Weight Change over the Course of Binge Eating Disorder Treatment: Relationship to Binge Episodes and Psychological Factors

Abstract

Objective: Treatment for binge eating disorder (BED), a condition associated with both excess adiposity and psychological distress, has not typically produced significant weight loss despite reducing binge eating. Characterizing factors that promote or inhibit weight loss in individuals with co-occurring BED and obesity may help explain overall nonsignificant weight changes during treatment.

Methods: In this study, 189 adults with BED participated in a randomized clinical trial evaluating the efficacy of 5 months of cognitive behavioral therapy. Assessments included measured height and weight at baseline, midtreatment, end of treatment (EOT), and 6-month follow-up, the Eating Disorder Examination interview, and questionnaires.

Results: During treatment, there was a mean weight gain of 1.3 ± 12.0 lb. Twenty-two percent of the sample lost ≥ 5 lb, and 25% of the sample gained ≥ 8 lb. Results showed that baseline objective binge eating episodes predicted weight over treatment. Changes in weight were significantly positively related to concurrent changes in shape concern, weight concern, and disinhibition, but not binge eating episodes. Changes in objective binge eating episodes from baseline to EOT were associated with changes in weight from EOT to follow-up.

Conclusions: Further investigation of eating behavior during BED treatment to understand the energy balance contributions to weight change or stability is warranted.

Trial registration: ClinicalTrials.gov NCT00041743.

Figure 1. (Objective 1) Weight variability over 5 months of BED treatment (EOT minus BL)

Note. Each vertical line represents one individual participant. BED = Binge Eating Disorder; EOT = End of treatment; BL = Baseline

Figure 2. (Objective 2) Baseline Objective Binge Episodes (OBEs) predicting weight trajectory over 5 m of BED treatment

Note. Weight trajectories in this figure display the model-based predicted values at each of three time points based upon mixed model analyses. The top line is one standard deviation above the mean of baseline number of OBEs in past 28 days for this sample; the middle line is the mean level of baseline number of OBEs in past 28 days for this sample; the bottom line is one standard deviation below the mean of baseline number of OBEs in past 28 days for this sample.