Management and Outcomes of Binge-Eating Disorder (BED)

Project Summary Title and Description

Title
Management and Outcomes of Binge-Eating Disorder (BED)
Description
Objectives. To evaluate the effectiveness and comparative effectiveness of treatments for patients with binge-eating disorder (BED) and bariatric surgery patients and children with loss-of-control (LOC) eating. Studies of BED therapies include pharmacological interventions, psychological and behavioral interventions, or combinations of approaches. We examined whether treatment effectiveness differed in patient subgroups and described courses of illness for BED and LOC eating. Data Sources. We searched MEDLINE,® EMBASE,® the Cochrane Library, Academic OneFile, and the Cumulative Index to Nursing and Allied Health Literature (CINAHL) through 1/19/2015. Eligible studies included randomized controlled trials (RCTs), nonrandomized trials, meta-analyses, and, for course of illness, cohort and case-control studies. Review Methods. Pairs of reviewers independently selected, extracted data from, and rated the risk of bias of relevant studies; they graded the strength of evidence using established criteria. We conducted meta-analysis for some treatment outcomes. Results. Of 52 included RCTs of treatment; 48 concerned BED therapy. Course of illness evidence came from 15 observational studies. We examined four major outcomes: binge eating and abstinence, eating-related psychopathology, weight, and general psychological and other outcomes. Second-generation antidepressants (as a class), topiramate (an anticonvulsant), and lisdexamfetamine (a stimulant) were superior to placebo in achieving abstinence and reducing binge episodes and/or binge days and eating-related obsessions and compulsions. Second-generation antidepressants decreased depression. Topiramate and lisdexamfetamine produced weight reduction in study populations that were virtually all overweight or obese. A few formats of cognitive behavioral therapy (CBT)—therapist-led, partially therapist-led, and guided self-help—were superior to placebo in achieving abstinence and reducing binge frequency. CBT for BED was generally ineffective for reducing weight or depression in this population. Therapist-led CBT was not superior to either partially therapist-led CBT or structured self-help CBT for binge-eating and weight outcomes. Behavioral weight loss treatment produced greater weight loss than CBT at the end of treatment but not over the longer run. Topiramate, fluvoxamine, and lisdexamfetamine were associated with sleep disturbance including insomnia; topiramate and lisdexamfetamine were associated with sympathetic nervous system arousal, headache, and GI upset. We found no evidence on bariatric surgery patients. Treatments for LOC eating in children did not achieve superior weight reduction outcomes. Evidence on course of either illness was limited. Early adolescent BED and LOC eating predicts such behaviors in the future. Conclusions. BED patients may benefit from treatment with second-generation antidepressants, lisdexamfetamine, topiramate, and CBT. Additional studies should address other treatments, combinations of treatment, and comparisons between treatments, treatment for postbariatric surgery patients and children, as well as the course of these illnesses.
Attribution
N/A
Authors of Report
N/A
Methodology description
We conducted focused searches of MEDLINE® (via PubMed), EMBASE®, CINAHL (nursing and allied health database), Academic OneFile, and the Cochrane Library. An experienced research librarian used a predefined list of search terms and medical subject headings (MeSH). The librarian completed the searches for the draft report on 6/23/2014; she conducted a second (update) search on 1/19/2015 during peer review. We searched for relevant unpublished and grey literature, including trial registries, specifically ClinicalTrials.gov and Health Services Research Projects in Progress. AHRQ requested Scientific Information Packets (SIPs) from the developers and distributors of interventions identified in the literature review. We included unpublished studies that met all inclusion criteria and contained enough information to permit us to make a standard risk-of-bias assessment. We searched reference lists of pertinent review articles for studies that we should consider for inclusion in this review, including our earlier review on this topic. Trained members of the research team reviewed article abstracts and full-text articles. Two members independently reviewed each title and abstract using the predefined inclusion and exclusion criteria. Studies marked for possible inclusion by either reviewer underwent a full-text review. Two members of the team independently reviewed each full-text article. If both reviewers agreed that a study did not meet the eligibility criteria, it was excluded; each reviewer recorded the primary reason for exclusion. If reviewers disagreed, they resolved conflicts by discussion and consensus or by consulting a third member of the review team. We screened unpublished studies and reviewed SIPs using the same title/abstract and full-text review processes. The project coordinator tracked abstract and full-text reviews in an EndNote database (EndNote® X4). We developed a template for evidence tables using the PICOTS framework and abstracted relevant information into them using Microsoft Excel. We recorded characteristics of study populations, interventions, comparators, settings, study designs, methods, and results. Six trained members of the team participated in the data abstraction. One reviewer initially abstracted the relevant data from each included article; a second more senior member of the team reviewed each data abstraction against the original article for completeness and accuracy.
PROSPERO
N/A
DOI
10.7301/Z0VX0DFX
Notes
The data in this project was entered retrospectively by importing data from Microsoft Excel files. Abstracted data for this project can be found in the following tabs of the extraction forms: design, baseline, arm details, outcome details, and adverse events when applicable. All quality data can be found in the Quality Assessments file.
Funding Source
Agency for Healthcare Research and Quality (AHRQ)

