Guided self-help treatment for recurrent binge eating: replication and extension.

Area of Science:

• Psychiatry
• Clinical Psychology
• Behavioral Science

Background:

• Binge eating disorder (BED) is a significant public health concern.
• Previous trials demonstrated the efficacy of guided self-help cognitive-behavioral therapy (CBT-GSH).
• Replication in a large health maintenance organization (HMO) is needed to assess real-world applicability.

Purpose of the Study:

• To replicate and extend findings of a previous CBT-GSH trial for BED.
• To compare CBT-GSH with usual care in a large HMO setting.
• To assess the generalizability of CBT-GSH in a real-world clinical practice.

Main Methods:

• A randomized clinical trial was conducted with 160 female HMO members diagnosed with recurrent binge eating.
• Participants received either manual-based guided self-help CBT (CBT-GSH) or usual care.
• Data were collected at baseline, post-treatment, and at 6- and 12-month follow-ups using intent-to-treat analyses.

Main Results:

• At 12 months, CBT-GSH achieved significantly higher remission rates (35%) compared to usual care (14%), with a number needed to treat of 5.
• The CBT-GSH group showed greater improvements in dietary restraint and eating, shape, and weight concerns.
• No significant differences in weight change were observed between the groups.

Conclusions:

• CBT-GSH is a robust and effective treatment for patients with recurrent binge eating disorder.
• The study confirms the effectiveness of CBT-GSH in a large HMO setting, suggesting its suitability for broader implementation.
• While effective, the magnitude of change was smaller than in prior studies, indicating potential differences in patient response based on recruitment and assessment intensity.