Group cognitive-behavioral treatment of binge eating disorder: A comparison of therapist-led versus self-help formats

Abstract

Objective The purpose of this study was to compare three group cognitive‐behavioral therapy (CBT) treatment models and a waiting list control condition (WL). Method: Sixty‐one women who met DSM‐IV criteria for binge eating disorder (BED) received treatment with the same cognitive‐behavioral treatment manual in 14 one‐hour sessions over an 8‐week period. All sessions consisted of psychoeducation for the first 30 min and group discussion for the second half hour. In the therapist‐led condition (TL; n = 16), a doctoral therapist led both the psychoeducational component and group discussion. In the partial self‐help condition (PSH; n = 19), participants viewed a 30‐min psychoeducational videotape, followed by participation in a therapist‐led discussion. In the structured self‐help condition (SH; n = 15), subjects viewed the 30‐min psychoeducational videotape and subsequently led their own 30‐min discussion. Eleven subjects were assigned to a wait‐list control condition (WL). The primary outcome variables were frequency and duration of self‐reported binge eating episodes. Results: A mixed effects linear modeling (random regression) analysis indicated that subjects in all three active treatment conditions showed a decrease in binge eating symptoms over time. No group differences in rates of change over time were observed, although analysis of covariance indicated that all three treatment conditions showed significantly greater improvement in binge eating compared to the WL condition. Discussion: The findings from this preliminary study suggest that CBT for BED can be delivered effectively in a structured group self‐help format. © 1998 by John Wiley & Sons, Inc. Int J Eat Disord 24: 125–136, 1998.

Predictors of treatment outcome for binge eating disorder

“…This study was approved by the Institutional Review Board at the University of Minnesota and has been described in detail previously (Peterson et al, 1998). Following initial telephone screening, potential participants who appeared to be eligible for the study were asked to attend an orientation session.…”

“…For the self-help sessions, group members were assigned to facilitate the discussion segment and written guidelines with topics were provided for each session. Because no differences in outcome or attrition were observed among the three conditions (Peterson et al, 1998), participants from all three conditions were included in the predictor of outcome analyses.…”

“…Antidepressant medications (Agras et al, 1994;Greeno & Wing, 1996;McCann & Agras, 1990), cognitive-behavioral therapy (CBT; Agras et al, 1994;Peterson et al, 1998;Telch, Agras, Rossiter, Wilfley, & Kenardy, 1990;Wilfley et al, 1993), and interpersonal therapy (Wilfley et al, 1993) have been investigated and have shown some promise in the treatment of individuals with BED. Increasingly more interest has been paid to the use of self-help and partial self-help techniques in the treatment of BED, with preliminary evidence indicating that these approaches are also helpful in reducing binge eating (Carter & Fairburn, 1998;Peterson et al, 1998;Wells, Garvin, Dohm & Striegel-Moore, 1998).…”

Binge eating disorder and obesity

“…There are now first results also in patients with BED using various modes of service delivery, eg group format with videotapes, 34 in-person on a one-to-one basis, 35,36 and even by telephone. 37 The results show a marked reduction in binge eating frequency as well as improvement in secondary outcome measures.…”

Psychoeducation in Binge Eating Disorder and EDNOS: a pilot study on the efficacy of a 10-week and a 1-year continuation treatment

“…Very little experience is available on the response rate of wait-list control groups in BED patients. In the trials by Peterson et al [14] and by Carter and Fairburn [15], the binge eating cessation rates for the wait-list conditions were of 10 and 8 %, respectively, to be compared with the cessation rates of about 40-50 % for the therapist guided CBT treatments.…”