«Psychological treatment of binge eating disorder an update» in pictures.
- Effectiveness of Binge Eating Disorder Treatments - Full Text View
- Binge-Eating Disorder: Treatment Effectiveness | Annals of Internal
- Combining Pharmacological and Psychological Treatments for
Effectiveness of Binge Eating Disorder Treatments - Full Text View
Acknowledgment: The authors thank Lauren Breithaupt and Margaret Sala for their assistance with abstract reviews. They acknowledge Isabelle Lanser, Michela Quaranta, Loraine Monroe, Laura Morgan, and Morgan Walker for their assistance with table development and manuscript preparation for this review. For their assistance with the report from which this manuscript was based, the authors also thank Meera Viswanathan, PhD Ina F. Wallace, PhD and Lynn Whitener, DrPH, MSLS.
Binge-Eating Disorder: Treatment Effectiveness | Annals of Internal
Although studies have shown that BWL produces significantly greater weight loss post-treatment (as compared to CBT, IPT, and CBTgsh), these differences are not maintained long-term [ 77, 89• ]. Furthermore, the addition of BWL during or following CBT does not appear to confer any additional benefit [ 78, 79, 76 ]. Notably, one study found that those abstinent from binge eating following CBT who subsequently received BWL experienced weight loss post-treatment (average of kg), whereas those who were not abstinent experienced weight gain (average of kg) [ 65 ]. Thus, BWL may be an effective weight-loss treatment for those who are abstinent from binge eating following specialist treatment, but this finding must be replicated.
Combining Pharmacological and Psychological Treatments for
Typically, treating binge-eating disorder on your own isn't effective. But in addition to professional help, you can take these self-care steps to reinforce your treatment plan:
Thien et al looked at a standard program designed for outpatient use, graduated in type of exercise, duration, and level of activity, and demonstrated that both the exercise and the control groups in the study achieved increases in BMI and body fat percentage. However, quality of life was increased in the exercise group, whereas the control group showed a decrease in all aspects of quality-of-life measures, although the difference was not statistically significant. [ 675 ]
Biologic and psychosocial factors are implicated in the pathophysiology of eating disorders, but the underlying causes and mechanisms remain unknown. 7,68,69
There is really no good treatment for obesity, maintains Christopher Fairburn, MD, a psychiatrist and eating disorders expert at the University of Oxford. Surgery is possibly the best, but it's pretty radical. Drug treatments help about 5 percent of people, but you have to keep taking them indefinitely. And behavioral relapses, he says. The psychology of it is very interesting, Fairburn adds. Losing weight is quite easy. But people can only keep it up for a while, then they tend to just throw in the towel.
Bettina E Bernstein, DO Distinguished Fellow, American Academy of Child and Adolescent Psychiatry Distinguished Fellow, American Psychiatric Association Clinical Assistant Professor of Neurosciences and Psychiatry, Philadelphia College of Osteopathic Medicine Clinical Affiliate Medical Staff, Department of Child and Adolescent Psychiatry, Children's Hospital of Philadelphia Consultant to theVillage, Private Practice Consultant PMHCC/CBH at Family Court, Philadelphia
Bettina E Bernstein, DO is a member of the following medical societies: American Academy of Child and Adolescent Psychiatry, American Psychiatric Association
Disclosure: Nothing to disclose.
Assessment of linolenic acid, retinol, vitamin A, vitamin D, and pantothenic acid levels can also be helpful, because early in anorexia, levels of vitamin A can be elevated, causing symptoms such as dizziness, cerebral edema, and nausea, as well as bone mineral loss. This tends to exacerbate worsening of the anorexia, thereby worsening the patient’s nutritional and general medical status. [ 657 ]
Cinkajzlova A, Lacinova Z, Klouckova J, Kavalkova P, Trachta P, Kosak M, et al. Angiopoietin-like protein 6 in patients with obesity, type 7 diabetes mellitus, and anorexia nervosa: The influence of very low-calorie diet, bariatric surgery, and partial realimentation. Endocr Res. 7566 May 7. 6-9. [Medline].
Daily morning weights, vital signs including orthostatic vital signs, fluid intake, and urine output should be measured. Frequent physical examinations should be performed to detect circulatory overload, refeeding edema, and bloating. Monitor serum electrolyte levels (low potassium or phosphorus), and get an electrocardiogram if needed. During the initial stages of the treatment, daily weights might be stressful for the patient. The patient can be given the choice to be informed of changes in daily weight or not be informed, especially if it causes anxiety, frustration, or distress.