A cognitive/behavioral approach to type 1 diabetic females with recurrent binge eating: a 3-year follow-up study

Abstract

Objective: To describe a comprehensive, cognitive/behavioral approach to the treatment of type 1 diabetic females with recurrent binge eating and to assess its effectiveness. Research design and methods: At the first visit to our outpatient clinic, type 1 diabetic females with recurrent binge eating ( n=28) were diagnosed as either bulimia nervosa (BN) or binge-eating disorder (BED), and underwent “outpatient counseling at first visit”. After a period of observation by the referring physician, patients without sufficient improvement were encouraged to undergo “integrated inpatient therapy”. According to the eating disorder diagnosis and the presence/absence of inpatient therapy, patients were divided into four groups: BN-inpatients, n=9; BN-outpatients, n=9; BED-inpatients, n=2; BED-outpatients, n=8. Glycosylated hemoglobin (HbA1c); psychological measures assessing eating disorder psychopathology (EDI), depression (SDS), and anxiety (STAI); binge eating and purging behavior for each group were compared between first visit and follow-up. Results: In BED-outpatients, significantly lower HbA1c, SDS score, and frequency and amount of binge eating were seen at 3 years after first visit. In BN-inpatients, significantly lower HbA1c; EDI, SDS, and STAI scores; frequency and amount of binge eating; and rate of purging behaviors were seen at 3 years after discharge. Conclusions: Type 1 diabetic females with recurrent binge eating were effectively treated. BED patients were successfully treated on an outpatient basis, while BN patients needed inpatient therapy.