Table 1 Summary of studies included in the review*
From: Binge-eating disorder diagnosis and treatment: a recap in front of DSM-5
Thematic area | Article n. | Authors | Patients n./ Articles n. | Duration (months) | Drop-out rates | Main results | Type of study |
|---|---|---|---|---|---|---|---|
Diagnostic issues and pathological features | 23 | Bautista-Diaz et al., 2012 [21] | 70 obese women (35 BED; 35 non BED) | ----- | ----- | Higher body dissatisfaction and stronger influence of socio-cultural factors on eating psychopathology (at self-administered test) in women with BED vs controls. | Case–control study |
Blomquist et al., 2011 [49] | 78 obese with BED | ----- | ----- | Mean weight gain of 15.1 pounds during the year before treatment in BED patients (structured interviews + self-administered test). Weight change associated with more frequent binge eating and overeating during breakfasts. | Retrospective observational study | ||
Blomquist et al., 2012 [14] | 84 obese with BED | ----- | ----- | Higher interpersonal problems (at interpersonal circumplex structural summary method) observed in in BED patients and associated with earlier onset of binges and overweight. | Cross-sectional study | ||
Carano et al., 2012 [12] | 80 BED | ----- | ----- | Among BED patients, 27.5% refer suicide ideation and 12.5% previous attempts of suicide (self-administered tests). Alexithymia related to higher suicide ideation and previous suicide attempts. | Cross-sectional study | ||
Carrard et al., 2012 [18] | 92 women with BED (full-criteria and subthreshold) | 6 treatment | 10.6 – 30.8% | Participants to an internet self-help program split by cluster analyses into pure dietary subtype (71.7%) and dietary-negative affect subtype (28.3%) (clinical interview + self-administered tests). Dietary-negative affect subtype show higher frequency of binges, more severe eating disorders, higher tendency to act rashly in the context of negative affect, greater sensitivity to punishment and higher dropout rates (30.8% vs 10.6%). | Case–control study | ||
Compare et al., 2012 [13] | 150 obese BED; 150 obese non BED; 150 healthy controls | ----- | ----- | Lower mindfulness scores (Five Facet Mindfulness Questionnaire) in BED patients than in healthy and obese controls. Mindfulness negatively correlated with binge frequency, body uneasiness and eating impulsivity (self-administered tests). | Case–control study | ||
Folope et al., 2012 [20] | 130 obese | ----- | ----- | Presence of EDs impaired significantly quality of life and is related to higher anxiety and depression rates (self-administered tests). | Cross-sectional study | ||
Gianini et al., 2013 [30] | 326 obese with BED | ----- | ----- | Difficulties with emotion regulation accounted for unique variance in both emotional overeating and general eating pathology (self-administered tests). | Cross-sectional study | ||
Grilo et al., 2009 [27] | 436 (195 BED with overvaluation; 129 BED subclinical overvaluation; 61 BN; 51 sub-threshold BN) | ----- | ----- | Clinical overvaluation of body shape and weight present in 60% of BED and related to significantly higher levels of eating disorder psychopathology. BED clinical overvaluation group show higher eating concern, shape concern, and weight concern than other groups. This feature warrants consideration either as a diagnostic specifier or as a dimensional severity rating. | Case–control study | ||
Grilo et al., 20131 [10] | 90 BED (52 with overvaluation; 38 without overvaluation) | 6 treatment + 12 follow-up | 24% (CBT) - 31% (BWL) | Participants randomly assigned to group CBT or BWL. Patients with overvaluation of weight and body shape had significantly greater levels of ED psychopathology, higher depression and lower self-esteem (semi-structured interviews + clinical measures). Overvaluation of shape/weight predicts non-remission from BED and higher frequency of binge eating at 12-month follow-up. | Prospective study | ||
Hudson et al., 2012 [5] | 888 first-degree relatives from a family study of BED | ----- | ----- | Using the proposed DSM-5 diagnostic criteria vs DSM-IV criteria (clinical interview) will likely have only a minimal effect on global BED prevalence. | Prevalence study | ||
