Meta-analysis of the efficacy of psychological and medical treatments for binge-eating disorder
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OBJECTIVE: To provide a comprehensive meta-analysis on the efficacy of psychological and medical treatments for binge-eating disorder (BED), including those targeting weight loss. METHOD: Through a systematic search before March 2018, 81 published and unpublished randomized-controlled trials (RCTs), totaling 7,515 individuals with BED (Diagnostic and Statistical Manual of Mental Disorders-Fourth Edition [DSM-IV] and Fifth Edition [DSM-5]), were retrieved and analyzed using random-effect modeling. RESULTS: In RCTs with inactive control groups, psychotherapy, mostly consisting of cognitive-behavioral therapy, showed large-size effects for the reduction of binge-eating episodes and abstinence from binge eating, followed by structured self-help treatment with medium-to-large effects when compared with wait-list. Pharmacotherapy and pharmacological weight loss treatment mostly outperformed pill placebo conditions with small effects on binge-eating outcome. These results were confirmed for the most common treatments of cognitive-behavioral therapy, self-help treatment based on cognitive-behavioral therapy, and lisdexamfetamine. In RCTs with active control groups, there was limited evidence for the superiority of one treatment category or treatment. In a few studies, psychotherapy outperformed behavioral weight loss treatment in short- and long-term binge-eating outcome and led to lower longer-term abstinence than self-help treatment, while combined treatment revealed no additive effect on binge-eating outcome over time. Overall study quality was heterogeneous and the quality of evidence for binge-eating outcome was generally very low. CONCLUSIONS: This comprehensive meta-analysis demonstrated the efficacy of psychotherapy, structured self-help treatment, and pharmacotherapy for patients with BED. More high quality research on treatments for BED is warranted, with a focus on long-term maintenance of therapeutic gains, comparative efficacy, mechanisms through which treatments work, and complex models of care. (PsycINFO Database Record (c) 2018 APA, all rights reserved).
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Abstinence rates in the current study (29.9%) were somewhat lower than those reported in various RCTs for BED (31%-61%).
“Abstinence rates were somewhat lower in the current study (29.9%) compared to various RCTs for BED: guided selfhelp CBT-E (31% based on self-report, and 48% based on interviewdata) (Melisse, Berg, et al., 2023a), self-help CBT-ED (36% -46% based on interview-data) (de Zwaan et al., 2017; Hilbert et al., 2019), or inperson CBT-ED (36% -61% based on interview-data) (de Zwaan et al., 2017; Hilbert et”
From Effectiveness of web-based guided self-help cognitive behavioral therapy-enhanced for binge-eating disorder: An implementation study (2024) · cites this paper as Hilbert et al., 2019
In ‘Pre-treatment to Post-treatment Change versus Inactive Control’ (page unavailable), the meta-analysis reports post-treatment binge-eating abstinence of 46% for self-help treatment and 53% for psychotherapy in RCTs. These figures support the comparison with the current study’s 29.9%, but the paper does not report 36% or 61% as abstinence rates; 61% is the upper bound of the psychotherapy estimate’s 95% confidence interval. (LLM, conf=0.86)
Experimental — accuracy not yet measuredThere were no significant differences in BMI across timepoints.
“Consistent with convergent findings across CBT-based programs for BED (4), there was no significant differences in BMI across timepoints”
From The acceptability, feasibility, and preliminary efficacy of a supported online self-help treatment program for binge-eating disorder (2023) · cites this paper as [4]
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- Authors
- Hilbert, A., Petroff, D., Herpertz, S., Pietrowsky, R., Tuschen-Caffier, B., Vocks, S., & Schmidt, R.
- Affiliations
- European Medicines Agency (NL)
- Corresponding author
- Hilbert, Anja
- Venue
- Journal of Consulting and Clinical Psychology
- Published
- 2019-01
- Volume
- 87
- Issue
- 1
- Pages
- 91-105
- ISSN
- 0022-006X (ISSN-L)
- 1939-2117
- OpenAlex
- W2905971773
- Cited by
- 283
- References
- 127
- Citations by year
- 2026: 22 · 2025: 38 · 2024: 41 · 2023: 49 · 2022: 47 · 2021: 44 · 2020: 29 · 2019: 11 · 2018: 1 · 2013: 1
- FWCI
- 3.60
- Type
- journal article
- Language
- en
- Open access
- green
- ul.qucosa.de
- Licence
- other-oa
- Locations
- Journal of Consulting and Clinical Psychology (publishedVersion)
- PubMed (publishedVersion)
- Qucosa (Saxon State and University Library Dresden) (submittedVersion, other-oa)
- 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, cognitive behavioral therapy, self-help treatment, pharmacotherapy, lisdexamfetamine, weight loss treatment, treatment efficacy, combined psychotherapy and pharmacotherapy
- MeSH terms
- Adult, Appetite Depressants, Female, Follow-Up Studies, Humans, Male, Obesity, Psychotherapy, Self Care, Self-Help Groups, Weight Loss, Randomized Controlled Trials as Topic, Treatment Outcome, Bariatric Surgery, Binge-Eating Disorder
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