The Efficacy of Psychological Therapies in Reducing Weight and Binge Eating in People with Bulimia Nervosa and Binge Eating Disorder Who Are Overweight or Obese-A Critical Synthesis and Meta-Analyses.

Marly Palavras,Phillipa Hay,Celso Alves Dos Santos Filho,Angélica Claudino

doi:10.3390/nu9030299

Abstract

Recurrent binge eating episodes, the core feature of Bulimia Nervosa (BN) and Binge Eating Disorder (BED), are frequently comorbid with obesity. Psychological interventions, notably Cognitive Behavioural Therapy (CBT), are effective for binge eating reduction in BED or BN but less so for weight loss. Behavioural Weight Loss Therapy (BWLT) shows effectiveness for binge eating reduction and weight loss but the latter appears poorly sustained over time. Our aim was to review evidence for efficacy of psychological therapies for BN/BED associated with overweight or obesity in reducing binge frequency and weight. A systematic search for randomized controlled trials with adult samples who had BN or BED was conducted considering articles in English, French, Spanish and Portuguese with no restrictions for the timeline publication ending in March 2016. A quality appraisal of the trials and meta-analyses comparing BWLT to CBT were done. This review identified 2248 articles for screening and 19 published articles were selected. No trials of BN were identified. This review found CBT was favoured compared to BWLT with regard to short-term binge eating reduction. However, insufficient evidence was found for superiority for BWLT efficacy compared to CBT considering binge eating remission, reduction of binge eating frequency and weight loss. More research is needed to test the efficacy of psychological treatments for BED or BN with co-morbid overweight or obesity, including trials evaluating binge eating remission and weight loss in the long-term.

Highlights

Eating disorders (EDs) are severe conditions that occur across age groups and in both sexes [1].Worldwide, they occur most frequently in young women, with prevalence rates that can be up to10% in community populations [2,3]
Results of Studies Comparing Psychological Interventions for Binge Eating Disorder Associated with Obesity
One study compared Cognitive Behavioural Therapy (CBT) only to CBT combined with exercise, or to maintenance intervention, or to both, and reported that the groups with CBT plus exercise had greater reductions in binge remission, frequency of binge eating and BMI compared to the non-exercise groups [43]

Summary

Introduction

Eating disorders (EDs) are severe conditions that occur across age groups and in both sexes [1].Worldwide, they occur most frequently in young women, with prevalence rates that can be up to10% in community populations [2,3]. Eating disorders (EDs) are severe conditions that occur across age groups and in both sexes [1]. Worldwide, they occur most frequently in young women, with prevalence rates that can be up to. The most common are Bulimia Nervosa (BN) and Binge Eating. Recurrent binge eating episodes are the core feature of both conditions and these are characterized by the consumption of an unusually large amount of food associated with the sense of loss of control over eating during the episode [5]. BN and recurrent binge eating are both increasing and are associated with considerable impairment, both psychological and physical, Nutrients 2017, 9, 299; doi:10.3390/nu9030299 www.mdpi.com/journal/nutrients.

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