Binge eating treatment
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Effective Treatments for Binge Eating Disorder: A Comprehensive Overview
Cognitive-Behavioral Therapy (CBT) for Binge Eating Disorder
Cognitive-behavioral therapy (CBT) is widely recognized as one of the most effective treatments for binge eating disorder (BED). Multiple studies have demonstrated that CBT significantly reduces binge-eating episodes and improves abstinence rates1 2 4. Both individual and group CBT formats have shown efficacy, with improvements sustained for up to 12 months post-treatment3 9. However, it is important to note that while CBT is effective in reducing binge eating, it does not typically result in significant weight loss7 9.
Structured Self-Help and Guided Self-Help Interventions
Structured self-help treatments, particularly those based on CBT principles, have also been shown to be effective in treating BED. These interventions typically involve guided self-help materials and have demonstrated medium-to-large effects in reducing binge-eating episodes when compared to wait-list controls1 4. Guided self-help CBT (CBTgsh) has been found to produce similar improvements in binge eating and associated psychopathology as more intensive individual therapies, with benefits maintained at 6-month follow-up6.
Pharmacotherapy for Binge Eating Disorder
Pharmacological treatments, including antidepressants, selective serotonin reuptake inhibitors (SSRIs), and lisdexamfetamine, have shown modest efficacy in reducing the frequency of binge-eating episodes2 4 7. Lisdexamfetamine, in particular, has been noted for its effectiveness in increasing binge abstinence compared to second-generation antidepressants5. However, the long-term effects of these medications remain unclear, and some may have undesirable side effects2 8.
Behavioral Weight Loss Therapy (BWL)
Behavioral weight loss therapy (BWL) has been explored as a treatment for BED, particularly in obese patients. While BWL has been effective in producing modest weight loss, it is generally less effective than CBT in reducing binge-eating episodes7 9. However, combining BWL with pharmacotherapy, such as naltrexone-bupropion, has shown promising results in improving both binge-eating remission rates and weight loss outcomes10.
Interpersonal Psychotherapy (IPT)
Interpersonal psychotherapy (IPT) has received modest support as a treatment for BED. While it is effective in reducing binge-eating frequency, its efficacy is generally lower compared to CBT and guided self-help interventions2. More research is needed to fully understand the long-term benefits and mechanisms of IPT in treating BED.
Combined and Sequential Treatments
Combining different treatment modalities, such as CBT followed by BWL, has been investigated, but results suggest that sequential treatments do not offer significant advantages over single-treatment approaches9. Similarly, combining pharmacotherapy with behavioral interventions has shown some benefits, but the additive effects are not always significant1 10.
Conclusion
In summary, CBT and structured self-help interventions based on CBT principles are the most strongly supported treatments for BED, demonstrating significant reductions in binge-eating episodes and improvements in abstinence rates. Pharmacotherapy, particularly with lisdexamfetamine, offers additional options, though long-term effects and side effects need further investigation. Behavioral weight loss therapy can be effective for weight management but is less effective in reducing binge eating compared to CBT. Future research should focus on long-term maintenance of therapeutic gains, comparative efficacy, and the development of integrated treatment models to optimize outcomes for individuals with BED.
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Most relevant research papers on this topic
Meta-Analysis of the Efficacy of Psychological and Medical Treatments for Binge-Eating Disorder
Psychotherapy, structured self-help treatment, and pharmacotherapy are effective for patients with binge-eating disorder.
Meta-Analysis
Highly CitedPsychological, pharmacological, and combined treatments for binge eating disorder: a systematic review and meta-analysis
CBT and guided self-help show moderate efficacy for binge eating disorder, while IPT, SSRI, and lisdexamfetamine show only modest support.
Meta-Analysis
Rigorous JournalBinge eating disorder treatment: a systematic review of randomized controlled trials.
Binge eating disorder treatment efficacy is variable, with individual or group CBT reducing binge eating and improving abstinence rates but not leading to weight loss.
Systematic ReviewHighly CitedMeta-analysis of the effectiveness of psychological and pharmacological treatments for binge eating disorder.
Psychotherapy and structured self-help, based on cognitive-behavioral interventions, are effective first-line treatments for binge eating disorder.
Meta-AnalysisHighly CitedComparative Effectiveness of Treatments for Binge‐Eating Disorder: Systematic Review and Network Meta‐Analysis
Lisdexamfetamine is better at increasing binge abstinence than second-generation antidepressants, and therapist-led cognitive behavioral therapy is better at reducing binge-eating frequency than behavioral weight loss.
Meta-AnalysisHighly CitedComparing integrative cognitive-affective therapy and guided self-help cognitive-behavioral therapy to treat binge-eating disorder using standard and naturalistic momentary outcome measures: A randomized controlled trial.
ICAT-BED and CBTgsh both effectively reduce binge eating and improve psychopathology in binge-eating disorder patients, with similar results at 6-month follow-up.
RCT
Very Rigorous JournalPsychological and Behavioral Treatments for Binge-Eating Disorder.
Behavioral weight loss therapy is a promising treatment for binge-eating disorder, with cognitive-behavioral therapy and interpersonal psychotherapy providing good outcomes and modest weight loss.
Highly CitedPharmacotherapy of Binge-Eating Disorder: A Review
Pharmacotherapy, including antidepressants, anticonvulsants, and antiobesity agents, shows promise in reducing binge eating, weight gain, and improving psychopathology in binge eating disorder patients.
Systematic ReviewCognitive-behavioral therapy, behavioral weight loss, and sequential treatment for obese patients with binge-eating disorder: a randomized controlled trial.
CBT is superior to behavioral weight loss for reducing binge eating, but BWL produces greater weight loss during treatment, supporting its use as an alternative treatment option for obese patients with binge-eating disorder.
RCTHighly CitedNaltrexone-Bupropion and Behavior Therapy, Alone and Combined, for Binge-Eating Disorder: Randomized Double-Blind Placebo-Controlled Trial.
Naltrexone-bupropion and behavioral weight loss therapy significantly improve binge-eating disorder, with behavioral weight loss therapy being more effective than no therapy.
RCT