Masheb et al., 2011a [32] | 311 women (39 BN; 69 BED; 203 controls) | ----- | ----- | Atypical eating patterns (e.g. nibbling, eating double meals and nocturnal eating) more frequent among EDs (at internet questionnaire). Breakfast consumption associated with lower BMI in BED and controls and more frequent meal consumption associated with less binge eating in BED. | Case–control study | ||
Masheb et al., 2013 [50] | 130 obese with BED | ----- | ----- | 83% of treatment seeking obese BED patients gained weight in year before treatment (structured interview + self-report questionnaires). No differences among weight gainers and weight maintainers/losers in current weight and eating behaviors. | Retrospective observational study | ||
Munsch et al., 2012a [31] | 22 women with BED | ----- | ----- | During binge days (at 1 week of ecological assessment) negative mood and tension are higher and significantly increased at first binge episode, while positive mood strongly and significantly decreased. No indications of accumulation of negative mood triggering binges followed by reinforcing mechanisms in terms of improvement of mood, unlikely to BN. | Cross-sectional study | ||
Ojserkis et al., 2012 [28] | 116 BED (84 with overvaluation, 31 without overvaluation; 1 excluded) | 4 treatment | 52.25% | Patients selected from a 16-week randomized controlled trial of BWL + individual CBT and/or fluoxetine**. Patients with overvaluation of weight and body shape show higher pre-treatment scores on depression and eating psychopathology and lower self-esteem (self-administered tests). At treatment termination patients with overvaluation still display high binge eating severity. | Prospective observational study | ||
Peterson et al., 2012 [8] | 188 EDs (71 AN, 95 BN, 122 BED) | 2 follow-up | 0% | Although longitudinal patterns of binge types are variable among individuals with EDs, consistency in objective and subjective binge episodes is most commonly observed. | Retrospective observational study | ||
Sawaoka et al., 2012 [15] | 113 overweight or obese with BED | ----- | ----- | Social anxiety positively and significantly related with shape and weight concerns and binge frequency (semi structural clinical interviews + self-report measure). Social anxiety and self-consciousness account for significant variance in eating, shape and weight concerns and ED severity but are not associated with BMI or dietary restraint. | Cross-sectional study | ||
Schag et al., 2013 [16] | 51 articles | ----- | ----- | Evidences of increased food-related impulsivity, coupled with increased reward sensitivity, in BED patients. BED could represent a specific phenotype of obesity with increased food-related impulsivity. | Literature review | ||
Striegel-Moore & Franko, 2008 [22] | ----- | ----- | ----- | Clinical utility and validity of BED diagnostic criteria is consistent and allow BED inclusion in DSM-V. | Literature review | ||
Thomas et al., 2009 [25] | 125 articles | ----- | ----- | EDNOS did not differ significantly from AN and BED on eating or general psychopathology while BN show greater eating and general psychopathology. Subthreshold BN or BED did not differ significantly from full syndrome cases. | Meta-analysis | ||
Trace et al., 2012 [6] | 13295 female twins | ----- | ----- | Lifetime prevalence of BN and BED increased linearly as the frequency criterion for binges decreased. As required duration increased, BED prevalence decreased slightly. | Prevalence study | ||
White & Grilo, 2011 [26] | 916 community volunteers (164 BED, 83 BN, 668 healthy controls) | ----- | ----- | All of the BED diagnostic criteria in DSM.IV have predictive value. Eating alone because embarrassed and feeling disgusted performed as the best inclusion and exclusion criteria, respectively. Eating when not hungry and eating alone because embarrassed are the best overall indicators for binge eating. | Cross sectional study | ||
