Cognitive behavioral guided self-help for the treatment of recurrent binge eating.
OBJECTIVE
Despite proven efficacy of cognitive behavioral therapy (CBT) for treating eating disorders with binge eating as the core symptom, few patients receive CBT in clinical practice. Our blended efficacy-effectiveness study sought to evaluate whether a manual-based guided self-help form of CBT (CBT-GSH), delivered in 8 sessions in a health maintenance organization setting over a 12-week period by master's-level interventionists, is more effective than treatment as usual (TAU).


METHODS
In all, 123 individuals (mean age = 37.2; 91.9% female, 96.7% non-Hispanic White) were randomized, including 10.6% with bulimia nervosa (BN), 48% with binge eating disorder (BED), and 41.4% with recurrent binge eating in the absence of BN or BED. Baseline, posttreatment, and 6- and 12-month follow-up data were used in intent-to-treat analyses.


RESULTS
At 12-month follow-up, CBT-GSH resulted in greater abstinence from binge eating (64.2%) than TAU (44.6%; number needed to treat = 5), as measured by the Eating Disorder Examination (EDE). Secondary outcomes reflected greater improvements in the CBT-GSH group in dietary restraint (d = 0.30); eating, shape, and weight concern (ds = 0.54, 1.01, 0.49, respectively; measured by the EDE Questionnaire); depression (d = 0.56; Beck Depression Inventory); and social adjustment (d = 0.58; Work and Social Adjustment Scale), but not weight change.


CONCLUSIONS
CBT-GSH is a viable first-line treatment option for the majority of patients with recurrent binge eating who do not meet diagnostic criteria for BN or anorexia nervosa.
Department of Psychology, Wesleyan University, Middletown, CT 06459, USA. rstriegel@wesleyan.edu
Ruth H
RH
Striegel-Moore
G Terence
GT
Wilson
Lynn
L
DeBar
Nancy
N
Perrin
Frances
F
Lynch
Francine
F
Rosselli
Helena C
HC
Kraemer
D000328:Adult; D000856:Anorexia Nervosa / Q000523:psychology / Q000628:therapy; D056912:Binge-Eating Disorder / Q000523:psychology / Q000628:therapy*; D001828:Body Image; D052018:Bulimia Nervosa / Q000523:psychology / Q000628:therapy; D015928:Cognitive Behavioral Therapy / Q000379:methods*; D005247:Feeding Behavior / Q000523:psychology; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008329:Managed Care Programs; D008370:Manuals as Topic; D008875:Middle Aged; D010555:Personality Inventory / Q000706:statistics & numerical data; D011594:Psychometrics; D011599:Psychopathology; D019057:Quality-Adjusted Life Years; D055502:Secondary Prevention; D012648:Self Care / Q000379:methods*; D012917:Social Adjustment; D016896:Treatment Outcome