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Meta-analysis of the efficacy of psychological and medical treatments for binge-eating disorder
Open accessAbstract
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 METHOD: Through a systematic search before March 2018, 81 published and unpublished randomized-controlled trials (RCTs), totaling 7,515 individuals with BED (Diagnostic and Statistical Manual of Mental Disorders-Fourth Edition [DSM-IV] and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 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
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“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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Metadata
- 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
- 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
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
What counts as a claim ›How we measure confidence ›How we check this ›
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