title: Guided self-help treatment for recurrent binge eating: replication and extension.
abstract: OBJECTIVE
  The aim of this study was to replicate and extend results of a previous blended efficacy and effectiveness trial of a low-intensity, manual-based guided self-help form of cognitive-behavioral therapy (CBT-GSH) for the treatment of binge eating disorders in a large health maintenance organization (HMO) and to compare them with usual care.
  
  
  METHODS
  To extend previous findings, the investigators modified earlier recruitment and assessment approaches and conducted a randomized clinical trial to better reflect procedures that may be reasonably carried out in real-world practices. The intervention was delivered by master's-level interventionists to 160 female members of a health maintenance organization who met diagnostic criteria for recurrent binge eating. Data collected at baseline, immediately posttreatment, and at six- and 12-month follow-ups were used in intent-to-treat analyses.
  
  
  RESULTS
  At the 12-month follow-up, CBT-GSH resulted in greater remission from binge eating (35%, N=26) than usual care (14%, N=10) (number needed to treat=5). The CBT-GSH group also demonstrated greater improvements in dietary restraint (d=.71) and eating, shape, and weight concerns (d=1.10, 1.24, and .98, respectively) but not weight change.
  
  
  CONCLUSIONS
  Replication of the pattern of previous findings suggests that CBT-GSH is a robust treatment for patients with recurrent binge eating. The magnitude of changes was significantly smaller than in the original study, however, suggesting that patients recruited and assessed with less intensive procedures may respond differently from their counterparts enrolled in trials requiring more comprehensive procedures.
authors: Kaiser Permanente Center for Health Research, Portland, OR 97227, USA. lynn.debar@kpchr.org
authors: Lynn L
authors: LL
authors: DeBar
authors: Ruth H
authors: RH
authors: Striegel-Moore
authors: G Terence
authors: GT
authors: Wilson
authors: Nancy
authors: N
authors: Perrin
authors: Bobbi Jo
authors: BJ
authors: Yarborough
authors: John
authors: J
authors: Dickerson
authors: Frances
authors: F
authors: Lynch
authors: Francine
authors: F
authors: Rosselli
authors: Helena C
authors: HC
authors: Kraemer
mesh_terms: D000328:Adult; D002032:Bulimia / Q000517:prevention & control*; D015928:Cognitive Behavioral Therapy / Q000379:methods; D005260:Female; D006801:Humans; D008875:Middle Aged; D017063:Outcome Assessment, Health Care / Q000379:methods; D016730:Program Development; D012648:Self Care / Q000379:methods*