Treatment outcome in people with subthreshold compared with full-syndrome binge eating disorder.
OBJECTIVE
There is a controversial discussion in the literature as to whether individuals with subthreshold binge eating disorder (subBED) differ clinically significantly from individuals with full-syndrome binge eating disorder (BED). This study was designed to compare eating-related and general psychopathology at baseline and in response to a multimodal treatment program in obese people with subBED compared with BED.


METHODS
A total of 96 obese participants (BMI > or = 30 kg/m(2)) were assessed for eating-related and general psychopathology at baseline. Thirty-nine participants meeting criteria for BED and 19 participants meeting criteria for subBED attended a 15-session outpatient group therapy including cognitive behavioral therapy extended by interpersonal therapy, nutritional counseling, and a supervised walking exercise. Participants with eating disorders were reassessed at the end of treatment and at 3-month follow-up. The obese control group without an eating disorder (n = 38) was assessed once. This was not a randomized controlled trial.


RESULTS
Intent-to-treat analyses revealed no differences between subBED and full-syndrome BED participants with regard to eating-related and general psychopathology at baseline and with regard to treatment outcome. All participants experienced substantial improvements, and the results remained stable during follow-up (except for dietary restraint). At follow-up, participants with subBED and BED remained different from non-eating disorder controls in eating-related but not general psychopathology.


CONCLUSIONS
The findings indicate that our multimodal treatment program is equally effective in obese subBED and BED participants, suggesting that a differentiation currently seems not to be of clinical significance.
Friederich
Hans-Christoph
HC
Department of Psychosomatic and General Internal Medicine, University of Heidelberg, Heidelberg, Germany.
Schild
Sandra
S
Wild
Beate
B
de Zwaan
Martina
M
Quenter
Andrea
A
Herzog
Wolfgang
W
Zipfel
Stephan
S
D000328:Adult; D052018:Bulimia Nervosa / Q000628:therapy*; D015928:Cognitive Behavioral Therapy; D003131:Combined Modality Therapy; D004035:Diet Therapy; D005081:Exercise Therapy; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009765:Obesity / Q000628:therapy; D013577:Syndrome; D016896:Treatment Outcome; D016138:Walking