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This study evaluated the use of dialectical behavior therapy (DBT) adapted for binge eating disorder (BED). Women with BED (N = 44) were randomly assigned to group DBT or to a wait-list control condition and were administered the Eating Disorder Examination in addition to measures of weight, mood, and affect regulation at baseline and posttreatment. Treated women evidenced significant improvement on measures of binge eating and eating pathology compared with controls, and 89% of the women receiving DBT had stopped binge eating by the end of treatment. Abstinence rates were reduced to 56% at the 6-month follow-up. Overall, the findings on the measures of weight, mood, and affect regulation were not significant. These results support former research into DBT as a treatment for BED.Binge eating disorder (BED) involves persistent and frequent episodes of uncontrollable binge eating in the absence of regular compensatory behaviors, according to Diagnostic and Statistical Manual of Mental Disorders (4th ed.; DSM-IV; American Psychiatric Association, 1994). Research has documented that BED has a chronic and persistent course, is associated with the serious health problem of obesity, and is frequently associated with psychiatric comorbidity. Moreover, BED is more common in males than are the other eating disorders (Marcus et al.

Objective Because psychoeducational primary prevention programs for eating disorders have met with little success, this preliminary experiment tested a dissonance‐based targeted preventive intervention. Method Female undergraduates (N = 30) with elevated body image concerns were assigned to a three‐session intervention, wherein they voluntarily argued against the thin ideal, or a delayed‐intervention control condition. Participants completed a baseline, termination, and a 1‐month follow‐up survey. Results The intervention resulted in a subsequent decrease in thin‐ideal internalization, body dissatisfaction, dieting, negative affect, and bulimic symptomatology, with most changes remaining at the 1‐month follow‐up. Discussion These preliminary results suggest that this dissonance‐based targeted prevention intervention reduces bulimic pathology and known risk factors for eating disturbances, and provide experimental support for the claim that thin‐ideal internalization contributes to body dissatisfaction, dieting, negative affect, and bulimic symptoms. © 2000 by John Wiley & Sons, Inc. Int J Eat Disord 27: 206–217, 2000.

Results suggest that moderate dieting is a central feature of BED and that affective disturbances occur in only a subset of cases. However, the confluence of dieting and negative affect signals a more severe variant of the disorder marked by elevated psychopathology, impaired social functioning, and a poorer treatment response.