RT Journal
A1 Wilson G, Wilfley DE, Agras W, Bryson SW
T1 PSychological treatments of binge eating disorder
JF Archives of General Psychiatry
JO Archives of General Psychiatry
YR 2010
FD January 1
VO 67
IS 1
SP 94
OP 01
DO 10.1001/archgenpsychiatry.2009.170
UL http://dx.doi.org/10.1001/archgenpsychiatry.2009.170
AB Context 
    Interpersonal psychotherapy (IPT) is an effective specialty treatment for binge eating disorder (BED). Behavioral weight loss treatment (BWL) and guided self-help based on cognitive behavior therapy (CBTgsh) have both resulted in short-term reductions in binge eating in obese patients with BED.Objective 
    To test whether patients with BED require specialty therapy beyond BWL and whether IPT is more effective than either BWL or CBTgsh in patients with a high negative affect during a 2-year follow-up.Design 
    Randomized, active control efficacy trial.Setting 
    University outpatient clinics.Participants 
    
						Two hundred five women and men with a body mass index between 27 and 45 who met DSM-IV criteria for BED.
					Intervention 
    Twenty sessions of IPT or BWL or 10 sessions of CBTgsh during 6 months.Main Outcome Measures 
    Binge eating assessed by the Eating Disorder Examination.Results 
    
						At 2-year follow-up, both IPT and CBTgsh resulted in greater remission from binge eating than BWL (P < .05; odds ratios: BWL vs CBTgsh, 2.3; BWL vs IPT, 2.6; and CBTgsh vs IPT, 1.2). Self-esteem (P < .05) and global Eating Disorder Examination (P < .05) scores were moderators of treatment outcome. The odds ratios for low and high global Eating Disorder Examination scores were 2.8 for BWL, 2.9 for CBTgsh, and 0.73 for IPT; for self-esteem, they were 2.4 for BWL, 1.9 for CBTgsh, and 0.9 for IPT.
					Conclusions 
    Interpersonal psychotherapy and CBTgsh are significantly more effective than BWL in eliminating binge eating after 2 years. Guided self-help based on cognitive behavior therapy is a first-line treatment option for most patients with BED, with IPT (or full cognitive behavior therapy) used for patients with low self-esteem and high eating disorder psychopathology.Trial Registration 
    
						clinicaltrials.gov Identifier: NCT00060762