Wolfe et al., 2009 [33] | 33 articles | ----- | ----- | Majority of binge episodes typically occur in less than 2 h, with size variability across BN and BED but a clinical importance likely related to objective food intake and an increased consumption of carbohydrates and fats. Loss of control is a core feature associated with higher depression, higher body dissatisfaction and poorer related quality of life. Negative affect is the most widely reported binge antecedent. | Literature review | ||
Global treatment | 7 | Brambilla et al., 2009 [35] | 30 (+5 dropped-out) BED (3 groups of 10 patients) | 6 treatment | 14% | Group 1: 1700-kcal diet + CBT + sertraline (50–150 mg/day) + topiramate (25–150 mg/day); group 2: diet + CBT + sertraline; group 3: nutritional counselling + CBT. Clinical interview and self-administered tests. Binge frequency and body weight decrease only in group 1. Group 2 improved in depression, interpersonal relationship and schizoid personality subscales. | Clinical trial |
Deumens et al., 2012 [59] | 212 BED | 5 treatment | 14% | Higher social embedding and higher openness predict better outcomes at CBT (self-administered tests). Higher depression, agoraphobia and extraversion predict poorer outcome. | Prospective observational study | ||
Flukinger et al., 2011 [37] | 78 BED | 4 treatment; 6 follow-up | 36% | Low self-esteem predicts premature treatment termination. Low self-esteem experiences, low global alliance, low mastery and clarification experiences predict dropout in patients who report discontentment with therapy as reason for premature termination. | Prospective observational study | ||
Grilo et al., 20111 [52] | 125 obese with BED (45 CBT; 45 BWL; 35 CBT + BWL) | 4 treatment + 12 follow-up | 24 - 40% | At 12-month, binge-eating remission rates of 51% (CBT), 36% (BWL), 40% (CBT + BWL) and mean BMI losses of −0.9%(CBT), −2.1% (BWL) and 1.5% (CBT + BWL). Overall significant percent BMI loss in CBT + BWL attributable to BWL. Binge-eating remission associated with greater percent BMI loss. | Prospective observational study | ||
Grilo et al., 2012a1 [44] | 90 obese with BED (45 CBT; 45 BWL) | 4 treatment + 12 follow-up | 24 - 40% | Rapid response (≥70% binge reduction in 4 weeks) is present in 57% of participants (67% CBT, 47% BWL) and predicts greater improvements across outcomes. CBT patients did comparably well regardless of rapid response in binge eating and eating psychopathology but not in weight loss. BWL patients without rapid response failed to improve further but those with rapid response show greater reductions in binge frequency, eating psychopathology and weight loss. | Prospective observational study | ||
Vocks et al., 2010 [36] | 38 articles (1973 patients) | ----- | ----- | Psychotherapy and structured self-help, mainly CBT, recommended as first line treatments for BED. Moderately positive effect on binges and depressive symptoms of pharmacotherapy, manly SSRI. Weight-loss treatments demonstrated moderate binge reduction at uncontrolled studies. Combination treatments not show higher effects than single-treatment. Only weight-loss treatment show a considerable weight reduction. | Literature meta-analysis | ||
Zunker et al., 20102 [45] | 179 BED patients (81 rapid responders; 98 non rapid responders) | 2.5 treatment | 34.6% | Participant randomized to 3 group manual-based CBT (therapist-led, therapist-assisted, self-help). Decrease in binges during treatment predicts clinical outcome. Participants with a 15% reduction in binges at week-one more likely to achieve remission. | Prospective observational study | ||
Behavioral interventions, psychoeducation and psychotherapies | 24 | Balestieri et al., 2013 [54] | 98 patients (54 BED; 44 EDNOS) | 2.5 weekly + 8 monthly sessions | 6.1% after 10 weeks, − 39.6% at 8 months | Psychoeducational intervention of 10 weekly group sessions. Post-treatment patients who maintained an ED were asked to participate to 2 fortnightly sessions + monthly sessions for 8 months. At 10 weeks 30.6% of patients remitted and all patients showed significant improvements on binge frequency, BMI, bulimic traits, body dissatisfaction, anxiety, depression and alexithymia. At 8 months 41% recovered from ED, with further reduction of binges and improvement of BMI. | Clinical trial |
