Short-term cognitive behavioral treatment does not improve outcome of a comprehensive very-low-calorie diet program in obese women with binge eating disorder

Abstract

The purpose of this study was to determine if the addition of cognitive behavior therapy (CBT) targeting binge eating behavior to a comprehensive very-low-calorie diet (VLCD) program would improve short- and long-term outcome in obese women with binge eating disorder (BED). Seventy-one subjects with BED participated in the 6-month program. They represent a subgroup of a larger sample of 154 women (83 without BED) who participated in the program. During the last 10 weeks of treatment half of the women with BED were randomly assigned to an additional CBT component targeting the eating disorder. The mean total weight loss at the end of the VLCD program was 35.2 lb (SD = 18.4) or 16.1% (SD = 8.2) of the original weight. At 1 year participants had maintained a mean weight loss of 5.5% (SD = 10.1) of initial body weight. Forty-seven participants (66.2% of 71) were binge free at the end of the program and 51.8% at the 1-month follow-up. At the 1-year follow-up 56.3% no longer met criteria for BED and 33% were abstinent (no binge eating) during the 6 months prior to the follow-up assessment. There were no significant differences between participants who received and who did not receive the additional CBT component. An additional CBT component added to a comprehensive VLCD program did not improve the results for obese participants with BED with regard to weight and binge eating and with regard to most of the eating-related and general psychopathological measures. However, the reduction of binge eating at the end of treatment and at follow-up is comparable with improvements achieved with drug therapy or psychotherapy specifically designed for the treatment of BED.