Preferences for Lisdexamfetamine vs Cognitive-Behavioral Therapy for Binge-Eating Disorder: Correlates and Outcomes
Sydney Yurkow1, Valentina Ivezaj1, Brian Pittman1
1Department of Psychiatry, Yale University School of Medicine, New Haven, Connecticut.
The Journal of Clinical Psychiatry
|May 8, 2025
Summary
Patient preference for cognitive behavioral therapy (CBT) or lisdexamfetamine (LDX) did not impact binge-eating disorder (BED) treatment outcomes in a recent clinical trial. Both treatments proved effective regardless of patient choice.
Area of Science:
- Psychiatry
- Clinical Psychology
- Pharmacology
Background:
- Binge-eating disorder (BED) has effective treatments, yet patient preferences and their impact on outcomes remain under-researched.
- Investigating patient preferences for cognitive behavioral therapy (CBT) and lisdexamfetamine (LDX) is crucial for personalized BED treatment.
- Understanding correlates of treatment preference can inform clinical practice and improve patient engagement.
Purpose of the Study:
- To determine the frequency and characteristics of patient preferences for CBT versus LDX in BED treatment.
- To examine whether patient preferences for CBT or LDX predict or moderate treatment outcomes.
- To analyze the association between patient preferences and sociodemographic/clinical factors in BED patients.
Main Methods:
- A randomized controlled trial involving 102 participants with DSM-5 defined BED.
- Participants indicated preferences for CBT or LDX before treatment initiation; treatment assignment was random.
- Outcomes including binge-eating remission, weight loss, and psychopathology were assessed by blinded evaluators.
Main Results:
- A significant portion of participants preferred LDX (43.1%) or had no preference (33.3%), while fewer preferred CBT (23.5%).
- Treatment preference was not linked to sociodemographic or baseline clinical characteristics.
- No significant interaction effects were found, indicating preferences did not moderate treatment outcomes for either CBT or LDX.
Conclusions:
- Patient preferences for CBT or LDX do not influence treatment outcomes in individuals with BED and obesity.
- Both CBT and LDX are effective interventions for BED, irrespective of patient preference.
- Findings suggest focusing on treatment efficacy rather than preference for these interventions in clinical practice.
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