Carrard et al., 2011 [62] | 74 women with BED (37 Group 1; 37 Group 2) | 6 treatment + 6 follow-up | 19 - 24,3% | Group 1: 6 months online CBT + 6 months follow-up; group 2: 6 months waiting list + 6 months online CBT. Regular e-mail contact with a coach during intervention. After treatment binge eating, drive for thinness, body dissatisfaction and interoceptive awareness significantly improved. Binge episodes, overall eating symptoms and hunger also decreased. Improvements maintained at follow-up. Higher shape concern and higher drive for thinness among dropouts. | Clinical trial | ||
Castellini et al., 2011 [9] | 793 mixed EDs (of which 283 BED) | 6 treatment + 72 follow-up | 0% | Patients evaluated with clinical interview undergo 6 months individual CBT. At 6-year follow-up, overall recovery rate was 59.2% for BED and 77.2% for subthreshold BED. Crossover rates (DSM-IV) of 8.8% from BED to BN and 10.9% from BN to BED. Relapse rates of 11.4% for BED and 12.1% for subthreshold-BED. Among relapsed patients who changed diagnosis 18.1% of BN developed BED, 18.7% of BED developed BN and 8.7% of subthreshold-BED developed BED. | Prospective observational study | ||
Compare et al., 2013 [46] | 189 obese with BED (63 EFT; 63 CT; 63 DT) | 5 treatment + 6 follow-up | 27% DT vs. 12.7% EFT vs. 0% CT | Patients randomized to Emotionally Focused Therapy (EFT), Dietary Counseling (DC), and Combined Treatment (CT). DC showed higher dropout rate. Body weight decreased in all three groups. Eating symptomatology decreased with CT and EFT. At follow-up, 71% of CT patients and 46% in EFT had subthreshold eating impulsivity, whereas no participants in the DC group reached this target. | Clinical trial | ||
Hilbert et al., 2012 [67] | 90 BED (45 CBT; 45 IPT) | 5 treatment, 48 follow-up | 24.7% of treated sample | 20 weekly group sessions + 3 individual sessions of CBT or IPT. Long-term BED recovery rates of 52.0% for CBT and 76.7% for IPT. Recovery from subclinical BED 72.0% for CBT and 83.9% for IPT (non-significant difference). BMI stable in both treatments. | Retrospective study | ||
Iacovino et al., 2012 [43] | 27 articles | ----- | ----- | Individual and group CBT associated with higher binge abstinence rates compared with supportive therapy and BWL. CBT guided self-help have superior outcomes than BWL guided self-help and comparable to IPT in patients with low additional pathology. IPT is the only treatment with comparable long-term outcomes to CBT. Psychodynamic IPT (additional focus on cyclical relational patterns and negative internalizations) comparable to CBT both post-treatment and at 12-month follow-up. DBT shows some promise as BED treatment, but requires further study. | Literature review | ||
Wilson & Zandberg, 2012 [61] | 24 articles (12 BN; 9 BED, 3 EDNOS) | ----- | ----- | Literature evidenced CBT guided self-help as a brief, cost-effective treatment for BED, comparable with more complex interventions and not necessarily contra-indicated for patients with comorbid conditions. | Literature review | ||
Klein et al., 2012 [64] | 10 women with BED or BN | 4.5 treatment | 50% | DBT showed positive preliminary outcomes on binge eating and eating psychopathology. | Descriptive study | ||
Leombruni et al., 2010 [53] | 297 BED patients | 2.5 treatment | 27% | Group psychoeducational intervention showed efficacy on eating impulsivity and related psychopathology. No significant results on weight and depression. Higher impulsivity correlates with higher drop-out rates. | Clinical trial | ||
Masheb et al., 2011b [40] | 50 obese with BED (25 CBT + ED; 25 CBT + GN) | 6 treatment | 14% | Patients randomized to CBT + low-Energy-Density diet (CBT + ED) or CBT + General Nutrition counseling not related to weight loss (CBT + GN). 30% of patients achieved at least a 5% weight loss with binge remission rates of 55–75%. No significant differences among treatments. Significantly better dietary outcomes on energy density, and fruit and vegetable consumption at CBT + ED. | Randomized controlled trial | ||
