Dialectical behavior therapy adapted for binge eating compared to cognitive behavior therapy in obese adults with binge eating disorder: a controlled study

Journal of Eating Disorders

Mirjam W. Lammers¹  Maartje S. Vroling¹  Tatjana van Strien²  Ross D. Crosby³ 

[1] Amarum, Expertise Centre for Eating Disorders, GGNet Network for Mental Health Care, Den Elterweg 75, 7207 AE, Zutphen, The Netherlands;Radboud University, Behavioural Science Institute, Montessorilaan 3, 6525 HR, Nijmegen, The Netherlands;Radboud University, Behavioural Science Institute, Montessorilaan 3, 6525 HR, Nijmegen, The Netherlands;Sanford Center for Biobehavioral Research, Fargo, North Dakota, USA;University of North Dakota School of Medicine and Health Sciences, Fargo, North Dakota, USA;

关键词: Binge eating disorder;    Cognitive behavior therapy;    Dialectical behavior therapy;    Group therapy;    Emotion regulation;   

DOI  :  10.1186/s40337-020-00299-z

来源: Springer

【 摘 要 】

BackgroundCurrent guidelines recommend cognitive behavior therapy (CBT) as the treatment of choice for binge eating disorder (BED). Although CBT is quite effective, a substantial number of patients do not reach abstinence from binge eating. To tackle this problem, various theoretical conceptualizations and treatment models have been proposed. Dialectical behavior therapy (DBT), focusing on emotion regulation, is one such model. Preliminary evidence comparing DBT adapted for BED (DBT-BED) to CBT is promising but the available data do not favor one treatment over the other. The aim of this study is to evaluate outcome of DBT-BED, compared to a more intensive eating disorders-focused form of cognitive behavior therapy (CBT+), in individuals with BED who are overweight and engage in emotional eating.MethodsSeventy-four obese patients with BED who reported above average levels of emotional eating were quasi-randomly allocated to one of two manualized 20-session group treatments: DBT-BED (n = 41) or CBT+ (n = 33). Intention-to-treat outcome was examined at post-treatment and at 6-month follow-up using general or generalized linear models with multiple imputation.ResultsOverall, greater improvements were observed in CBT+. Differences in number of objective binge eating episodes at end of treatment, and eating disorder psychopathology (EDE-Q Global score) and self-esteem (EDI-3 Low Self-Esteem) at follow-up reached statistical significance with medium effect sizes (Cohen’s d between .46 and .59). Of the patients in the DBT group, 69.9% reached clinically significant change at end of the treatment vs 65.0% at follow-up. Although higher, this was not significantly different from the patients in the CBT+ group (52.9% vs 45.8%).ConclusionsThe results of this study show that CBT+ produces better outcomes than the less intensive DBT-BED on several measures. Yet, regardless of the dose-difference, the data suggest that DBT-BED and CBT+ lead to comparable levels of clinically meaningful change in global eating disorder psychopathology. Future recommendations include the need for dose-matched comparisons in a sufficiently powered randomized controlled trial, and the need to determine mediators and moderators of treatment outcome.Trial registrationNederlands Trial Register: NL3982 (NTR4154). Date of registration: 2013 August 28, retrospectively registered,

【 授权许可】

CC BY