Review2018

Rates of abstinence following psychological or behavioral treatments for binge‐eating disorder: Meta‐analysis

174 citations0/0 files storedInternational Journal of Eating Disorders

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Eating Disorders and Behaviors Nutrition, Health and Food Behavior Anxiety, Depression, Psychometrics, Treatment, Cognitive Processes

Abstract

OBJECTIVE: Standardized effect sizes reported in previous meta-analyses of binge-eating disorder (BED) treatment are sometimes difficult to interpret and are criticized for not being a useful indicator of the clinical importance of a treatment. Abstinence from binge eating is a clinically relevant component of a definition of a successful treatment outcome. This meta-analysis estimated the prevalence of patients with BED who achieved binge eating abstinence following psychological or behavioral treatments. METHOD: This meta-analysis included 39 randomized controlled trials, with 65 treatment conditions and 2,349 patients. Most conditions comprised cognitive-behavioral therapy (n = 40). Pooled event rates were calculated at posttreatment and follow-up using random effects models. RESULTS: The total weighted percentage of treatment-completers who achieved abstinence at posttreatment was 50.9% (95% CI = 43.9, 57.8); this estimate was almost identical at follow-up (50.3%; 95% CI = 43.6, 56.9). The total weighted percentage of patients who achieved abstinence at posttreatment in the intention-to-treat analysis (all randomized patients) was 45.1% (95% CI =40.7, 49.5), and at follow-up it was 42.3% (95% CI =37.5, 47.2). Interpersonal psychotherapy (IPT) produced the highest abstinence rates. Clinician-led group treatments produced significantly higher posttreatment (but not follow-up) abstinence estimates than guided self-help treatments. Neither timeframe for achieving abstinence, assessment type (interview/questionnaire), number of treatment sessions, patient demographics, nor trial quality, moderated the abstinence estimates. DISCUSSION: The present findings demonstrate that 50% of patients with BED do not fully respond to treatment. Continued efforts toward improving eating disorder treatments are needed.

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References

2013Diagnostic and Statistical Manual of Mental Disorders 2009Preferred Reporting Items for Systematic Reviews and Meta-Analyses: The PRISMA Statement 2002Quantifying heterogeneity in a meta‐analysis 2009Introduction to Meta‐Analysis 2000Trim and Fill: A Simple Funnel‐Plot–Based Method of Testing and Adjusting for Publication Bias in Meta‐Analysis 2000Practical Meta-Analysis 2020Cochrane Handbook for Systematic Reviews of Interventions 1994Assessment of eating disorders: Interview or self‐report questionnaire?

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