Comparing treatments for binge eating
Many programs claim they can help you reduce binge eating and lose weight, but they often don't have any research to back up that claim. Researchers in the United States and Switzerland just released two independent studies comparing different treatments for binge eating disorder. They examined how well therapy and/or medication helped reduce binge eating, not just in the first few weeks, but months and years after treatment ends.
A team of researchers led by Dr. Carlos Grilo at Yale University compared a form of psychotherapy, cognitive behavior therapy, to medication. They released their results last week in the Journal of Clinical and Counseling Psychology. In their study, 81 adults who were overweight and met criteria for binge eating disorder were randomly assigned to one of three groups: 1) medication only (fluoxetine, an antidepressant), 2) cognitive behavior therapy + medication, and 3) cognitive behavior therapy + placebo pills.
This type of design is the gold standard in treatment research. The study also marks the first time anyone has compared treatments for binge eating disorder while randomly assigning people to groups (which helps us know the treatment led to changes versus, say, something about the participants) and also using a placebo (versus giving no medication).
Dr. Grilo and his colleagues found that people who received cognitive behavior therapy had the best results. About 1 year after treatment ended, the researchers asked everyone how often they had been binge eating in the last month. About 35% of people who received cognitive behavioral therapy + placebo said they had zero binge eating episodes compared to only about 4% who received the medication fluoxetine. The people who had therapy + meds didn’t do as well as the people who had therapy + placebo. While these results are promising, none of these treatments led to a significant decrease in weight loss and clearly many people were still struggling with binge eating a year after treatment.
Another study, conducted in Switzerland and released online last month in the journal, Behavior Research and Therapy, compared cognitive behavior therapy to a more general weight loss program. The researchers waited six years after treatment ended to see how much people were still binge eating. They found that 20% of people who previously received cognitive behavior therapy said they had zero binge eating episodes in the last month (compared to 35% in the study described earlier). The general weight loss program showed relatively similar results with 17% saying they had zero binge eating episodes in the last month. Unlike the study described earlier, people in this study were at a lower weight compared to when they started treatment, but not much lower.
If you’re suffering from binge eating, these studies show that there are solid treatments based on research that can help. You’re more likely to notice changes while you’re in treatment, which usually lasts a few months. Continuing to avoid binge eating months and years after treatment ends may be more challenging, but many people are able to do it.
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Dr. Gupta is a professor at Barnard College of Columbia University and provides individual therapy at Tribeca Psychology
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