Examining depression scores as predictors and moderators of treatment outcomes in patients with binge‐eating disorder

2021 ◽  
Author(s):  
Carlos M. Grilo ◽  
Ralitza Gueorguieva ◽  
Brian Pittman
Keyword(s):  
Eating Disorder ◽  
Binge Eating ◽  
Treatment Outcomes ◽  
Binge Eating Disorder

Change in impulsivity is prospectively associated with treatment outcomes for binge-eating disorder

2021 ◽  
pp. 1-9
Author(s):  
Rebecca G. Boswell ◽  
Ralitza Gueorguieva ◽  
Carlos M. Grilo
Keyword(s):  
Eating Disorder ◽  
Binge Eating ◽  
Treatment Outcomes ◽  
Binge Eating Disorder ◽  
Pharmacological Treatment ◽  
Rapid Change ◽  
Post Treatment ◽  
Controlled Clinical Trial ◽  
Eating Disorder Psychopathology

Abstract Background Impulsivity may be a process underlying binge-eating disorder (BED) psychopathology and its treatment. This study examined change in impulsivity during cognitive-behavioral therapy (CBT) and/or pharmacological treatment for BED and associations with treatment outcomes. Methods In total, 108 patients with BED (NFEMALE = 84) in a randomized placebo-controlled clinical trial evaluating the efficacy of CBT and/or fluoxetine were assessed before treatment, monthly throughout treatment, at post-treatment (16 weeks), and at 12-month follow-up after completing treatment. Patients completed established measures of impulsivity, eating-disorder psychopathology, and depression, and were measured for height and weight [to calculate body mass index (BMI)] during repeated assessments by trained/monitored doctoral research-clinicians. Mixed-effects models using all available data examined changes in impulsivity and the association of rapid and overall changes in impulsivity on treatment outcomes. Exploratory analyses examined whether baseline impulsivity predicted/moderated outcomes. Results Impulsivity declined significantly throughout treatment and follow-up across treatment groups. Rapid change in impulsivity and overall change in impulsivity during treatment were significantly associated with reductions in eating-disorder psychopathology, depression scores, and BMI during treatment and at post-treatment. Overall change in impulsivity during treatment was associated with subsequent reductions in depression scores at 12-month follow-up. Baseline impulsivity did not moderate/predict eating-disorder outcomes or BMI but did predict change in depression scores. Conclusions Rapid and overall reductions in impulsivity during treatment were associated with improvements in specific eating-disorder psychopathology and associated general outcomes. These effects were found for both CBT and pharmacological treatment for BED. Change in impulsivity may be an important process prospectively related to treatment outcome.

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.

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.

Klassifikation von Essstörungen im Zuge von DSM-V mit besonderem ­Fokus auf der Diagnostik von Ess­anfällen bei der Binge-Eating-Störung

2011 ◽  
Vol 59 (4) ◽  
pp. 267-274 ◽  
Author(s):  
Anja Hilbert
Keyword(s):  
Eating Disorder ◽  
Binge Eating ◽  
Binge Eating Disorder ◽  
Klinische Relevanz ◽  
Dsm V

Zusammenfassung.Die Klassifikation von Essstörungen steht im Zentrum aktuellen Forschungsinteresses. Gerade relativ rezente diagnostische Kategorien wie die Binge-Eating- oder Essanfallsstörung (Binge Eating Disorder, BED) und diagnostische Hauptmerkmale wie Essanfälle bedürfen im Zuge der Überarbeitungen des DSM einer Überprüfung. In dem vorliegenden Artikel werden zunächst die für das DSM-V vorgeschlagenen Veränderungen der diagnostischen Kriterien der BED und anderer Essstörungen beschrieben. An­schließend wird das Essanfallsmerkmal der Größe der verzehrten Nahrungsmenge in einer Forschungsübersicht hinsichtlich seiner klinischen Relevanz für die BED betrachtet. Dabei zeigt sich, dass sowohl objektive als auch subjektive Essanfälle psychopathologisch relevant sind. Jedoch sind objektive Essanfälle aufgrund ihrer Assoziation mit einem geringeren Behandlungserfolg, einer größeren residualen Symptomatik und vermehrten Rückfalltendenzen das vergleichsweise stringentere Erfolgskriterium in der Therapieerfolgsforschung der BED. Vor diesem Hintergrund erscheint es für die BED zentral, neben objektiven Essanfällen zusätzlich auch subjektive Essanfälle zu erfassen. Für das DSM-V wird empfohlen, ein Schema zu entwerfen, um das Auftreten und die Häufigkeit dieser Formen von Essanfällen für die BED sowie für andere klinische und subklinische Formen von Essanfällen systematisch zu erheben. Eine sorgfältige Erfassung der Essanfallsgröße in Studien zur Psychopathologie, zum Verlauf und zur Behandlung, wird es erlauben, die klinische Relevanz dieses Merkmals über das Essstörungsspektrum hinweg weiter zu klären.

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