Placebo Produces Better Binge-Eating Outcomes Than Antidepressants

People who have binge-eating issues (BED) tend to have higher body mass indexes (BMI) and more body fat than those without BED. There are many types of treatment designed to address BED and other food and eating issues, but to date cognitive behavioral therapy (CBT) has been shown to be most effective. Some research has suggested that antidepressants could help reduce BED, but few studies have compared the effectiveness of CBT alone to CBT with antidepressants. To fill this void in research, Carlos M. Grilo of the Department of Psychiatry at Yale University conducted a study that evaluated the short-term and long-term effects of three different types of treatment for BED.

Grilo enlisted 81 obese individuals with BED and enrolled them in a treatment that included fluoxetine only, CBT with fluoxetine (antidepressant), or CBT and placebo. The participants were evaluated for frequency of binge eating, body weight, BMI, and depression before they began treatment and again six and 12 months post-treatment. The results revealed that although all three groups had some remission, the greatest improvements were found in the CBT-plus-placebo group. Fluoxetine-only participants had remission rates of 2.7%, CBT-plus-fluoxetine had a remission rate of 26.9%, and CBT-plus-placebo led to remission rates over 35% at 12-month follow-up.

Taken together, the findings show that CBT, with or without fluoxetine, was better at reducing symptoms of BED than fluoxetine alone. None of the participants saw significant weight loss after treatment, but those in the CBT-plus-fluoxetine group had lower BMI at follow-up than participants in either fluoxetine group. Grilo noted that his study included only white, female participants and additional research should include a more diverse sample in order to further examine the effectiveness of CBT for BED. “Future studies should examine patient characteristics (e.g., self-efficacy) and intervening events (e.g., stressful events) that may be associated with longer-term outcomes of maintenance and relapse,” he added. Until then, these findings provide clear evidence that CBT is more effective than antidepressants alone for the treatment of BED.

Grilo, C. M., Crosby, R. D., Wilson, G. T., Masheb, R. M. (2012). 12-month follow-up of fluoxetine and cognitive behavioral therapy for binge eating disorder. Journal of Consulting and Clinical Psychology. Advance online publication. doi: 10.1037/a0030061

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  • David


    October 11th, 2012 at 11:22 PM

    So CBT plus placebo works best but antidepressants help in weight loss?I dont quite get this.How could an antidepressant possibly affect weight loss?

  • Tiffany


    October 12th, 2012 at 3:58 AM

    Really? Because I had this theory forst! I don’t think that antidepressants have done anything to help anyone I have known to take then except make them gain weight!

  • Kiley


    October 12th, 2012 at 10:01 AM

    I can eat all I want and will not gain weight. I have seen others that can eat all throughout the day and they are not obese by any means. So when you say people with BED tend to have higher BMI, is it that the BED leads to higher BMI or is it that those with bodies that put on weight quite easily tend to be affected by BED more often?

  • Joel williams

    Joel williams

    October 12th, 2012 at 2:59 PM

    So what I get from this is that with binge eating behaviors there really isn’t that mental issues at all that many so called “experts” want us to believe.

    If a placebo works then how can there ever have been a real problem to begin with? If this is something that is actually real, then a placebo is not going to do the trick.

  • Marquette


    October 13th, 2012 at 6:48 AM

    Since when would you provide some form of medication for binge eating anyway?
    I would surely have believed that therapy and behavior modification skills would be far more helpful and important than just popping a pill. I am not a counselor or medical professional so maybe there are these kinds of treatments that I just don’t know about.
    But I have always imagined that these would be people who need the kind of help that comes from sitting down talking to someone and creating a skill set for problem solving, not something pharaceutical in nature unless there is some sort of anxiety or depression that they are dealing with too.

  • Polly


    October 15th, 2012 at 11:19 AM

    So the key to all of this, the real solution, is that mediucation alone is in no way the answer to the real problems associated with beinge eating. This is a serious issue, one that we have to remember stems form a lot of pain from somewhere down the line. CBT is the only thing that is going to allow you to really dig deep, discover why you are doing this to yourself, and help you heal from that pain. A drug can’t do that, and I think that we all know that. There has to be a trained professional talking with you and working with you every step of the way, helping you believe in yourself as well as helping you to relieve yourself of that pain that you have been carrying with you for too long and allowing to lead you down this destructive behavioral path.

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