eating disorders

Binge Eating Disorder Best Treated with Face-to-Face Therapy

Face-to-face cognitive behavioral therapy (CBT) reduced binge eating episodes faster and more effectively than an internet-based guided self-help intervention (GSH-I), according to the findings of a recent study.

The randomized clinical trial included 178 adult patients with a binge eating disorder who were recruited from 7 outpatient clinics in the USA from August 1, 2010 to December 31, 2011. Patients were randomly assigned to twenty 50-minute face-to-face CBT sessions or to 11 internet modules, completed sequentially, and weekly email contacts.

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The difference in the number of days with objective binge eating episodes (OBEs) during the previous 28 days between the start and end of treatment were assessed as the primary outcome. Secondary outcomes included OBEs at 6-months and 1.5-years post-treatment, eating disorder and general psychopathologic findings, body mass index, and quality of life.

A total of 169 patients had at least 1 post-baseline assessment and were included in the modified intention-to-treat analysis, and 116 patients completed the 1.5-year follow-up. 

Face-to-face CBT was found to be superior to GSH-I. During the 4 months of treatment and 6-months post-treatment, CBT effectively reduced binge eating days, successfully promoted abstinence from binge eating, and reduced eating-related psychopathologic findings compared with GSH-I.

However, exploratory analyses of the patients who completed the 1.5 years of follow-up showed that these differences were insignificant 1 year after treatment.

“Face-to-face CBT leads to quicker and greater reductions in the number of OBE days, abstinence rates, and eating disorder psychopathologic findings and may be a better initial treatment option than GSH-I,” the researchers concluded. “Internet-based guided self-help remains a viable, slower-acting, low-threshold treatment alternative compared with CBT for adults with [binge eating disorder].”

—Melissa Weiss


de Zwaan M, Herpertz S, Zipfel S, et al. Effect of internet-based guided self-help vs individual face-to-face treatment on full or subsyndromal binge eating disorder in overweight or obese patients: the INTERBED Randomized Clinical Trial [published online August 2, 2017]. JAMA Psychiatry. doi:10.1001/jamapsychiatry.2017.2150.