Meta-Analysis of the Efficacy of Psychological and Medical Treatments for Binge-Eating Disorder
Autor(en): | Hilbert, Anja Petroff, David Herpertz, Stephan Pietrowsky, Reinhard Tuschen-Caffier, Brunna Vocks, Silja Schmidt, Ricarda |
Stichwörter: | binge-eating disorder; BULIMIA-NERVOSA; COGNITIVE-BEHAVIORAL THERAPY; FOLLOW-UP; GUIDED SELF-HELP; intervention; meta-analysis; OBESE-PATIENTS; OVERWEIGHT INDIVIDUALS; PHARMACOLOGICAL-TREATMENTS; Psychology; Psychology, Clinical; PUBLICATION BIAS; RANDOMIZED CONTROLLED-TRIAL; treatment; WEIGHT-LOSS | Erscheinungsdatum: | 2019 | Herausgeber: | AMER PSYCHOLOGICAL ASSOC | Journal: | JOURNAL OF CONSULTING AND CLINICAL PSYCHOLOGY | Volumen: | 87 | Ausgabe: | 1 | Startseite: | 91 | Seitenende: | 105 | Zusammenfassung: | 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 Method: Through a systematic search before March 2018, 81 published and unpublished randomized-controlled trials (RCTs), totaling 7,515 individuals with BED (Diagnostic and Statistical Manual of Mental Disorders-Fourth Edition [DSM-IV] and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 cognitivebehavioral 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 cognitivebehavioral 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. |
ISSN: | 0022006X | DOI: | 10.1037/ccp0000358 |
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geprüft am 01.06.2024