Masson et al., 2013 [66] | 60 BED (30 treatment; 30 wait-list) | 3 treatment + 6 follow-up | 25% | Self -help based in DBT manual + six 20-min support calls. Post-treatment efficacy on binge remission, quality of life and eating psychopathology at 6-month follow-up (clinical interview + self-report). | Randomized controlled trial | ||
Munsch et al., 2012a [31] | 80 obese with BED (44 CBT; 36 BWL) | 4 treatment + 12 extended care + 72 follow-up | Treatment 27.5% (CBT) -25% (BWL); Follow-up 41% (CBT) - 28% (BWL) | Patients randomized to CBT or BWL group intervention. Strong outcome improvement during active treatment but worsening at follow-up, however with residual improvement at 6-year follow-up relative to pretreatment values. Comparable long-term effects between CBT and BWL. Rapid response predicts favorable outcome. | Clinical trial | ||
Peterson et al., 20092 [63] | 259 BED (69 wait-list; 67 self-help; 63 therapist-assisted; 60 therapist-led) | 5 treatment; 12 follow-up | 26% mean | Therapist-led vs self-help CBT-based intervention. Binge abstinence in 51.7% of therapist-led, 33.3% of therapist-assisted, 17.9% of self-help group and 10.1% of wait-list. No differences in abstinence rates at follow-up. Therapist-led group show more reductions in binge eating at post treatment and follow-up. Treatment completion rates higher in therapist-led (88.3%) and wait-list (81.2%) groups than in therapist-assisted (68.3%) and self-help (59.7%) groups. | Randomized controlled trial | ||
Ricca et al., 2010 [57] | 144 BED and subthreshold-BED (72 individual CBT; 72 group CBT) | 5 treatment; 36 follow-up | 7% | Individual and group CBT (clinical interview + self-reported tests) show similar long-term response with a significant binge reduction and mild weight reduction. Lower emotional eating and binge eating severity predict full recovery. Overweight during childhood, full blown BED diagnosis and high emotional eating predict treatment resistance. | Prospective randomized controlled trial | ||
Robinson & Safer, 20122 [7] | 101 BED patients (50 DBT; 51 ACGT) | 5 treatment | 4% DBT 33.3% ACGT | Comparing DBT to active comparison group therapy (ACGT), patients with Avoidant Personality Disorder or earlier onset of overweight and dieting evidenced worsened outcome. | Randomized controlled trial | ||
Safer et al., 20103 [65] | 101 BED patients (50 DBT; 51 ACGT) | 5 treatment; 12 follow-up | 4% DBT 33.3% ACGT | Group DBT compared to ACGT show significantly lower dropout rate. Post-treatment binge abstinence and reduction achieved more quickly with DBT-BED but no difference at follow-up. | Randomized controlled trial | ||
Safer & Joyce, 20113 [48] | 101 BED patients (50 DBT; 51 ACGT) | 5 treatment; 12 follow-up | 4% DBT 33.3% ACGT | Rapid responders, especially to group DBT, show higher binge abstinence at end of treatment and 1 year follow-up and also significantly less attrition. | Randomized controlled trial | ||
Schlup et al., 2010 [58] | 76 BED women (40 CBT-L; 36 CBT-S) | 2-4 treatment; 12 follow-up | 14% (CBT-S) - 35% (CBT-L) | Comparing long and short term CBT - 16 sessions (CBT-L) vs 8 sessions (CBT-S) – both treatments show significant binge reductions. At the end of active treatment, but not at follow-up, better outcomes in CBT-L. Treatment efficacy for rapid responders and individuals with high dietary negative affect differs between CBT-L and CBT-S. | Randomized controlled trial | ||
Striegel-Moore et al., 2010 [60] | 123 patients (59 BED; 13 BN; 51 subthreshold BED/BN) (59 CBT-gsh; 64 TAU) | 3 treatment; 12 follow-up | 16.3% | CBT based guided self-help (CBT-gsh, 8 sessions) vs treatment as usual (TAU, non-dietary primary care management). At follow-up, CBT-gsh show greater binge abstinence and adjustment but not weight change. | Randomized controlled trial | ||
Tasca et al., 2012 [41] | 95 BED (48 PIP; 47 gCBT) | 4 treatment; 6 follow-up | 22% | Both group Psychodynamic Interpersonal Psychotherapy (gPIP) and group CBT (gCBT) improve interpersonal problems (self-administered tests). Higher effects of gPIP on patients with Cold/Distant interpersonal problems and attachment avoidance. | Clinical trial | ||
