Self-help for binge eating disorder in primary care: a randomized controlled trial with ethnically and racially diverse obese patients
Open accessAbstract
Objective The objective was to examine the effectiveness of a self-help treatment as a first line primary care intervention for binge eating disorder (BED) in obese patients. This study compared the effectiveness of a usual care plus self-help version of cognitive behavioral therapy (shCBT) to usual care (UC) only in ethnically/racially diverse obese patients with BED in primary care settings in an urban center.Method 48 obese patients with BED were randomly assigned to either shCBT (N = 24) or UC (N = 24) for four months. Independent assessments were performed monthly throughout treatment and at post-treatment.Results Binge-eating remission rates did not differ significantly between shCBT (25%) and UC (8.3%) at post-treatment. Mixed models of binge eating frequency determined using the Eating Disorder Examination (EDE) revealed significant decreases for both conditions but that shCBT and UC did not differ. Mixed models of binge eating frequency from repeated monthly EDE-questionnaire assessments revealed a significant treatment-by-time interaction indicating that shCBT had significant reductions whereas UC did not during the four-month treatments. Mixed models revealed no differences between groups on associated eating disorder psychopathology or depression. No weight loss was observed in either condition.Conclusions Our findings suggest that pure self-help CBT did not show effectiveness relative to usual care for treating BED in obese patients in primary care. Thus, self-help CBT may not have utility as a front-line intervention for BED for obese patients in primary care and future studies should test guided-self-help methods for delivering CBT in primary care generalist settings.
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Psychological functioning was measured using the Beck Depression Inventory (BDI) and Beck Depression Inventory-II (BDI-II) scale in eight studies.
“Psychological functioning was measured using the Beck Depression Inventory (BDI) and Beck Depression Inventory-II (BDI-II) scale [124] in eight studies”
From Helping patients help themselves: A systematic review of self-management support strategies in primary health care practice (2019) · cites this paper as [93]
The Methods (Diagnostic Assessments and Repeated Measures) state that this trial used the 21-item Beck Depression Inventory (BDI) to measure depression. The paper does not identify its measure as the BDI-II; the eight-study count describes the citing document’s group of studies, not a finding established by this trial. (LLM, conf=0.88)
Experimental — accuracy not yet measuredInterventions targeting eating disorders were evaluated in four RCTs.
“Interventions targeting eating disorders were evaluated in four RCTs”
From Helping patients help themselves: A systematic review of self-management support strategies in primary health care practice (2019) · cites this paper as [93]
Nine studies reported disease knowledge as an outcome.
“Nine studies reported disease knowledge as an outcome [52, 66–68, 71, 81, 82, 88, 93, 111].”
From Helping patients help themselves: A systematic review of self-management support strategies in primary health care practice (2019) · cites this paper as [93]
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References 53 · Cited by 59
Research works printed but not linked: 1
- First MB Spitzer RL Gibbon M Williams JBW 1996 Structured clinical interview for DSM-IV Axis I disorders - patient Edition (SCID-I/P, Version 2.0) New York New York State Psychiatric Institute
- Authors
- Grilo, C. M., White, M. A., Gueorguieva, R., Barnes, R. D., & Masheb, R. M.
- Affiliations
- Yale University (US)
- Corresponding author
- Grilo, Carlos M.
- Venue
- Behaviour Research and Therapy
- Publisher
- Elsevier BV
- Published
- 2013-12
- Volume
- 51
- Issue
- 12
- Pages
- 855-861
- ISSN
- 0005-7967 (ISSN-L)
- PMC
- PMC3863907
- OpenAlex
- W2062027452
- Cited by
- 59
- References
- 53
- Citations by year
- 2026: 1 · 2025: 2 · 2024: 9 · 2023: 6 · 2022: 4 · 2021: 3 · 2020: 6 · 2019: 6 · 2018: 9 · 2017: 5 · 2016: 1 · 2015: 4 · 2014: 3
- FWCI
- 2.97
- Type
- journal article
- Language
- en
- Open access
- green
- www.ncbi.nlm.nih.gov
- Locations
- Behaviour Research and Therapy (publishedVersion)
- PubMed (publishedVersion)
- PubMed Central (acceptedVersion)
- Funders
- National Institutes of Health (R01 DK073542, K24 DK070052, K23 DK092279)
- Topics
- Social Sciences › Psychology › Clinical Psychology › Eating Disorders and Behaviors
- Health Sciences › Nursing › Nutrition and Dietetics › Nutrition, Health and Food Behavior
- Social Sciences › Psychology › Experimental and Cognitive Psychology › Anxiety, Depression, Psychometrics, Treatment, Cognitive Processes
- Keywords
- binge eating disorder, obesity, primary care, usual care, binge eating frequency, eating disorder psychopathology, depression, racial and ethnic diversity, weight loss
- MeSH terms
- Combined Modality Therapy, Depression, Female, Humans, Male, Middle Aged, Obesity, Primary Health Care, Self Care, Cognitive Behavioral Therapy, Body Mass Index, Treatment Outcome, Binge-Eating Disorder
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