title: A randomized controlled comparison of guided self-help cognitive behavioral therapy and behavioral weight loss for binge eating disorder.
abstract: We performed a randomized controlled study to test the relative efficacy of guided self-help (gsh) cognitive-behavioral therapy (CBTgsh) and behavioral weight loss treatment (BWLgsh) treatments for binge eating disorder (BED). To provide an additional partial control for non-specific influences of attention, a third control (CON) treatment condition was included. We tested the treatments using a guided self-help approach given the promising results from initial studies using minimal therapist guidance. Ninety consecutive overweight patients (19 males, 71 females) with BED were randomly assigned (5:5:2 ratio) to one of three treatments: CBTgsh (N=37), BWLgsh (N=38), or CON (N=15). The three 12-week treatment conditions were administered individually following guided self-help protocols. Overall, 70 (78%) completed treatments; CBTgsh (87%) and CON (87%) had significantly higher completion rates than BWLgsh (67%). Intent-to-treat analyses revealed that CBTgsh had significantly higher remission rates (46%) than either BWLgsh (18%) or CON (13%). Weight loss was minimal and differed little across treatments. The findings suggest that CBT, administered via guided self-help, demonstrates efficacy for BED, but not for obesity. The findings support CBT administered via guided self-help as a first step in the treatment of BED and provide evidence for its specific effects.
authors.affiliation: Department of Psychiatry, Yale University School of Medicine, 301 Cedar Street-2nd Floor, P.O. Box 208098, New Haven, CT 06520, USA. carlos.grilo@yale.edu
authors.forename: Carlos M
authors.initials: CM
authors.lastname: Grilo
authors.forename: Robin M
authors.initials: RM
authors.lastname: Masheb
mesh_terms: D000328:Adult; D000704:Analysis of Variance; D001521:Behavior Therapy / Q000379:methods*; D016022:Case-Control Studies; D015928:Cognitive Behavioral Therapy / Q000379:methods*; D004311:Double-Blind Method; D005260:Female; D006801:Humans; D006963:Hyperphagia / Q000523:psychology / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D011615:Psychotherapy, Group; D012657:Self-Help Groups; D015431:Weight Loss