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.
"Moreover binge eating disorder (BED) is typically connected with obesity (American Psychiatric Association, 2000; Hill, 2005; Berkowitz and Fabricatore, 2011; Gearhardt et al., 2011c; Wilson, 2011; Schag et al., 2013; Faulconbridge and Bechtel, 2014), even if not occurring exclusively in conjunction with overweight conditions. According to Hill (2005, p. 27), “it is apparent that BED is more common in the obese than in normal-weight individuals. "
[Show abstract][Hide abstract] ABSTRACT: Obesity is currently an important public health problem of epidemic proportions (globesity). Inpatient rehabilitation interventions that aim at improving weight-loss, reducing obesity-related complications and changing dysfunctional behaviors, should ideally be carried out in a multidisciplinary context with a clinical team composed of psychologists, dieticians, psychiatrists, endocrinologists, nutritionists, physiotherapists, etc. Long-term outpatient multidisciplinary treatments are likely to constitute an essential aspect of rehabilitation. Internet-based technologies can improve long-term obesity rehabilitation within a collaborative approach by enhancing the steps specified by psychological and medical treatment protocols. These outcomes may be augmented further by the mHealth approach, through creating new treatment delivery methods to increase compliance and engagement. mHealth (m-health, mobile health) can be defined as the practice of medicine and public health, supported by mobile communication devices for health services and information. mHealth applications which can be implemented in weight loss protocols and obesity rehabilitation are discussed, taking into account future research directions in this promising area.
Frontiers in Psychology 06/2014; 5:559. DOI:10.3389/fpsyg.2014.00559 · 2.80 Impact Factor
[Show abstract][Hide abstract] ABSTRACT: Objective:
To evaluate the effectiveness of Cognitive Behavioral Therapy (CBT) in the success of postoperative weight loss after 2 years of CB.
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.
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.
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.
Nutricion hospitalaria: organo oficial de la Sociedad Espanola de Nutricion Parenteral y Enteral 07/2013; 28(4):1109-1114. DOI:10.3305/nh.2013.28.4.6536 · 1.04 Impact Factor
[Show abstract][Hide abstract] 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.
Farnaz Fouladi, James E Mitchell, Ross D Crosby, Scott G Engel, Scott Crow, Laura Hill, Daniel Le Grange, Pauline Powers, Kristine J Steffen
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