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05 January 2010

Psychotherapy best for binge eaters

Certain kinds of talk therapy and guided self-help are both more likely than behavioural weight loss treatment to keep people free from binge eating disorder, according to a new study.

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Certain kinds of talk therapy and guided self-help are both more likely than behavioural weight loss treatment to keep people free from binge eating disorder, according to a new study.

In prior research, these treatments for binge eating have had similar short-term results. Long-term data, however, have been lacking, according to the report in the Archives of General Psychiatry.

How the study was done

To investigate, Dr G. Terence Wilson, from Rutgers University in Piscataway, New Jersey and colleagues assigned 205 men and women with binge eating disorder to six months of treatment with either 20 sessions of interpersonal psychotherapy, 20 sessions of behavioural weight loss treatment, or 10 sessions of guided self-help cognitive behavioural therapy.

Interpersonal psychotherapy is a short-term treatment that focuses on how people relate to others. Cognitive behavioral therapy is also relatively short-term, but focuses on emotional responses to situations.

In the guided self-help treatment used in the study, patients used a cognitive behavioural manual under guidance from a therapist. The behavioural weight loss treatment included some kilojoule restriction, and exercise.Subjects were all overweight or obese and had been diagnosed with binge eating disorder.

What the study showed

When the researchers looked at the rate of binge eating immediately after treatment, and six months later, there were no differences between the groups.

Two years later, however, "both interpersonal therapy and cognitive behaviour therapy/guided self-help were significantly more effective than behavioural weight loss therapy in terms of remission from binge eating," according to the investigators.

About 60% of the interpersonal therapy and cognitive behaviour therapy/guided self-help groups were in remission after two years, compared with about 40 % of the behavioural weight loss group. Those with low self-esteem and very severe binge eating symptoms also benefited more from interpersonal psychotherapy.

Based on the results, the authors suggest that doctors try cognitive behaviour therapy/guided self-help treatment first, except in patients with low self-esteem and severe symptoms, who should receive interpersonal psychotherapy. - (Reuters Health, January 2010)

 
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