Responses to weight loss treatment among obese individuals with and without BED: A matched-study meta-analysis

Psychology Department, St. John Fisher College, Rochester, NY 14618, USA.
Eating and weight disorders: EWD (Impact Factor: 0.79). 07/2007; 12(2):54-60. DOI: 10.1007/BF03327579
Source: PubMed


The moderating influence of binge eating status on obese individuals' responses to weight loss treatment was evaluated with a meta-analysis of 36 tests of weight loss treatment (n=792) that were matched to control key background variables. After controlling for pre-treatment weight, treatment produced more weight loss in samples of obese non-BED compared with obese BED participants. Weight loss treatment produced large posttreatment reductions in depression in both obese BED and non-BED samples. The results indicate that BED status moderated post-treatment weight loss among people in weight treatment programs. Obese BED (average weight loss=1.3 kg) samples lost negligible weight compared to obese non-BED (average weight loss=10.5 kg) samples. BED status did not moderate psychological responses to treatment: both BED and non-BED samples experienced large post-treatment reductions in depression. The clinical implications of these findings are discussed.

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    • "They exhibit higher lifetime rates of affective disorder [8] and a lower quality of life [9, 10]. BED obese individuals undergoing weight loss treatment lose less weight than obese patients without BED [11]. Taken together, these factors support the systematic screening of BED in people seeking a treatment for obesity [6]. "
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    ABSTRACT: A significant percentage of obese patients suffer from binge eating disorder (BED), with negative consequences on psychological health, quality of life, weight loss treatment and maintenance. Cognitive behavioral therapy (CBT), delivered in traditional or self-help format, is effective in reducing BED symptoms. To improve dissemination, a self-help treatment program composed of eleven CBT based modules was implemented on the Internet and evaluated in a population of adult obese patients with BED. Forty-two obese BED patients wait-listed for a multi-disciplinary obesity treatment took part in the study. Twenty-two patients completing the six-month online guided self-help treatment program were compared to a control group of twenty patients without intervention. Both groups were evaluated before and after six months of Internet self-help treatment or waiting list. A follow-up evaluation was carried out six months later. Participants in the online self-help treatment program showed higher binge eating abstinence rates, lower EDE-Q shape and weight concerns, and improved TFEQ disinhibition of eating and hunger scores compared to the control group. They also scored better on psychological health and quality of life measures after intervention, and gains were maintained at follow-up. No effect was found regarding BMI. The number of modules completed was correlated with a better quality of life improvement at post evaluation. Participants rated the program as useful and easy to use. The Internet seems to be a valuable tool for disseminating CBT for BED obese patients. Acceptance of new technology was good in this population. Further research is needed with a larger sample to corroborate these results.
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    ABSTRACT: Le traitement médicamenteux des compulsions alimentaires chez le malade obèse est encore l’objet d’incertitudes. En effet, si quelques études contrôlées sont disponibles, elles n’ont inclus que trop peu de malades au total. Les antidépresseurs de type inhibiteurs de la recapture de la sérotonine, l’orlistat et les derniers anti-épileptiques ont fait la preuve de leur efficacité (niveau de preuve: bon), mais aussi de leurs effets secondaires, en particulier les anti-épileptiques. Ces médicaments ne sont efficaces en moyenne que chez un malade sur deux; ils n’agissent qu’après un délai d’au moins trois semaines et leurs effets persistent tant que dure leur prise. La dose efficace est en règle élevée. Leurs effets favorables sont d’autant plus importants et durent d’autant plus qu’un travail psychocomportemental a été effectué en parallèle. The effectiveness of pharmacological treatment of compulsive eating disorders in obese patients is as yet uncertain. Although some clinical trials have been carried out, not enough patients were involved in total. Antidepressants such as selective serotonin reuptake inhibitors, orlistat and the newest anti-epileptics have all been shown to be successful (proof level: good), but have also been seen to have side effects, particularly with respect to anti-epileptic drugs. On average, these drugs only work for one in two patients, they take at least three weeks to work and they only work for as long as they are being taken. They are generally only effective when taken in high doses. Their success is greater and more durable if used simultaneously with psycho-behavioral therapy.
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