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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