The majority of those who seek treatment for binge eating disorder also have accompanying obesity or overweight. The best available psychological treatments for binge eating disorder produce good and lasting outcomes with regard to control over eating but virtually no weight loss, yet control over eating and weight loss are both important and valued goals of those who seek treatment.
We have devised a model of the processes maintaining both the binge eating and the overweight or obesity that occurs in many patients with binge eating disorder who seek treatment. The model draws on previous research findings to highlight and integrate the factors maintaining both the disordered eating and the accompanying overweight or obesity.
We outline a new treatment based on the proposed model that explicitly addresses the twin goals of cessation of binge eating and weight loss in an integrated fashion. The proposed treatment incorporates and integrates elements from two previously tested evidence-based interventions, enhanced cognitive behavioural therapy for eating disorders shown to reduce binge eating and cognitive behaviour therapy of obesity, which produces weight loss.
To meet a major challenge for the treatment of binge eating disorder (BED), we have proposed that an integrated treatment with the goals of addressing both binge eating and overweight or obesity is worth researching further. Should this treatment be successful, the goals of many patients who seek treatment for BED are more likely to be met.
Level of evidence
This brief report proposes a new approach to clinical practice to be researched further. The evidence on the basis of which the case is made is derived from Level 1: evidence obtained from at least one properly designed randomized controlled trial; systematic reviews and meta-analyses; and experimental studies.
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Hilbert A, Petroff D, Herpertz S, Pietrowsky R (2019) Meta-analysis of the efficacy of psychological and medical treatments for binge-eating disorder. J Consult Clin Psychol 87:91–105. https://doi.org/10.1037/ccp0000358.supp
National Institute for Health and Care Excellence. (2017) Eating disorders: recognition and treatment. https://www.nice.org.uk/guidance/ng69. Accessed Mar 2019
Hilbert A, Bishop ME, Stein RI, Tanofsky-Kraff M, Swenson AK, Welch RR, Wilfley DE (2012) Long-term efficacy of psychological treatments for binge eating disorder. Br J Psychiatry 200:232–237. https://doi.org/10.1192/bjp.bp.110.089664
Masheb RM, Grilo CM, Rolls BJ (2011) A randomized controlled trial for obesity and binge eating disorder: low-energy-density dietary counseling and cognitive-behavioral therapy. Behav Res Ther 49:821–829. https://doi.org/10.1016/j.brat.2011.09.006
Blanchet C, Mathieu M-E, St-Laurent A, Fecteau S, St-Amour N, Drapeau V (2018) A systematic review of physical activity interventions in individuals with binge eating disorders. Curr Obes Rep 7:76–88. https://doi.org/10.1007/s13679-018-0295-x
Fairburn CG, Cooper Z, Shafran R (2003) Cognitive behaviour therapy for eating disorders: a “transdiagnostic” theory and treatment. Behav Res Ther 41:509–528. https://doi.org/10.1016/S0005-7967(02)00088-8
Elran-Barak R, Sztainer M, Goldschmidt AB, Crow SJ, Peterson CB, Hill LL, Crosby RD, Powers P, Mitchell JE, Le Grange D (2015) Dietary restriction behaviors and binge eating in anorexia nervosa, bulimia nervosa and binge eating disorder: trans-diagnostic examination of the restraint model. Eat Behav 18:192–196. https://doi.org/10.1016/j.eatbeh.2015.05.012
Hrabosky JI, White MA, Masheb RM, Grilo CM (2007) Physical activity and its correlates in treatment-seeking obese patients with binge eating disorder. Int J Eat Disord 40:72–76. https://doi.org/10.1002/eat.20323
Cooper Z, Doll HA, Hawker DM, Byrne S, Bonner G, Eeley E, O’Connor ME, Fairburn CG (2010) Testing a new cognitive behavioural treatment for obesity: a randomized controlled trial with three-year follow-up. Behav Res Ther 48:706–713. https://doi.org/10.1016/j.brat.2010.03.008
Wilson GT, Fairburn CC, Agras WS, Walsh BT, Kraemer H (2002) Cognitive-behavioral therapy for bulimia nervosa: time course and mechanisms of change. J Consult Clin Psychol 70:267–274. https://doi.org/10.1037/0022-006X.70.2.267
Jensen MD, Ryan DH, Apovian CM, Ard JD, Comuzzie AG, Donato KA, Hu FB, Hubbard VS, Jakicic JM, Kushner RF, Loria CM, Millen BE, Nonas CA, Pi-Sunyer FX, Stevens J, Stevens VJ, Wadden TA, Wolfe BM, Yanovski SZ (2014) 2013 AHA/ACC/TOS guideline for the management of overweight and obesity in adults. J Am Coll Cardiol 63:2985–3023. https://doi.org/10.1016/j.jacc.2013.11.004
Hagan KE, Forbush KT, Chen P-Y (2017) Is dietary restraint a unitary or multi-faceted construct? Psychol Assess 29:1249–1260. https://doi.org/10.1037/pas0000429
Blomquist KK, Grilo CM (2011) Predictive significance of changes in dietary restraint in obese patients with binge eating disorder during treatment. Int J Eat Disord 44:515–523. https://doi.org/10.1002/eat.20849
Linardon J, Wade TD, De La Piedad Garcia X, Brennan L (2017) The efficacy of cognitive-behavioral therapy for eating disorders: a systematic review and meta-analysis. J Consult Clin Psychol 85:1080–1094. https://doi.org/10.1037/ccp0000245
Dalle Grave R, Calugi S, Bosco G, Valerio L, Valenti C, El Ghoch M, Zini D (2018) Personalized group cognitive behavioural therapy for obesity: a longitudinal study in a real-world clinical setting. Eat Weight Disord. https://doi.org/10.1007/s40519-018-0593-z
The Look AHEAD Research Group (2014) Eight-year weight losses with an intensive lifestyle intervention: the look AHEAD study. Obesity 22:5–13. https://doi.org/10.1002/oby.20662
Dalle Grave R, Melchionda N, Calugi S, Centis E, Tufano A, Fatati G, Fusco MA, Marchesini G (2005) Continuous care in the treatment of obesity: an observational multicentre study. J Intern Med 258:265–273. https://doi.org/10.1111/j.1365-2796.2005.01524.x
No external funding was received for this work.
Conflict of interest
Zafra Cooper declares that she has no conflict of interest.Simona Calugi declares that she has no conflict of interest.Riccardo Dalle Grave declares that he has no conflict of interest.
All studies referred to and previously published by the authors involving human participants were in accordance with the ethical standards of the relevant institutional committees and with the 1964 Helsinki Declaration and its later amendments.
Informed consent was obtained from all participants.
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Cooper, Z., Calugi, S. & Dalle Grave, R. Controlling binge eating and weight: a treatment for binge eating disorder worth researching?. Eat Weight Disord 25, 1105–1109 (2020). https://doi.org/10.1007/s40519-019-00734-4
- Binge eating disorder
- Cognitive behavioural therapy
- Weight loss
- Binge eating