Behavioral treatment of obese binge eaters: do they need different care?

This study investigated the relationship between binge eating and the outcome of weight loss treatment. Participants in a 48-week trial of a structured diet combined with exercise and behavior therapy were classified into one of four groups: no overeating; episodic overeating; subthreshold binge-eating disorder(BED); and BED. Binge eating status was not associated with either dropout or adherence to the diet, but did affect weight loss and mood. The BED group lost significantly more weight at the end of treatment than all other groups, even when adjusting for initial weight. At 1-year follow-up, there were no differences among groups in weight loss or weight regain. The BED group began treatment with significantly higher BDI scores, but improvement in mood occurred by week 5. On the basis of these findings, and a review of the recent literature, we conclude that obese binge eaters respond as favorably to standard dietary and behavioral treatments as do obese nonbingers.