Key Questions

1. What is the evidence for the effectiveness of treatments or combinations of treatments for binge-eating disorder?
2. What is the evidence for harms associated with treatments for binge-eating disorder?
3. Does the effectiveness of treatments for binge-eating disorder differ by age, sex, race, ethnicity, initial body mass index, duration of illness, or coexisting conditions?
4. What is the course of illness of binge-eating disorder?
5. Does the course of illness of binge-eating disorder differ by age, sex, race, ethnicity, sexual orientation, body mass index, duration of illness, or coexisting conditions?
6. What is the evidence for the effectiveness of treatments or combinations of treatments for loss-of-control eating among bariatric surgery patients?
7. What is the evidence for harms associated with treatments for loss-of-control eating among bariatric surgery patients?
8. Does the effectiveness of treatments for loss-of-control eating among bariatric surgery patients differ by age, sex, race, ethnicity, initial body mass index, duration of illness, or coexisting conditions?
9. What is the course of illness of loss-of-control eating among bariatric surgery patients?
10. Does the course of illness of loss-of-control eating among bariatric surgery patients differ by age, sex, race, ethnicity, sexual orientation, initial body mass index, duration of illness, or coexisting conditions?
11. What is the evidence for the effectiveness of treatments or combinations of treatments for loss-of-control eating among children?
12. What is the evidence for harms associated with treatments for loss-of-control eating among children?
13. Does the effectiveness of treatments for loss-of-control eating among children differ by age, sex, race, ethnicity, initial body mass index, duration of illness, or coexisting conditions?
14. What is the course of illness of loss-of-control eating among children?
15. Does the course of illness of loss-of-control eating among children differ by age, sex, race, ethnicity, initial body mass index, duration of illness, or coexisting conditions?

Associated Extraction Forms

Associated Studies (each link opens a new tab)