Vancampfort et al., 2013 [47] | 3 articles (211 BED women) | ----- | ----- | Aerobic and yoga exercises reduce binges and BMI. Aerobic exercise also reduces depressive symptoms. CBT with aerobic exercise and not CBT alone reduces BMI. CBBT with aerobic exercise is more effective on depressive symptoms than CBT alone. | Literature review | ||
Vanderlinden et al., 2012 [56] | 56 obese with BED | 7 treatment; 60 follow-up | ---- | Weekly group CBT improves eating behaviors, weight and psychopathology up to 3.5 years follow-up. | Prospective randomized controlled trial | ||
Wilson et al., 2010 [42] | 206 BED patients (64 BWL; 66 CBTgsh; 75 IPT) | 6 treatment; 24 follow-up | 7% IPT; 28% BWL; 30% CBTgsh | Comparing individual BWL, individual IPT and group CBTgsh. Both IPT and CBTgsh resulted in greater binge remission than BWL. Moderators of outcome were self-esteem and eating psychopathology (semi structured interview + self-administered tests). CBTgsh can be a first-line treatment option, with IPT (or full CBT) suitable for patients with low self-esteem and high eating disorder psychopathology. | Clinical trial | ||
Woolhouse et al., 2012 [39] | 43 women (31% BN; 50% BED; 19% subthreshold BN/BED) | 2.5 treatment; 3 follow-up | 23.25% | Mindfulness + group CBT reduces binge eating, dieting and body image dissatisfaction both at end of treatment and follow-up. Qualitative interviews with 16 patients attributed the efficacy of mindfulness to increasing self-awareness. | Clinical trial | ||
Pharmacological treatments | 13 | Arbaizar et al., 2008 [74] | 5 articles (528 BED patients) | ------ | ----- | Short-term treatment with topiramate (50-600 mg/day) is more effective than placebo in decreasing binges and weight in both BN and BED. High number of withdrawals and small sample sizes limit the generalizability of this result | Literature review |
Calandra et al., 2012 [71] | 30 depressed patients with BED (15 bupropion; 15 sertraline) | 6 treatment | 0% | Bupropion (150 mg/day) and (sertraline 200 mg/day) both reduced anxious-depressive symptoms and binge frequency. Bupropion more effective in reducing weight, with weight loss proportional to BMI, and improving sexual performances. | Randomized controlled trial | ||
Grilo et al., 2012b [55] | 81 overweight with BED (27 fluoxetine, 26 CBT + fluoxetine; 28 CBT+ placebo) | 4 treatment; 12 follow-up | 28.4% | Remission rates at 12-month follow-up of 3.7% for fluoxetine-only, 26.9% for CBT + fluoxetine, and 35.7% for CBT + placebo. None of the treatments produced significant changes in BMI. CBT + fluoxetine and CBT + placebo did not differ from each other. | Double blind placebo controlled trial | ||
Guerdjikova et al., 2009 [76] | 51 obese with BED (26 lamotrigine, 25 placebo) | 4 | 44% | Lamotrigine (236+/−150 mg/day) and placebo performed similar on binge reduction, eating pathology, obsessive-compulsive symptoms, impulsivity, and global severity of illness. Lamotrigine was associated with a numerically greater amount of weight loss and significant reductions of glucose, insulin, and triglycerides. | Double blind placebo controlled trial | ||
Guerdjikova et al., 2012 [72] | 40 BED with depression (20 duloxetine; 20 placebo) | 3 | 32.5% | Duloxetine (mean 78.7 mg/day) superior to placebo in reducing binge frequency, weight and Clinical Global Impression-Severity of Illness ratings for binge eating and depressive disorders. Changes in BMI and measures of eating pathology, depression and anxiety did not differ. | Double blind placebo controlled trial | ||
Blom et al., 2014 [69] | 10 articles (234 BED patients) | ----- | ----- | Studying placebo response in BED, 38% of patients show partial response and 26% attain cessation. Lower baseline binge eating and longer study participation associated with higher response. | Pooled analysis of clinical trials | ||
Leombruni et al., 2008 [70] | 42 overweight with BED (22 sertraline; 20 fluoxetine) | 6 | 35.7% | Sertraline (100–200 mg/day) and fluoxetine (40–80 mg/day) show similar efficacy on binge frequency, weight loss and psychopathology. Results were maintained by responders over 24 weeks. | Randomized double blind controlled trial | ||
