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Randomized Controlled Trial
. 2020 Jan;53(1):20-30.
doi: 10.1002/eat.23167. Epub 2019 Sep 9.

Examining sex as a predictor and moderator of treatment outcomes for binge-eating disorder: Analysis of aggregated randomized controlled trials

Janet A Lydecker  1 , Ralitza Gueorguieva  1   2 , Robin Masheb  1   3 , Marney A White  1   4 , Carlos M Grilo  1   5
Affiliations
Randomized Controlled Trial

Examining sex as a predictor and moderator of treatment outcomes for binge-eating disorder: Analysis of aggregated randomized controlled trials

Janet A Lydecker et al. Int J Eat Disord. 2020 Jan.

Abstract

Objective: This study examined whether sex predicted and/or moderated treatment outcomes among men and women who participated in binge-eating disorder (BED) randomized controlled trials (RCTs).

Method: Data were aggregated from RCTs performed at one medical center. RCTs tested cognitive-behavioral therapy, behavioral weight loss, multimodal treatment, and/or control conditions. Participants were 660 adults, both men (n = 170) and women (n = 490), with Diagnostic and Statistical Manual-fourth edition (DSM-IV)-defined BED. Doctoral-level research-clinicians assessed participants using structured interviews and established self-report measures of eating-disorder psychopathology and depression, and measured height and weight. Assessments occurred at baseline, throughout treatment, and at post-treatment.

Results: Sex was not a significant moderator of any treatment outcomes. Mixed models revealed sex had a main effect: men had lower eating-disorder psychopathology and lost more weight than women over the course of treatment.

Discussion: Both epidemiological and RCT studies report disparities in treatment-seeking between men and women with BED. Despite this, men have comparable or better treatment outcomes compared with women, including significantly greater weight loss. Thus, disseminating evidence-based BED treatments is promising for both men and women. Additional research is necessary, however, to understand treatment effects-including other predictors and moderators of outcomes-across diverse providers, treatment settings, and patient groups.

Keywords: behavioral weight loss; binge-eating disorder; cognitive-behavioral therapy; gender; psychotherapy; sex; treatment.

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Conflict of interest statement

Potential conflicts of interest: The authors (Lydecker, Gueorguieva, Masheb, White, Grilo) report no conflicts of interest. Drs. Grilo and Gueorguieva report several broader interests which did not influence this research or paper.

Dr. Grilo’s broader interests include: Consultant to Sunovion and Weight Watchers; Honoraria for lectures, CME activities, and presentations at scientific conferences; and Royalties from Guilford Press and Taylor & Francis Publishers for academic books. Dr. Gueorguieva discloses consulting for Palo Alto Health Sciences, Mathematica Policy Research and Knopp Biosciences, a provisional patent submission by Yale University: Chekroud, AM., Gueorguieva, R., & Krystal, JH. “Treatment Selection for Major Depressive Disorder” [filing date 3rd June 2016, USPTO docket number Y0087.70116US00], and Royalties from Taylor & Francis for an academic book.

Figures

Figure 1.
Figure 1.
Binge-Eating Episodes by Sex, Treatment, and Time * Significant difference between men and women, p<.05; omitted asterisks indicate non-significant difference between men and women.
Figure 2.
Figure 2.
Binge Eating Remission by Sex, Treatment, and Time * Significant difference between men and women, p<.05; omitted asterisks indicate non-significant difference between men and women.
Figure 3.
Figure 3.
Percent Weight Loss by Sex, Treatment, and Time * Significant difference between men and women, p<.05; omitted asterisks indicate non-significant difference between men and women.
Figure 4.
Figure 4.
Attainment of 5% Weight Loss by Sex and Treatment at Post * Significant difference between men and women, p<.05; omitted asterisks indicate non-significant difference between men and women.
See this image and copyright information in PMC

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