Appetite-focused cognitive behavioral therapy for the early intervention of binge eating disorder

This study sought to examine and compare the efficacy of two early intervention group treatments for binge eating disorder (BED): cognitive-behavioral therapy (CBT) and a modified version of CBT, appetite-focused CBT (CBT-AF). Twenty overweight college-aged women with subclinical or recent-onset BED were assigned to one of the two conditions. Treatment was provided in small groups and consisted of 10 weekly sessions, lasting 1.5 hours each. The first phase of both treatments focused on changing problematic eating patterns, and the second phase emphasized learning strategies for healthy weight loss/weight management. The primary goals of both treatments were to: (1) prevent the continuation and/or escalation of binge eating and other BED-related symptomatology and (2) initiate modest weight loss or prevent the weight gain commonly experienced by individuals with BED over time.; Participants in the CBT and the CBT-AF treatment groups demonstrated substantial, but not differential, improvement in terms of eating disordered pathology and general psychiatric distress. More specifically, participants reported significant change in the following areas: decrease in number of binge episodes, reduction in eating disorder symptomatology, improvement in body image, and decline in general psychopathology. These gains were evident at posttreatment and maintained at 4-month follow-up. Participants in both treatment groups maintained their weight over the course of treatment and follow-up, but did not lose weight. The results support the efficacy of CBT-based (both standard and appetite-focused) early interventions for BED, and demonstrate that such treatments can be successfully delivered in a brief group format. Thus, appetite monitoring provides a viable alternative to monitoring food intake within CBT in a population with subclinical or recent-onset BED. Further work is needed to determine if client characteristics are associated with preference for treatment or are useful in predicting improved response to each intervention.