(PS5-78) Transdiagnostic effects of a single-session acceptance-based workshop targeting loss of control eating in pregnancy: Impact on restrictive eating

Abstract Text:

Introduction: Disordered eating is common during pregnancy and has been linked to poor outcomes for mothers and infants. Given that disordered eating behaviors (e.g., restriction, binge eating) regularly co-occur, transdiagnostic interventions are needed to address a range of disordered eating behaviors during the perinatal period. In a pilot study of an online, acceptance-based, single-session workshop that teaches skills to cope with cravings during pregnancy, we found the intervention condition experienced significant reductions in binge and loss-of-control (LOC) eating relative to the waitlist control at one-month follow-up. The purpose of this study is to examine whether the intervention also reduced restrictive eating behaviors.

Methods: N=130 pregnant women in their second trimester who endorsed cravings were randomized to the intervention or waitlist control, with n=46 completing the intervention. Participants reported demographics at baseline and completed measures of depression (Edinburgh Postnatal Depression Scale) and restrictive eating behaviors (Perinatal Eating Behaviors Scale; PEBS) at baseline and 1-month follow-up. Restrictive eating items from PEBS included item 5 (avoidance of certain foods to influence weight and shape), item 11 (restriction of portion size), and item 12 (desire to feel hunger).

Results: We conducted separate univariate analyses of variance to examine differences in restrictive eating change score (PEBS items 5, 11, and 12) between the intervention and control groups, adjusting for baseline age, gestational weeks, parity, pre-pregnancy body mass index, depression, and restriction. A Bonferroni correction (adjusted α = .0167) was applied to account for multiple comparisons. We found a significant effect of treatment assignment on PEBS item 5 change scores, F(1, 79) = 8.31, p = .005, such that, on average, restrictive eating decreased in the intervention group and increased in the control at 1-month follow-up. There were no significant effects of treatment assignment on PEBS item 11 or 12 change scores.

Conclusions: Preliminary results indicate this workshop may improve certain aspects of restrictive eating in pregnant people, specifically, avoidance of certain foods to influence weight and shape (PEBS item 5). This item reflects skills taught in the workshop such as eating craved foods mindfully, rather than suppressing these urges. The items that were non-significant (PEBS 11 and 12) indexed restriction of portion size and desire to feel hungry—it is possible the intervention’s focus on coping with cravings did not translate to improving these types of restrictive behaviors, although a fully powered efficacy trial is needed. Given acceptance and commitment therapy is designed to be transdiagnostic, future work should examine whether acceptance-based skills can target a spectrum of disordered eating behaviors during the perinatal period to improve maternal, child, and family outcomes.