Cognitive Behavioral Therapy for Binge Eating Disorder!!!

It has only been during the past couple of decades that we, as a culture, have discussed and addressed eating disorders. The two eating disorders discussed most often are anorexia nervosa and bulimia. Anorexia nervosa has been defined as a serious eating disorder primarily affecting young women in their teens and early twenties, that is characterized especially by an intense fear of weight gain leading to faulty eating patterns, malnutrition, and usually excessive weight loss. Bulimia nervosa has been defined as a serious eating disorder that occurs chiefly in females, characterized by overeating, usually followed by self-induced vomiting, or laxative or diuretic abuse, and is often accompanied by guilt and depression. The American Psychiatric Association’s Diagnostic and Statistical Manual of Mental Disorders, fourth edition (DSM-IV), includes the diagnosis of eating disorders not otherwise specified (NOS). Individuals with eating disorders in this category manifest symptoms of eating disorders, but do not meet the diagnostic criteria for a specific eating disorder.

Cognitive behavioral therapy (CBT) is a psychological method of treatment that aims to solve problems concerning dysfunctional emotions, behaviors and cognitions which involves a therapist working with the patient to understand how thoughts and feelings influence behavior. The goal of the therapy is to change negative thought patterns that lead to the patient’s anxiety, replacing them with positive, more realistic ones. Elements of the therapy include exposure strategies to allow the patient to gradually confront their anxieties and feel more comfortable in anxiety-provoking situations, as well as to practice the skills they have learned. CBT can be used alone or in conjunction with medication. CBT usually helps one third of the patients substantially, while another third does not respond at all to treatment.

A study, published in the Journal of Consulting and Clinical Psychology, sought to evaluate whether cognitive behavioral therapy can be an effective treatment for binge eating disorder. The study included 123 subjects, who were randomized to receive either CBT in eight sessions over a twelve week period or standard care. After six months, it was determined that abstinence from binge eating was greater in the intervention group (74.5% versus 44.1%). By twelve months, the difference between the groups was smaller, but still significant. The researchers suggest that the shrinking benefit over time may indicate that some kind of a short booster session with a health coach may be a really good way to help sustain the achieved benefits. It was also found that although CBT was initially more costly than usual care, over time it was actually more cost effective since the patients used fewer healthcare services. This information seems to indicate that CBT may be a viable treatment option for the majority of patients with binge eating disorder.1

1 Striegel-Moore RH, Wilson GT, Debar L, et al. Cognitive behavioral guided self-help for the treatment of recurrent binge eating. J Consult Clin Psychol. June2010;78(3):312-21.