Leombruni et al., 2009 [73] | 45 BED fullcriteria or subthreshold | 3 | 31% | Duloxetine (60–120 mg) reduces binges, eating impulsivity, depression, weight, BMI and clinical global impression. | Clinical trial | ||
Marazzitti et al., 2012 [75] | ------ | ----- | ----- | Topiramate (25-1400 mg/day) and zonisamide (100-600 mg/day) seem to suppress appetite and increase eating control, leading to BMI reduction | Literature overview | ||
McElroy et al., 2011a [77] | 40 BED (20 acamprosate; 20 placebo) | 2.5 | 38% | Acamprosate (999–2997 mg/day) improves binge frequency, obsessive-compulsiveness, food craving and quality of life. | Double blind placebo controlled trial | ||
Mc Elroy et al., 2011b [78] | 12 BED | 4 | 41.6% | Sodium oxybate (mean 7.1 g/day) reduces binge frequency, eating pathology, obsessive-compulsive symptoms, food cravings and weight. | Clinical trial | ||
McElroy et al., 2012 [68] | 22 articles | ----- | ----- | SSRIs are the most studied drugs effective on binge eating and psychiatric and weight symptoms. However most weight reductions would not be considered clinically significant. Duloxetine is effective on binge eating, weight loss and depressive symptoms. Reboxetine showed preliminary reductions in binge frequency and BMI. Topiramate is useful in BED with obesity, decreasing weight and obsessive-compulsive eating pathology as well as trait impulsivity. Orlistat in combination with CBT or dietary therapy, enhances weight loss and reduces binge eating. Zonisamide, naltrexone (high doses), stimulants, and glutamate-modulating agents show promises for BED treatment. Data are not sufficient to recommend pharmacotherapy as single first-line therapy, however drugs plays an important role in BED management. | Literature review | ||
Reas & Grilo, 2008 [38] | 14 articles (1279 patients) | ----- | ----- | Pharmacotherapies have a clinical significance over placebo on binge remission and weight loss (statistically but not clinically significant). No data on long-term effects. Combining medications with psychotherapy failed to enhance outcomes. Promising findings, albeit modest, reported for orlistat/topiramate + CBT/BWL. Limited utility of SSRI. Need for additional large and longer studies. | Literature review | ||
Surgical interventions | 4 | Ashton et al., 2011 [84] | 128 bariatric surgery candidates with binge eating | 12 follow-up | ----- | Positive responders to a brief CBT intervention targeting binge eating lost more weight both at 6 months and 12 postoperatively. | Longitudinal study |
Beck et al., 2012 [83] | 45 bariatric surgery patients | 24 follow-up | 33% of eligible patients | Binge eating and ineffectiveness (self-administered tests) correlate with lower weight loss after surgery. | Retrospective study | ||
Faulconbridge et al., 20134 [81] | 85 obese with BED (36 bariatric surgery, 49 BWL) | 12 surgical follow-up vs. 12 BWL treatment | 41.2-17.6% to follow-up | Surgery vs BWL group treatment (20 weekly sessions + 10 fortnightly + 4 monthly sessions). Surgery participants lost significantly more weight. Improvements in mood and quality observed both in surgery and BWL intervention, with no differences at follow-up. Positive correlation between weight loss and change in depression scores. Weight loss at one time point predicted depression score at next time point, but depression score did not predict subsequent weight loss. | Longitudinal study | ||
Wadden et al., 20114 [82] | 144 surgically treated (59 no ED, 36 BED), 49 BWL intervention for obese with BED | 12 surgical follow-up vs. 12 BWL treatment | 41.2-17.6% to follow-up | At follow-up, surgically-treated participants without BED lost 24.2% of initial weight, compared with 22.1% for those with BED. Both groups achieved clinically significant improvements in several cardiovascular disease (CVD) risk factors. BED participants who received BWL lost 10.3% at 1 year. Mean binges number fell sharply in both BED groups at 1 year. Groups did not differ significantly in BED remission rates or in improvements in CVD risk factors. | Prospective observational study |