Examining race as a predictor and moderator of treatment outcomes for binge-eating disorder: Analysis of aggregated randomized controlled trials
- PMID: 31008634
- PMCID: PMC6589831
- DOI: 10.1037/ccp0000404
Examining race as a predictor and moderator of treatment outcomes for binge-eating disorder: Analysis of aggregated randomized controlled trials
Abstract
Objective: To examine whether race predicted or moderated response to treatments for binge-eating disorder (BED).
Method: Participants were 592 adults (n = 113 Black; n = 479 White) with DSM-IV-defined BED who participated in randomized controlled trials (RCTs) at 1 medical center. Data were aggregated from RCTs for BED testing cognitive-behavioral therapy, behavioral weight loss, multimodal treatment, and/or control conditions. Participants had weight and height measured and were assessed using established interviews and self-report measures at baseline, throughout treatment, and post treatment.
Results: Race did not significantly moderate treatment outcomes. Mixed models revealed a main effect of race: Black participants had fewer binge-eating episodes and lower depression than White participants across time points. Race also had a main effect in generalized estimating equations with a significantly greater proportion of Black participants achieving binge-eating remission than White participants. Race did not predict percent weight loss, but a significantly lower proportion of Black participants attained 5% weight loss than White participants. Race did not significantly predict global eating-disorder severity.
Conclusion: Despite disparities in treatment-seeking reported in epidemiological and RCT studies, Black individuals appear to have comparable or better treatment outcomes in BED treatment research compared with White individuals, except they were less likely to attain 5% weight loss at post treatment. This suggests that disseminating evidence-based treatments for BED among diverse populations holds promise and treatments may not require further adaptation prior to dissemination. Implementation research is needed to test treatment effectiveness across diverse providers, settings, and patient groups to improve understanding of potential predictors and moderators. (PsycINFO Database Record (c) 2019 APA, all rights reserved).
Conflict of interest statement
Figures






Similar articles
-
Testing the validity and clinical utility of the severity specifiers for binge-eating disorder for predicting treatment outcomes.J Consult Clin Psychol. 2020 Feb;88(2):172-178. doi: 10.1037/ccp0000464. J Consult Clin Psychol. 2020. PMID: 31894997 Free PMC article.
-
Examining sex as a predictor and moderator of treatment outcomes for binge-eating disorder: Analysis of aggregated randomized controlled trials.Int J Eat Disord. 2020 Jan;53(1):20-30. doi: 10.1002/eat.23167. Epub 2019 Sep 9. Int J Eat Disord. 2020. PMID: 31497876 Free PMC article. Clinical Trial.
-
Treatment of binge eating disorder in racially and ethnically diverse obese patients in primary care: randomized placebo-controlled clinical trial of self-help and medication.Behav Res Ther. 2014 Jul;58:1-9. doi: 10.1016/j.brat.2014.04.002. Epub 2014 May 2. Behav Res Ther. 2014. PMID: 24857821 Free PMC article. Clinical Trial.
-
Meta-analysis on the long-term effectiveness of psychological and medical treatments for binge-eating disorder.Int J Eat Disord. 2020 Sep;53(9):1353-1376. doi: 10.1002/eat.23297. Epub 2020 Jun 25. Int J Eat Disord. 2020. PMID: 32583527 Review.
-
Meta-analysis of the effects of cognitive-behavioral therapy for binge-eating-type disorders on abstinence rates in nonrandomized effectiveness studies: Comparable outcomes to randomized, controlled trials?Int J Eat Disord. 2018 Dec;51(12):1303-1311. doi: 10.1002/eat.22986. Int J Eat Disord. 2018. PMID: 30584663 Review.
Cited by
-
Clinical moderators and predictors of cognitive-behavioral therapy by guided-self-help versus therapist-led for binge-eating disorder: Analysis of aggregated clinical trials.Int J Eat Disord. 2021 Oct;54(10):1875-1880. doi: 10.1002/eat.23601. Epub 2021 Sep 2. Int J Eat Disord. 2021. PMID: 34472114 Free PMC article.
-
Eating Disorder Severity and Treatment Outcome Across Race/Ethnicity, Sexual Orientation, and Socioeconomic Status: Intersectional Inequities in a Clinical Sample.medRxiv [Preprint]. 2025 May 22:2025.05.21.25328100. doi: 10.1101/2025.05.21.25328100. medRxiv. 2025. PMID: 40661283 Free PMC article. Preprint.
-
Predictors of Treatment Outcome in Eating Disorders: A Roadmap to Inform Future Research Efforts.Curr Psychiatry Rep. 2023 May;25(5):213-222. doi: 10.1007/s11920-023-01416-w. Epub 2023 Mar 30. Curr Psychiatry Rep. 2023. PMID: 36995577 Free PMC article. Review.
-
Randomized Controlled Trial of Treatments for Loss-of-Control Eating Following Bariatric Surgery.Obesity (Silver Spring). 2021 Apr;29(4):689-697. doi: 10.1002/oby.23124. Epub 2021 Mar 10. Obesity (Silver Spring). 2021. PMID: 33694287 Free PMC article. Clinical Trial.
-
Cognitive-behavioral therapy for binge-eating disorder for non-responders to initial acute treatments: Randomized controlled trial.Int J Eat Disord. 2023 Aug;56(8):1544-1553. doi: 10.1002/eat.23975. Epub 2023 May 5. Int J Eat Disord. 2023. PMID: 37144325 Free PMC article. Clinical Trial.
References
-
- American Psychiatric Association. (2004). Diagnostic and Statistical Manual of Mental Disorders (Fourth, Text Revision ed.). Washington, DC: Author.
-
- American Psychiatric Association. (2013). Diagnostic and Statistical Manual of Mental Disorders (5th ed.). Arlington, VA: American Psychiatric Publishing.
-
- Appolinario JC, Bacaltchuk J, Sichieri R, Claudino AM, Godoy-Matos A, Morgan C, … Coutinho W (2003). A randomized, double-blind, placebo-controlled study of sibutramine in the treatment of binge-eating disorder. Archives of General Psychiatry, 60, 1109–1116. doi: 10.1001/archpsyc.60.11.1109 - DOI - PubMed
-
- Beck AT, & Steer R (1987). Manual for revised Beck Depression Inventory. New York: Psychological Corporation.
-
- Beck AT, Steer RA, & Carbin MG (1988). Psychometric properties of the Beck Depression Inventory: Twenty-five years of evaluation. Clinical Psychology Review, 8, 77–100.