Placebo response in binge eating disorder

M Joy Jacobs‐Pilipski,Lisa R.R Lilenfeld,Denise E Wilfley,Delia Smith West,Christopher G Fairburn,Robert I Berkowitz,B Timothy Walsh,James I Hudson,Scott J Crow

doi:10.1002/eat.20287

Abstract

Objective:Placebo response in studies of binge eating disorder (BED) has raised concern about its diagnostic stability. The aims of this study were (1) to compare placebo responders (PRs) with nonresponders (NRs); (2) to investigate the course of BED following placebo response; and (3) to examine attributions regarding placebo response.Method:The baseline placebo run-in phase (BL) was part of a RCT investigating sibutramine hydrochloride for BED; it included 451 participants, ages 19–63, diagnosed with BED. Follow-up (FU) included 33 PRs.Results:In this study, 32.6% of participants responded to placebo (PRs = 147; NRs = 304). PRs exhibited significantly less symptom severity. At FU (n = 33), many PRs reported continued symptoms.Conclusion:PRs exhibited significantly less severe pathology than NRs. Placebo response in BED may transitory or incomplete. The results of this study suggest variable stability in the BED diagnosis. © 2006 by Wiley Periodicals, Inc. Int J Eat Disord 2007

Highlights

Binge eating disorder (BED) consists of recurrent episodes of binge eating in which large amounts of food are eaten with accompanying loss of control.[1]
The results of this study suggest variable stability in the binge eating disorder (BED) diagnosis
Similar to the rates reported for the controlled phases of other pharmacotherapy trials, approximately one third of the participants in the baseline placebo run-in phase (BL) sample responded to placebo

Summary

Introduction

Binge eating disorder (BED) consists of recurrent episodes of binge eating in which large amounts of food are eaten with accompanying loss of control.[1]. Placebo-controlled pharmacological studies of BED have revealed highly variable, and often marked, rates of short-term placebo response.[6,7] Placebo response in BED has been defined by a marked reduction in binge eating symptomatology during placebo administration. A review of pharmacological treatments for BED by Carter et al.[5] indicates a mean placebo response rate of 33%. The rate of placebo response in BED is similar to that in other major psychiatric illnesses, including major depressive disorder and bipolar disorder,[8,9,10] but not bulimia nervosa (BN), which has a markedly lower rate of placebo response than that associated with other psychiatric illnesses.[11] A meta-analysis of placebo response in unipolar depression indicated a mean placebo response rate of 32.8%.9. A meta-analysis of bipolar disorder revealed a mean placebo response rate of 29%.8 A meta-analysis of placebo response in unipolar depression indicated a mean placebo response rate of 32.8%.9 A meta-analysis of bipolar disorder revealed a mean placebo response rate of 29%.8

Methods

Results

Discussion

Conclusion