title: A randomized controlled trial for obesity and binge eating disorder: low-energy-density dietary counseling and cognitive-behavioral therapy.
abstract: The present study examined a dietary approach - lowering energy density - for producing weight loss in obese patients with binge eating disorder (BED) who also received cognitive-behavioral therapy (CBT) to address binge eating. Fifty consecutive participants were randomly assigned to either a six-month individual treatment of CBT plus a low-energy-density diet (CBT+ED) or CBT plus General Nutrition counseling not related to weight loss (CBT+GN). Assessments occurred at six- and twelve-months. Eighty-six percent of participants completed treatment, and of these, 30% achieved at least a 5% weight loss with rates of binge remission ranging from 55% to 75%. The two treatments did not differ significantly in weight loss or binge remission outcomes. Significant improvements were found for key dietary and metabolic outcomes, with CBT+ED producing significantly better dietary outcomes on energy density, and fruit and vegetable consumption, than CBT+GN. Reductions in energy density and weight loss were significantly associated providing evidence for the specificity of the treatment effect. These favorable outcomes, and that CBT+ED was significantly better at reducing energy density and increasing fruit and vegetable consumption compared to CBT+GN, suggest that low-energy-density dietary counseling has promise as an effective method for enhancing CBT for obese individuals with BED.
authors: Yale School of Medicine, Department of Psychiatry, 301 Cedar Street, P.O. Box 208098, New Haven, CT 06520-8098, USA. robin.masheb@yale.edu
authors: Robin M
authors: RM
authors: Masheb
authors: Carlos M
authors: CM
authors: Grilo
authors: Barbara J
authors: BJ
authors: Rolls
mesh_terms: D000328:Adult; D056912:Binge-Eating Disorder / Q000503:physiopathology / Q000523:psychology / Q000628:therapy*; D001794:Blood Pressure / Q000502:physiology; D015992:Body Mass Index; D031204:Caloric Restriction / Q000379:methods / Q000706:statistics & numerical data*; D015928:Cognitive Behavioral Therapy / Q000379:methods / Q000706:statistics & numerical data*; D037001:Directive Counseling / Q000379:methods / Q000706:statistics & numerical data*; D004435:Eating / Q000523:psychology; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D044623:Nutrition Therapy / Q000379:methods / Q000706:statistics & numerical data*; D009765:Obesity / Q000503:physiopathology / Q000523:psychology / Q000628:therapy*; D010349:Patient Compliance / Q000706:statistics & numerical data; D011569:Psychiatric Status Rating Scales / Q000706:statistics & numerical data; D055105:Waist Circumference / Q000502:physiology; D015431:Weight Loss / Q000502:physiology