title: The efficacy of self-help group treatment and therapist-led group treatment for binge eating disorder.
abstract: OBJECTIVE
  The purpose of this investigation was to compare three types of treatment for binge eating disorder to determine the relative efficacy of self-help group treatment compared to therapist-led and therapist-assisted group cognitive-behavioral therapy.
  
  
  METHODS
  A total of 259 adults diagnosed with binge eating disorder were randomly assigned to 20 weeks of therapist-led, therapist-assisted, or self-help group treatment or a waiting list condition. Binge eating as measured by the Eating Disorder Examination was assessed at baseline, at end of treatment, and at 6 and 12 months, and outcome was assessed using logistic regression and analysis of covariance (intent-to-treat).
  
  
  RESULTS
  At end of treatment, the therapist-led (51.7%) and the therapist-assisted (33.3%) conditions had higher binge eating abstinence rates than the self-help (17.9%) and waiting list (10.1%) conditions. However, no between-group differences in abstinence rates were observed at either of the follow-up assessments. The therapist-led condition also showed more reductions in binge eating at end of treatment and follow-up assessments compared to the self-help condition, and treatment or waiting period completion rates were higher in the therapist-led (88.3%) and waiting list (81.2%) conditions than in the therapist-assisted (68.3%) and self-help (59.7%) conditions.
  
  
  CONCLUSIONS
  Therapist-led group cognitive-behavioral treatment for binge eating disorder led to higher binge eating abstinence rates, greater reductions in binge eating frequency, and lower attrition compared to group self-help treatment. Although these findings indicate that therapist delivery of group treatment is associated with better short-term outcome and less attrition than self-help treatment, the lack of group differences at follow-up suggests that self-help group treatment may be a viable alternative to therapist-led interventions.
authors.affiliation: Department of Psychiatry, University of Minnesota Medical School, 2450 Riverside Ave., Minneapolis, MN 55454, USA. peter161@umn.edu
authors.forename: Carol B
authors.initials: CB
authors.lastname: Peterson
authors.forename: James E
authors.initials: JE
authors.lastname: Mitchell
authors.forename: Scott J
authors.initials: SJ
authors.lastname: Crow
authors.forename: Ross D
authors.initials: RD
authors.lastname: Crosby
authors.forename: Stephen A
authors.initials: SA
authors.lastname: Wonderlich
mesh_terms: D000328:Adult; D000368:Aged; D056912:Binge-Eating Disorder / Q000628:therapy*; D015928:Cognitive Behavioral Therapy / Q000379:methods*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D011615:Psychotherapy, Group / Q000379:methods*; D012648:Self Care / Q000379:methods; D012657:Self-Help Groups / Q000458:organization & administration*; D016896:Treatment Outcome; D014850:Waiting Lists