疗如何影响症状关系的重要性，而不仅仅是症状强度。（PsycInfo 数据库记录 (c) 2022 APA，保留所有权利）。