scholarly journals Examining Self-Weighing Behaviors and Associated Features and Treatment Outcomes in Patients with Binge-Eating Disorder and Obesity with and without Food Addiction

Nutrients ◽  
2020 ◽  
Vol 13 (1) ◽  
pp. 29
Author(s):  
Ashley A. Wiedemann ◽  
Valentina Ivezaj ◽  
Ralitza Gueorguieva ◽  
Marc N. Potenza ◽  
Carlos M. Grilo
Keyword(s):  
Weight Loss ◽  
Eating Disorder ◽  
Weight Gain ◽  
Binge Eating ◽  
Treatment Outcomes ◽  
Binge Eating Disorder ◽  
Food Addiction ◽  
Behavioral Weight Loss ◽  
Eating Disorder Examination ◽  
Before And After

Food addiction (FA) has been linked to clinical features in binge-eating disorder (BED) and obesity. A feature of behavioral weight loss (BWL) treatment involves frequent weighing. However, little is known regarding how frequency of self-weighing and related perceptions are associated with BWL outcomes among individuals with BED and obesity stratified by FA status. Participants (n = 186) were assessed with the Eating Disorder Examination before and after BWL treatment. Mixed effects models examined FA (presence/absence) before and after (post-treatment and 6- and 12-month follow-up) treatment and associations with frequency of weighing and related perceptions (reactions to weighing, sensitivity to weight gain and shape/weight acceptance). Participants with FA reported more negative reactions to weighing and less acceptance of shape/weight throughout treatment and follow-ups, and both variables were associated with greater disordered eating at follow-ups among participants with FA. Sensitivity to weight gain decreased over time independent of FA status. Frequency of weighing was associated with a greater likelihood of achieving 5% weight loss only among those without FA. Reactions to weighing and sensitivity to weight gain are associated with FA and poorer treatment outcomes in individuals with BED and obesity. Targeting these features may improve BWL outcomes among individuals with BED, obesity and FA.

Psychiatric comorbidity as predictor and moderator of binge-eating disorder treatment outcomes: an analysis of aggregated randomized controlled trials

2021 ◽  
pp. 1-9
Author(s):  
Janet A. Lydecker ◽  
Carlos M. Grilo
Keyword(s):  
Weight Loss ◽  
Eating Disorder ◽  
Binge Eating ◽  
Treatment Outcomes ◽  
Binge Eating Disorder ◽  
Psychiatric Comorbidity ◽  
Controlled Trials ◽  
Eating Frequency ◽  
Randomized Controlled ◽  
Eating Disorder Psychopathology

Abstract Background Psychiatric comorbidity is common in binge-eating disorder (BED) but effects on treatment outcomes are unknown. The current study aimed to determine whether psychiatric comorbidity predicted or moderated BED treatment outcomes. Methods In total, 636 adults with BED in randomized-controlled trials (RCTs) were assessed prior, throughout, and posttreatment by doctoral research-clinicians using reliably-administered semi-structured interviews, self-report measures, and measured weight. Data were aggregated from RCTs testing cognitive-behavioral therapy, behavioral weight loss, multi-modal (combined pharmacological plus cognitive-behavioral/behavioral), and/or control conditions. Intent-to-treat analyses (all available data) tested comorbidity (mood, anxiety, ‘any disorder’ separately) as predictors and moderators of outcomes. Mixed-effects models tested comorbidity effects on binge-eating frequency, global eating-disorder psychopathology, and weight. Generalized estimating equation models tested binge-eating remission (zero binge-eating episodes during the past month; missing data imputed as failure). Results Overall, 41% of patients had current psychiatric comorbidity; 22% had mood and 23% had anxiety disorders. Psychiatric comorbidity did not significantly moderate the outcomes of specific treatments. Psychiatric comorbidity predicted worse eating-disorder psychopathology and higher binge-eating frequency across all treatments and timepoints. Patients with mood comorbidity were significantly less likely to remit than those without mood disorders (30% v. 41%). Psychiatric comorbidity neither predicted nor moderated weight loss. Conclusions Psychiatric comorbidity was associated with more severe BED psychopathology throughout treatment but did not moderate outcomes. Findings highlight the need to improve treatments for BED with psychiatric comorbidities but challenge perspectives that combining existing psychological and pharmacological interventions is warranted. Treatment research must identify more effective interventions for BED overall and for patients with comorbidities.

Randomized controlled trial testing behavioral weight loss versus multi-modal stepped-care treatment for binge eating disorder

2016 ◽  
Vol 33 (S1) ◽  
pp. S163-S163 ◽  
Author(s):  
C. Grilo
Keyword(s):  
Weight Loss ◽  
Eating Disorder ◽  
Binge Eating ◽  
Binge Eating Disorder ◽  
Mixed Models ◽  
Controlled Trial ◽  
Stepped Care ◽  
Behavioral Weight Loss ◽  
Co Morbidity ◽  
Remission Rates

IntroductionBinge eating disorder (BED) is prevalent, associated with obesity and elevated psychiatric co-morbidity, and represents a treatment challenge.Objective and aimsA controlled comparison of multi-modal, stepped-care versus behavioral-weight-loss (BWL) for BED.MethodsOne hundred and ninety-one patients (71% female, 79% white) with BED and co-morbid obesity (mean BMI 39) were randomly assigned to 6 months of BWL (n = 39) or stepped-care (n = 152). Within stepped-care, patients started BWL for one month; treatment-responders continued BWL while non-responders switched to cognitive-behavioral-therapy (CBT) and all stepped-care patients were additionally randomized to anti-obesity medication or placebo (double-blind) for five months. Independent assessments were performed by research-clinicians at baseline, throughout treatment, and post-treatment (90% assessed) with reliably-administered structured interviews.ResultsIntent-to-treat analyses of remission rates (0 binges/month) revealed BWL and stepped-care did not differ significantly overall (74% vs 64%); within stepped-care, remission rates differed (range 40% - 79%) with medication significantly superior to placebo (P < 0.005) and among initial non-responders switched to CBT (P < 0.002). Mixed-models analyses of binge eating frequency revealed significant time effects but BWL and stepped-care did not differ overall; within stepped-care, medication was significantly superior to placebo overall and among initial non-responders switched to CBT. Mixed models revealed significant weight-loss but BWL and stepped-care did not differ overall; within stepped-care, medication was significantly superior to placebo overall and among both initial responders continued on BWL and non-responders switched to CBT.ConclusionsOverall, BWL and stepped-care treatments produced improvements in binge-eating and weight loss in obese BED patients. Anti-obesity medication enhanced outcomes within a stepped-care model.Disclosure of interestThe author has not supplied his/her declaration of competing interest.

Binge Eating Disorder and Food Addiction

2011 ◽  
Vol 4 (3) ◽  
pp. 201-207 ◽  
Author(s):  
Ashley N. Gearhardt ◽  
Marney A. White ◽  
Marc N. Potenza
Keyword(s):  
Eating Disorder ◽  
Binge Eating ◽  
Binge Eating Disorder ◽  
Food Addiction
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