Treatment of Binge Eating Disorder

Rutgers-The State University of New Jersey, Graduate School of Applied and Professional Psychology, 152 Frelinghuysen Road, Piscataway, NJ 08854, USA.
The Psychiatric clinics of North America (Impact Factor: 1.87). 12/2011; 34(4):773-83. DOI: 10.1016/j.psc.2011.08.011
Source: PubMed

ABSTRACT Cognitive-behavioral therapy and interpersonal psychotherapy are currently the most effective treatments for binge eating disorder in terms of cessation of binge eating, reduction of specific eating disorder psychopathology, and associated forms of psychopathology and psychosocial functioning. Treatment effects are generally well-maintained at follow-up. These specialty psychological treatments do not produce clinically significant weight loss, however. Guided self-help is a brief, cost-effective, and readily disseminable alternative to specialty treatments that require significantly more time and resources. Behavioral weight loss treatment produces short-term weight loss that is typically regained over follow-up. Pharmacotherapy is unsupported by available evidence.

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    ABSTRACT: Objective: To evaluate the effectiveness of Cognitive Behavioral Therapy (CBT) in the success of postoperative weight loss after 2 years of CB. Methods: A prospective observational study was conducted in consecutive patients with morbid obesity aged between 18 and 59 yrs and enrolled in the bariatric surgery program of the Obesity Surgery Unit of our hospital from June 2007 through June 2010, with two years postoperative follow-up. Participants were divided into two groups according to their participation in Cognitive Behavioral Therapy or not. Over a 3-month period, CBT was applied in 12 2-h sessions. The main dependent variables studied were body weight and height, from which we calculated BMI and percentage of excess weight lost (weight lost x 100)/(initial weight-ideal weight), classifying patients as successful (E ) those with EPP > 50%, and unsuccessful (NE) those with EPP <50%. Participants were also, assessed for general (stress, anxiety, depression and self-esteem) and specific (binge eating and food craving) psychopathology. Results: Of the 35 patients with bariatric surgery, 30 responded postoperative evaluations, 16 underwent CBT before CB and 14 underwent surgery without receiving psycho-nutritional therapy, (76% female) with a mean age of 41 ± 9.5 years. The mean baseline BMI was 42 ± 10 and 45% of patients were classified as super obese (BMI: 56 ± 6). Mean excess weight loss (EPP) was 77%. According to the EPP were classified as "successful" (S) (59%) and "unsuccessful" (U) (41%). Of the patients assigned to S, 94% received CBT (15 individuals of 17 total), compared with only 12% who did not receive (2 individuals of the 17 total) with statistically significant differences (p < 0.05). Also, the S patients appeared to be significantly less anxious and stressed and have higher self-esteem (P < 0.05). Regarding specific psychopathology, the food craving guided by hunger, loss of control over food intake and guilt was lower in patients who achieved > 50% of EPP (p < 0.04, p < 0.001, p < 0.001, respectively). It was also noted that these patients were plans to eat less and ate less for positive reinforcement (p < 0.03 and p < 0.000, respectively) than the patient group NE. Conclusions: Patients who achieved successful results in the evolution of weight loss at two years of CB are mostly (94%) who received CBT, presenting lower psychological comorbidity than NE. CBT could positively influence postoperative outcomes.
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    ABSTRACT: Growing evidence suggests that pharmacotherapy may be beneficial for some patients with binge eating disorder (BED), an eating disorder characterized by repetitive episodes of uncontrollable consumption of abnormally large amounts of food without inappropriate weight loss behaviors. In this paper, we provide a brief overview of BED and review the rationales and data supporting the effectiveness of specific medications or medication classes in treating patients with BED. We conclude by summarizing these data, discussing the role of pharmacotherapy in the BED treatment armamentarium, and suggesting future areas for research.
    Therapeutics and Clinical Risk Management 05/2012; 8:219-41. DOI:10.2147/TCRM.S25574 · 1.47 Impact Factor
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    ABSTRACT: Abstract The rates of paediatric obesity have risen dramatically. Given the challenge of successful weight loss and maintenance, preventive interventions are sorely needed. Furthermore, since a substantial proportion of individuals do not respond to traditional behavioural weight loss therapy, alternative approaches are required. Psychological treatments for binge eating disorder have been generally effective at reducing binge episodes and producing weight maintenance or modest weight loss in obese adults. Given the strong link between loss of control eating and obesity in youths, binge eating disorder treatment may serve as a viable form of excess weight gain prevention. An adapted version of interpersonal psychotherapy for binge eating disorder is one such intervention that we have considered. A description of the theoretical basis and proposed mechanism is described. Adaptations of interpersonal psychotherapy and other established therapies for binge eating disorder may serve as platforms from which to develop and disseminate obesity and eating disorder prevention programs in children and adolescents.
    International Review of Psychiatry 06/2012; 24(3):262-70. DOI:10.3109/09540261.2012.676032 · 1.80 Impact Factor
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