Heterogeneity moderates treatment response among patients with binge eating disorder.
OBJECTIVE
The purpose of the study was to explore heterogeneity and differential treatment outcome among a sample of patients with binge eating disorder (BED).


METHODS
A latent class analysis was conducted with 205 treatment-seeking, overweight or obese individuals with BED randomized to interpersonal psychotherapy (IPT), behavioral weight loss (BWL), or guided self-help based on cognitive behavioral therapy (CBTgsh). A latent transition analysis tested the predictive validity of the latent class analysis model.


RESULTS
A 4-class model yielded the best overall fit to the data. Class 1 was characterized by a lower mean body mass index (BMI) and increased physical activity. Individuals in Class 2 reported the most binge eating, shape and weight concerns, compensatory behaviors, and negative affect. Class 3 patients reported similar binge eating frequencies to Class 2, with lower levels of exercise or compensation. Class 4 was characterized by the highest average BMI, the most overeating episodes, fewer binge episodes, and an absence of compensatory behaviors. Classes 1 and 3 had the highest and lowest percentage of individuals with a past eating disorder diagnosis, respectively. The latent transition analysis found a higher probability of remission from binge eating among those receiving IPT in Class 2 and CBTgsh in Class 3.


CONCLUSIONS
The latent class analysis identified 4 distinct classes using baseline measures of eating disorder and depressive symptoms, body weight, and physical activity. Implications of the observed differential treatment response are discussed.
Sysko
Robyn
R
Division of Clinical Therapeutics, The New York State Psychiatric Institute, New York, NY 10032, USA. syskor@childpsych.columbia.edu
Hildebrandt
Tom
T
Wilson
G Terence
GT
Wilfley
Denise E
DE
Agras
W Stewart
WS
D000328:Adult; D000368:Aged; D001521:Behavior Therapy; D056912:Binge-Eating Disorder / Q000175:diagnosis / Q000523:psychology / Q000628:therapy*; D015992:Body Mass Index; D015928:Cognitive Behavioral Therapy; D003131:Combined Modality Therapy; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008019:Life Style; D008297:Male; D008875:Middle Aged; D009765:Obesity / Q000175:diagnosis / Q000523:psychology / Q000628:therapy*; D050177:Overweight / Q000175:diagnosis / Q000523:psychology / Q000628:therapy*; D010555:Personality Inventory / Q000706:statistics & numerical data; D011594:Psychometrics; D011613:Psychotherapy; D012648:Self Care; D015431:Weight Loss; D055815:Young Adult