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

Abstract

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.

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?

“…The first was that these abstinence estimates in clinically representative studies were similar to those reported in recent meta‐analyses of efficacy studies. More specifically, our post‐treatment estimates calculated for BN and BED patients were comparable to the post‐treatment estimates calculated in RCTs of CBT for BN (Linardon & Wade, ) and BED (Linardon, ). The second finding was that we found no significant relationship between the degree of clinical representativeness of included studies and the overall abstinence estimates, although we did find preliminary that certain characteristics (e.g., licensed therapists vs. research therapist) may be associated with smaller effects.…”

“…For example, some reported outcomes only related to binge‐purge frequencies, others reported outcomes reflecting global scores on several disparate measurement tools (e.g., Eating Disorder Examination and Eating Attitudes Test), yet some only reported outcomes related to specific symptom subscales (e.g., shape and weight concerns). Thus, pooling many operationally distinct outcomes together into a summary effect would have not only prevented us from directly comparing our findings with those from previously reported meta‐analyses of RCTs (Linardon, ; Linardon & Wade, ), but would have also offered little clinically relevant information. Consequently, conducting a meta‐analysis solely on abstinence rates was most appropriate for our aims.…”

“…Binge‐purge abstinence was selected as our sole outcome for several reasons. First, the prevalence of patients with BN and BED who achieved abstinence in efficacy studies (RCTs) of CBT was estimated in two recent meta‐analyses (Linardon, ; Linardon & Wade, ), which allows the present study findings to be directly benchmarked against these RCT estimates. In these meta‐analyses, CBT abstinence rates were found to be higher for BED (intention‐to‐treat [ITT] = 48.4% [95% CI = 42.4, 54.5] and completers = 58.2% [95% CI = 49.5, 66.5]) than for BN patients (ITT = 33.1% [95% CI = 28.0, 38.6] and completers = 43.0% [95% CI = 35.4, 51.0]).…”

“…Thus, the effects of CBT delivered in nonrandomized studies for all eating disorders on abstinence estimates are currently unknown. The present meta‐analysis has the following three aims: To estimate the percentage of patients with BN, BED, and atypical eating disorders who achieve binge‐purge abstinence following CBT. To compare these estimates with the abstinence estimates derived from previous meta‐analyses of RCTs of CBT for BN (Linardon & Wade, ) and BED (Linardon, ). To test whether these abstinence estimates are significantly moderated by various study characteristics (e.g., sample demographics, treatment modality, and number of planned sessions) and by the degree of clinical representativeness, as rated by the seven criteria proposed by Hans and Hiller (). …”

Disordered eating among Australian adolescents: Prevalence, functioning, and help received

“…Health promotion programs may complement school‐based DE prevention programs such as Bodythink (Eating Disorders Association & Faberge Lever, ), “Happy Being Me” (Richardson & Paxton, ) and “The Body Project” (Stice, Butryn, Rohde, Shaw, & Marti, ); programs that aim to reduce current or future eating pathology and promote body confidence. Promotion and prevention programs are all the more important in light of recent research which highlights that even evidence‐based treatments for eating disorders yield disappointing results (Linardon, ; Linardon & Wade, ).…”