Status: Strong Research Support

Description

Cognitive Behavioral Therapy (CBT) for binge eating disorder directly targets the cardinal features of the disorder, namely binge eating and its associated loss of control and distress. Importantly, this treatment aims to resolve the maladaptive eating patterns that maintain the binge eating. CBT for binge eating disorder is conducted in approximately twenty weekly sessions, which encompass three phases. For obese individuals with binge eating disorder, the first phase of treatment explicitly addresses the need to prioritize cessation of binge eating over immediate weight loss, and helps the patient establish a regular pattern of eating and an appropriate weight monitoring schedule. Nutritional education is provided and regular exercise is encouraged. In the second phase, the focus shifts to reducing shape and weight concerns and expanding one’s definition of self-worth, and challenging notions of food addiction or other cognitions that may perpetuate the binge eating. The third phase is devoted to maintenance planning and the prevention of relapse in the future. In CBT, the therapist works collaboratively with the patient to disrupt the factors maintaining the binge eating with the goal to achieve abstinence from this behavior. This treatment can be delivered in either individual or group formats. Therapists can also guide patients in a self-help version of CBT for binge eating disorder.

 

Key References (in reverse chronological order)

  • Grilo, C.M., Masheb, R.M. (2005). A randomized controlled comparison of guided self-help cognitive behavioral therapy and behavioral weight loss for binge eating disorder.Behaviour Research and Therapy, 43(11), 1509-1525.
  • Devlin, M.J., Goldfein, J.A., Petkova, E., Jiang, H., Raizman, P.S., Wolk, S.,Mayer, L., Carino, J., Bellace, D., Kanenetz, C., Dobrow, I., & Walsh, T. (2005). Cognitive behavioral therapy and fluoxetine as adjuncts to group behavioral therapy for binge eating disorder. Obesity Research, 13(6), 1077-1088.
  • Grilo, C.M., Masheb, R.M., & Salant, S.L. (2005). Cognitive behavioral therapy guided self-help and orlistat for the treatment of binge eating disorder: A randomized, double-blind, placebo-controlled trial. Biological Psychiatry, 57, 1193-1201.
  • Grilo, C.M., Masheb, R.M., & Wilson, G.T. (2005). Efficacy of cognitive behavioral therapy and fluoxetine for the treatment of binge eating disorder: A randomized double-blind placebo-controlled comparison. Biological Psychiatry, 57, 301-309.
  • Wilfley, D.E., Welch, R.R., Stein, R.I., Spurrell, E.B., Cohen, L.R., Saelens, B.E., Dounchis, J.Z., Frank, M.A., Wiseman, C.V., & Matt, G.E. (2002). A randomized comparison of group cognitive-behavioral therapy and group interpersonal psychotherapy for the treatment of overweight individuals with binge-eating disorder. Archives of General Psychiatry, 59(8), 713-721.
  • Wilfley, D. E., Agras, W. S., Telch, C. F., Rossiter, E. M., Schneider, J. A., Cole, A. G., Sifford, L., & Raeburn, S. D. (1993). Group cognitive-behavioral therapy and group interpersonal psychotherapy for the nonpurging bulimic individual: A controlled comparison. Journal of Consulting and Clinical Psychology, 61, 296-305.
  • Full reference list

 

Clinical Resources

  • Marcus, M. (1997). Adapting treatment for patients with binge eating disorder. In D.M. Garner & P.E. Garfinkel (Eds.), Handbook of Treatment for Eating Disorders (2nd Ed.), (pp. 484-493). New York: The Guilford Press.
  • Wilfley, D.E., Grilo, C.M., & Rodin, J. (1997). Group psychotherapy for the treatment of bulimia nervosa and binge eating disorder: Research and clinical methods. In J.L. Spira (Ed.), Group therapy for medically ill patients (pp. 225-295). New York: Guilford Press.
  • Fairburn, C. G. (1995). Overcoming binge eating. New York: Guilford Press.
  • Fairburn, C. G., Marcus, M.D., & Wilson, G. T. (1993). Cognitive-behavioral therapy for binge eating and bulimia nervosa: A comprehensive treatment manual. In C. G. Fairburn & G. T. Wilson (Eds.), Binge eating: Nature, assessment and treatment (pp. 361-404). New York: Guilford Press.

 

Training Opportunities

  • Contact Michael J. Devlin, MD (Columbia University) mjd5@columbia.edu
  • Christopher G. Fairburn, DM, FRCPsych (Oxford University) credo@medsci.ox.ac.uk
  • Carlos Grilo, PhD (Yale University) carlos.grilo@yale.edu
  • Marsha Marcus, PhD (University of Pittsburgh) marcusmd@upmc.edu (research only)
  • Denise Wilfley, PhD (Washington University) wilfleyd@psychiatry.wustl.edu (research only)
  • G. Terence Wilson, PhD (Rutgers University) (research only)