Group therapy for binge eating disorder

January 01, 0001

Group therapy for binge eating disorder

Interpersonal psychotherapy (IPT) is an effective specialty treatment for binge eating disorder (BED). Behavioral weight loss treatment (BWL) and guided self-help based on cognitive behavior therapy (CBTgsh) have both resulted in short-term reductions in binge eating in obese patients with BED. These US authors conducted a randomized controlled trial to test whether patients with BED require specialty therapy beyond BWL and whether IPT is more effective than either BWL or CBTgsh in patients with a high negative affect during a 2-year follow-up. They enrolled 205 women and men with a body mass index between 27 and 45 who met DSM-IV criteria for BED. Intervention consisted of 20 sessions for instruction and discussion of homework. Therapist-guided sessions used videotapes for the education segment. Self-guided groups received detailed guidelines and facilitation rotated among participants.

They found: “At 2-year follow-up, both IPT and CBTgsh resulted in greater remission from binge eating than BWL (odds ratios, BWL vs CBTgsh = 2.3, BWL vs IPT = 2.6, and CBTgsh vs IPT = 1.2). Self-esteem and global Eating Disorder Examination scores were moderators of treatment outcome. The odds ratios for low and high global Eating Disorder Examination scores were 2.8 for BWL, 2.9 for CBTgsh, and 0.73 for IPT. For self-esteem, they were 2.4 for BWL, 1.9 for CBTgsh, and 0.9 for IPT.”

The authors concluded: “Interpersonal psychotherapy and CBTgsh are significantly more effective than BWL in eliminating binge eating after 2 years. Guided self-help based on cognitive behavior therapy is a first-line treatment option for most patients with BED, with IPT (or full cognitive behavior therapy) used for patients with low self-esteem and high eating disorder psychopathology.”

Long term benefits with any group approach seems questionable.

For the full abstract, click here.

Arch Gen Psychiatry 164(1):85-91, January 2010 © 2010 to the American Medical Association
A Randomized Placebo-Controlled Clinical Trial of 5 Smoking Cessation Pharmacotherapies. Megan E. Piper, Stevens S. Smith, Tanya R. Schlam, et al. Correspondence to: Dr. Piper: [email protected]

Category: P. Psychological. Social Problems. Keywords: binge eating disorder, psychological treatment, group treatment, behavioral therapy, randomized controlled trial
Synopsis edited by Dr Linda French, Toledo, Ohio. Posted on Global Family Doctor 12 January 2010

Pearls are an independent product of the Cochrane primary care group and are meant for educational use and not to guide clinical care.