Physical activity, weight, and cardiovascular risk factors after lifestyle behavioral weight loss treatment for binge-eating disorder

Background Modest weight loss is associated with improved cardiovascular disease risk factors in binge-eating disorder (BED) with obesity following lifestyle behavioral weight loss treatment. Purpose This study examined changes in physical activity and associations with outcomes following lifestyle behavioral weight loss treatment. Methods In this secondary analysis of a randomized controlled trial for BED with obesity testing standard lifestyle behavioral weight loss treatment and a stepped-care approach built upon lifestyle behavioral weight loss treatment, physical activity, weight, cardiovascular disease risk factors, and eating-disorder psychopathology were assessed at baseline, posttreatment (after 6-month lifestyle behavioral weight loss treatment), and 12-month follow-up (18 months after baseline). Results Physical activity was infrequent at baseline (18.2% “active”), increased during treatment (49.1% “active” at posttreatment), and remained increased at 12-month follow-up (48.0% “active”). At posttreatment, moderate and active groups lost more weight than sedentary. At 12-month follow-up, active group had lower body mass index and greater percent weight loss than sedentary group. Physical activity and physical activity change were related to few cardiovascular disease risk factor outcomes, in contrast with significant associations between weight loss and improvements in several cardiovascular disease risk factor outcomes. Additionally, at posttreatment, active group had lower eating-disorder psychopathology, while sedentary group was less likely to attain binge-eating remission. Conclusions Lifestyle behavioral weight loss treatment for BED with obesity was associated with increased physical activity sustained through 12-month follow-up. Increased and moderate/active physical activity levels were associated with weight loss and improved eating-disorder psychopathology, but not cardiovascular disease risk factor outcomes/changes, which were associated with weight loss.