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Psychological Treatments for Binge Eating Disorder

Abstract

Binge eating disorder (BED) is the most prevalent eating disorder in adults, and individuals with BED report greater general and specific psychopathology than non-eating disordered individuals. The current paper reviews research on psychological treatments for BED, including the rationale and empirical support for cognitive behavioral therapy (CBT), interpersonal psychotherapy (IPT), dialectical behavior therapy (DBT), behavioral weight loss (BWL), and other treatments warranting further study. Research supports the effectiveness of CBT and IPT for the treatment of BED, particularly for those with higher eating disorder and general psychopathology. Guided self-help CBT has shown efficacy for BED without additional pathology. DBT has shown some promise as a treatment for BED, but requires further study to determine its long-term efficacy. Predictors and moderators of treatment response, such as weight and shape concerns, are highlighted and a stepped-care model proposed. Future directions include expanding the adoption of efficacious treatments in clinical practice, testing adapted treatments in diverse samples (e.g., minorities and youth), improving treatment outcomes for nonresponders, and developing efficient and cost-effective stepped-care models.

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Acknowledgements

The authors would like to thank Heather Waldron for her assistance in preparing this manuscript.

The following funding sources are also acknowledged: NIDDK grant 5T32HL007456, NIMH grants 5K24MH070446-09, 1R01MH095748 and 5R29MH051384, CTSA grant UL1RR024992, and the Washington University Chancellor's Graduate Fellowship Program.

Disclosure

J.M. Iacovino, D.M. Gredysa, and M. Altman reported no potential conflicts of interest relevant to this article. D.E. Wilfley has received research grants from National Institutes of Health (NIH) and National Institute of Mental Health (NIMH); has served as a board member of Minnesota Obesity Center, Wellspring Academies, and UnitedHealth Group; and has served as a consultant for Lee Regional Visiting Nurse Association.

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Correspondence to Juliette M. Iacovino.

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Iacovino, J.M., Gredysa, D.M., Altman, M. et al. Psychological Treatments for Binge Eating Disorder. Curr Psychiatry Rep 14, 432–446 (2012). https://doi.org/10.1007/s11920-012-0277-8

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Keywords

  • Binge eating disorder
  • Eating disorders
  • Loss of control
  • Psychological treatments
  • Treatment review
  • Randomized controlled trials
  • Cognitive behavioral therapy
  • Guided self-help
  • Interpersonal psychotherapy
  • Behavioral weight loss
  • Dialectical behavior therapy