Self-help versus therapist-led group cognitive-behavioral treatment of binge eating disorder at follow-up.

OBJECTIVE: The purpose of this study was to evaluate the longer-term outcome of three group cognitive-behavioral therapy (CBT) delivery models for the treatment of binge eating disorder (BED). METHOD: Fifty-one participants were assigned to one of three conditions. In the therapist-led condition (TL; n = 16), a psychologist provided psychoeducational information for the first half hour and led a group discussion for the second half hour of each session. In the partial self-help condition (PSH; n = 19), participants viewed a 30-min psychoeducational videotape, followed by a therapist-led discussion. In the structured self-help condition (SSH; n = 16), participants watched a psychoeducational videotape and led their own discussion. RESULTS: Reductions in binge eating episodes and associated symptoms were observed for all three treatments at post, 1-month, 6-month, and 1-year follow-up, with no significant differences among the three conditions. DISCUSSION: These findings suggest that CBT for BED can be delivered successfully using videotape and a structured self-help group format and that improvements in binge eating are maintained up to 1 year follow-up.

A comparison of onset of binge eating versus dieting in the development of bulimia nervosa.

OBJECTIVE: This study further investigates the hypothesis that dieting is the precursor to the development of binge eating. METHOD: The temporal relationship of onset of binge eating and dieting is examined from retrospective self-reports collected at baseline from women participating in two bulimia nervosa (BN) treatment studies (N = 221). Twenty women were identified who reported binge eating prior to the onset of dieting ("binged first," BF). For comparison, 20 similar age individuals reporting dieting onset preceding that of binge eating ("dieted first," DF) were selected. RESULTS: A subset of women (8.8%) seeking treatment for BN endorsed the development of binge eating prior to dieting onset. The BF pattern of BN development was associated with earlier age of onset of binge eating, later onset of purging, increased desired weight, and increased actual weight. Binge eating prior to dieting onset was also associated with improved response to group cognitive-behavioral treatment at 6-month follow-up. CONCLUSIONS: This study provides support for the hypothesis that dieting is a risk factor, but not necessarily a precursor, to the development of binge eating in BN. Implications for treatment and future research are discussed.