title: Rapid response in psychological treatments for binge eating disorder.
abstract: OBJECTIVE
  Analysis of short- and long-term effects of rapid response across 3 different treatments for binge eating disorder (BED).
  
  
  METHODS
  In a randomized clinical study comparing interpersonal psychotherapy (IPT), cognitive-behavioral therapy guided self-help (CBTgsh), and behavioral weight loss (BWL) treatment in 205 adults meeting Diagnostic and Statistical Manual of Mental Disorders (4th ed.; DSM-IV; APA, 1994) criteria for BED, the predictive value of rapid response, defined as ≥70% reduction in binge eating by Week 4, was determined for remission from binge eating and global eating disorder psychopathology at posttreatment, 6-, 12-, 18-, and 24-month follow-ups.
  
  
  RESULTS
  Rapid responders in CBTgsh, but not in IPT or BWL, showed significantly greater rates of remission from binge eating than nonrapid responders, which was sustained over the long term. Rapid and nonrapid responders in IPT and rapid responders in CBTgsh showed a greater remission from binge eating than nonrapid responders in CBTgsh and BWL. Rapid responders in CBTgsh showed greater remission from binge eating than rapid responders in BWL. Although rapid responders in all treatments had lower global eating disorder psychopathology than nonrapid responders in the short term, rapid responders in CBTgsh and IPT were more improved than those in BWL and nonrapid responders in each treatment. Rapid responders in BWL did not differ from nonrapid responders in CBTgsh and IPT.
  
  
  CONCLUSIONS
  Rapid response is a treatment-specific positive prognostic indicator of sustained remission from binge eating in CBTgsh. Regarding an evidence-based, stepped-care model, IPT, equally efficacious for rapid and nonrapid responders, could be investigated as a second-line treatment in case of nonrapid response to first-line CBTgsh.
authors: Department of Medical Psychology and Medical Sociology, Integrated Research and Treatment Center for Adiposity Diseases, University of Leipzig Medical Center.
authors: Anja
authors: A
authors: Hilbert
authors: Eating and Weight Disorder Program, Icahn School of Medicine at Mount Sinai.
authors: Thomas
authors: T
authors: Hildebrandt
authors: Department of Psychiatry, Stanford University School of Medicine.
authors: W Stewart
authors: WS
authors: Agras
authors: Department of Psychiatry, Washington University School of Medicine.
authors: Denise E
authors: DE
authors: Wilfley
authors: Graduate School of Applied and Professional Psychology, Rutgers, The State University of New Jersey.
authors: G Terence
authors: GT
authors: Wilson
mesh_terms: D000328:Adult; D056912:Binge-Eating Disorder / Q000523:psychology / Q000628:therapy*; D002032:Bulimia / Q000523:psychology / Q000628:therapy*; D015928:Cognitive Behavioral Therapy; D003131:Combined Modality Therapy; D006801:Humans; D009765:Obesity / Q000523:psychology*; D011379:Prognosis; D016896:Treatment Outcome; D015431:Weight Loss / Q000502:physiology*