Adaptating CBT-OB for Binge-Eating Disorder

  • Riccardo Dalle Grave
  • Massimiliano Sartirana
  • Marwan El Ghoch
  • Simona Calugi


Patients with binge-eating disorder (BED) respond quite well to psychological interventions, including non-intensive guided self-help based on cognitive behavioural therapy (CBT). However, the main problem to date is that these treatments, like behavioural therapy for obesity and medications, do not produce significant weight loss. Indeed, BED is maintained by multiple and heterogeneous mechanisms that are difficult to fully address via the available treatments. With this in mind, CBT for obesity (CBT-OB) has been adapted for patients with concomitant BED, integrating strategies and procedures from CBT-E (“Enhanced”)—a treatment recommended by the National Institute for Health and Care Excellence guidelines for all eating disorders and ages. All patients with BED and obesity start the treatment at Stage 1 of CBT-E. Then, after 4 weeks, in Stage 2 of CBT-E, the decision is taken whether to continue with CBT-E or to shift to standard CBT-OB. This decision will be made taking into account the patient’s response to treatment, any presentation of overvaluation of shape and weight and general attitude. Specifically, CBT-OB can be started if patients display a remission from binge eating and do not report overvaluation of shape and weight. Otherwise, the treatment continues with CBT-E Stages 3 and 4. CBT-OB can then be started if patients have achieved remission from binge eating and do not report the overvaluation of shape and weight at the post-treatment review session, 20 weeks after the end of CBT-E.


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Copyright information

© Springer International Publishing AG, part of Springer Nature 2018

Authors and Affiliations

  • Riccardo Dalle Grave
    • 1
  • Massimiliano Sartirana
    • 1
  • Marwan El Ghoch
    • 1
  • Simona Calugi
    • 1
  1. 1.Department of Eating and Weight DisordersVilla Garda HospitalGardaItaly

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