TitleAuthorsYear
Two novel treatments to reduce overeating in overweight children: a randomized controlled trial.
Randomized, controlled trial of an internet-facilitated intervention for reducing binge eating and overweight in adolescents.2008
A pilot study of interpersonal psychotherapy for preventing excess weight gain in adolescent girls at-risk for obesity.2010
Targeted prevention of excess weight gain and eating disorders in high-risk adolescent girls: a randomized controlled trial.2014
A placebo-controlled, randomized trial of fluoxetine in the treatment of binge-eating disorder.2002
A double-blind, randomized pilot trial of chromium picolinate for binge eating disorder: results of the Binge Eating and Chromium (BEACh) study.2013
Lamotrigine in the treatment of binge-eating disorder with obesity: a randomized, placebo-controlled monotherapy trial.2009
High-dose escitalopram in the treatment of binge-eating disorder with obesity: a placebo-controlled monotherapy trial.2008
Duloxetine in the treatment of binge eating disorder with depressive disorders: a placebo-controlled trial.2011
Fluvoxamine in the treatment of binge-eating disorder: a multicenter placebo-controlled, double-blind trial.1998
A randomized, double-blind trial comparing sertraline and fluoxetine 6-month treatment in obese patients with Binge Eating Disorder.2008
Atomoxetine in the treatment of binge-eating disorder: a randomized placebo-controlled trial.2007
Zonisamide in the treatment of binge eating disorder with obesity: a randomized controlled trial.2006
Citalopram in the treatment of binge-eating disorder: a placebo-controlled trial.2003
Topiramate in the treatment of binge eating disorder associated with obesity: a randomized, placebo-controlled trial.
Placebo-controlled trial of sertraline in the treatment of binge eating disorder.2000
Topiramate for the treatment of binge eating disorder associated with obesity: a placebo-controlled study.2007
A placebo-controlled pilot study of the novel opioid receptor antagonist ALKS-33 in binge eating disorder.2013
Efficacy and safety of lisdexamfetamine for treatment of adults with moderate to severe binge-eating disorder: a randomized clinical trial.
A double-blind, placebo-controlled trial of fluvoxamine in binge eating disorder: a high placebo response.2003
Bupropion for overweight women with binge-eating disorder: a randomized, double-blind, placebo-controlled trial.2013
Does interpersonal therapy help patients with binge eating disorder who fail to respond to cognitive-behavioral therapy?1995
Appetite monitoring in the treatment of Binge Eating Disorder
Randomised controlled trial of a guided self-help treatment on the Internet for binge eating disorder.2011
Cognitive-behavioral self-help for binge eating disorder: a controlled effectiveness study.1998
Adapted motivational interviewing for women with binge eating disorder: a randomized controlled trial.2008
The STRATOB study: design of a randomized controlled clinical trial of Cognitive Behavioral Therapy and Brief Strategic Therapy with telecare in patients with obesity and binge-eating disorder referred to residential nutritional rehabilitation.2011
Virtual reality for enhancing the cognitive behavioral treatment of obesity with binge eating disorder: randomized controlled study with one-year follow-up.2013
Emotion-focused therapy and dietary counseling for obese patients with binge eating disorder: a propensity score-adjusted study.2013
Short-term cognitive behavioral treatment does not improve outcome of a comprehensive very-low-calorie diet program in obese women with binge eating disorder
Predictors and mediators of treatment outcome in patients with binge eating disorder.2007
The effects of extending cognitive-behavioral therapy for binge eating disorder among initial treatment nonresponders.1997
Effectiveness of spouse involvement in cognitive behavioral therapy for binge eating disorder.2003
Self-help for binge eating disorder in primary care: a randomized controlled trial with ethnically and racially diverse obese patients.
Treatment of binge eating disorder in racially and ethnically diverse obese patients in primary care: randomized placebo-controlled clinical trial of self-help and medication.
Cognitive-behavioral therapy, behavioral weight loss, and sequential treatment for obese patients with binge-eating disorder: a randomized controlled trial.
A randomized controlled comparison of guided self-help cognitive behavioral therapy and behavioral weight loss for binge eating disorder.2005
Body image interventions in cognitive-behavioural therapy of binge-eating disorder: a component analysis.2004
Does ecological momentary assessment improve cognitive behavioural therapy for binge eating disorder? A pilot study
A randomized controlled trial for obesity and binge eating disorder: low-energy-density dietary counseling and cognitive-behavioral therapy.2011
A randomized wait-list controlled pilot study of dialectical behaviour therapy guided self-help for binge eating disorder.2013
A randomized comparison of cognitive behavioral therapy and behavioral weight loss treatment for overweight individuals with binge eating disorder.2007
Exercise augments the effects of cognitive-behavioral therapy in the treatment of binge eating.2001
Group cognitive-behavioral treatment of binge eating disorder: a comparison of therapist-led versus self-help formats.1998
The efficacy of self-help group treatment and therapist-led group treatment for binge eating disorder.
Comparison of individual and group cognitive behavioral therapy for binge eating disorder. A randomized, three-year follow-up study.2010
Virtual-reality-based multidimensional therapy for the treatment of body image disturbances in binge eating disorders: a preliminary controlled study.2002
Six-month follow-up of in-patient experiential cognitive therapy for binge eating disorders.2003
Outcome from a randomized controlled trial of group therapy for binge eating disorder: comparing dialectical behavior therapy adapted for binge eating to an active comparison group therapy.2010
The efficacy of a short version of a cognitive-behavioral treatment followed by booster sessions for binge eating disorder.2009
A non-randomized direct comparison of cognitive-behavioral short- and long-term treatment for binge eating disorder.2010
Attachment scales predict outcome in a randomized controlled trial of two group therapies for binge eating disorder: An aptitude by treatment interaction2006
Dialectical behavior therapy for binge eating disorder.2001
A randomized comparison of group cognitive-behavioral therapy and group interpersonal psychotherapy for the treatment of overweight individuals with binge-eating disorder.2002
Psychological treatments of binge eating disorder.2010
Weight loss, cognitive-behavioral, and desipramine treatments in binge eating disorder. An additive design
Multivariate therapeutic approach to binge-eating disorder: combined nutritional, psychological and pharmacological treatment.2009
Double-blind, randomized, placebo-controlled trial of topiramate plus cognitive-behavior therapy in binge-eating disorder.2007
Cognitive behavioral therapy and fluoxetine for binge eating disorder: two-year follow-up.2007
Effect of orlistat in obese patients with binge eating disorder.2005
Cognitive behavioral therapy guided self-help and orlistat for the treatment of binge eating disorder: a randomized, double-blind, placebo-controlled trial.2005
Orlistat with behavioral weight loss for obesity with versus without binge eating disorder: randomized placebo-controlled trial at a community mental health center serving educationally and economically disadvantaged Latino/as.2013
Efficacy of cognitive behavioral therapy and fluoxetine for the treatment of binge eating disorder: a randomized double-blind placebo-controlled comparison.2005
Imipramine and diet counseling with psychological support in the treatment of obese binge eaters: a randomized, placebo-controlled double-blind study.1999
Effectiveness of cognitive behavioural psychotherapy alone and combined with pharmacotherpy in binge eating disorder: a differential research
Binge eating disorder in obesity: comparison of different therapeutic strategies.2005
Fluoxetine and fluvoxamine combined with individual cognitive-behaviour therapy in binge eating disorder: a one-year follow-up study.2001
Zonisamide Combined with Cognitive Behavioral Therapy in Binge Eating Disorder: A One-year Follow-up Study.2009
One-year follow-up of cognitive-behavioral therapy for obese individuals with binge eating disorder.1997
Weight loss and postoperative complications in morbidly obese patients with binge eating disorder treated by laparoscopic adjustable gastric banding.2005
Different moderators of cognitive-behavioral therapy on subjective and objective binge eating in bulimia nervosa and binge eating disorder: a three-year follow-up study.2013
Friends' dieting and disordered eating behaviors among adolescents five years later: findings from Project EAT.2010
Recurrent overeating: an empirical comparison of binge eating disorder, bulimia nervosa, and obesity.1993
Prospective association of common eating disorders and adverse outcomes.2012
Natural course of preadolescent loss of control eating.2013
Reproductive health outcomes in eating disorders.2013
Change in attachment insecurity is related to improved outcomes 1-year post group therapy in women with binge eating disorder.
A comprehensive meta-analysis of the risk of suicide in eating disorders.2011
Suicide attempts and mortality in eating disorders: a follow-up study of eating disorder patients.2014
Loss of control over eating predicts outcomes in bariatric surgery patients: a prospective, 24-month follow-up study.
Comorbid psychopathology in binge eating disorder: relation to eating disorder severity at baseline and following treatment.
Heterogeneity moderates treatment response among patients with binge eating disorder.
SPD489 in Adults Aged 18-55 Years With Moderate to Severe Binge Eating Disorder, SPD489-343
SPD489 in Adults Aged 18-55 Years With Moderate to Severe Binge Eating Disorder, SPD489-344

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