Cognitive-behavioral therapy for binge eating disorder in adolescents: study protocol for a randomized controlled trial

Abstract

BackgroundBinge eating disorder is a prevalent adolescent disorder, associated with increased eating disorder and general psychopathology as well as an increased risk for overweight and obesity. As opposed to binge eating disorder in adults, there is a lack of validated psychological treatments for this condition in adolescents. The goal of this research project is therefore to determine the efficacy of age-adapted cognitive-behavioral therapy in adolescents with binge eating disorder – the gold standard treatment for adults with binge eating disorder.Methods/designIn a single-center efficacy trial, 60 12- to 20-year-old adolescents meeting diagnostic criteria of binge eating disorder (full-syndrome or subthreshold) according to the Diagnostic and Statistical Manual of Mental Disorders 4th or 5th Edition, will be centrally randomized to 4 months of cognitive-behavioral therapy (n = 30) or a waiting-list control condition (n = 30). Using an observer-blind design, patients are assessed at baseline, mid-treatment, post-treatment, and at 6- and 12-month follow-ups after the end of treatment. In 20 individual outpatient sessions, cognitive-behavioral therapy for adolescents focuses on eating behavior, body image, and stress; parents receive psychoeducation on these topics. Primary endpoint is the number of episodes with binge eating over the previous 28 days at post-treatment using a state-of-the art clinical interview. Secondary outcome measures address the specific eating disorder psychopathology, general psychopathology, mental comorbidity, self-esteem, quality of life, and body weight.DiscussionThis trial will allow us to determine the short- and long-term efficacy of cognitive-behavioral therapy in adolescent binge eating disorder, to determine cost-effectiveness, and to identify predictors of treatment outcome. Evidence will be gathered regarding whether this treatment will help to prevent excessive weight gain. If efficacy can be demonstrated, the results from this trial will enhance availability of evidence-based treatment of adolescent binge eating disorder.Trial registrationGerman Clinical Trials Register: DRKS00000542

The Effectiveness of Group Cognitive Behavioral Therapy Based on Cash’s Eight-Step Model in Body Image of Primiparous Women

“…The obtained results demonstrated that group cognitive behavioral therapy based on Cash's eightstep model is a suitable method to improve total body image and some of its aspects among primiparous women. The findings of this study are in agreement with the results obtained in previous studies focusing on the effect of cognitive behavioral therapy on other groups, including the effectiveness of cognitive behavioral therapy in negative body image (23,24,29), body image of women under mastectomy (25), and body image of Iranian girl students (26) in addition to studies dealing with the effectiveness of cognitive behavioral therapy in those who are suffering from body dysmorphic disorder (32,34,37), persons with binge eating disorder (33,35), and burnt women (36). No exclusive study has been carried out using Cash's cognitive behavioral therapy on primiparous women's body image, although there are much evidence on vulnerability of body image in this group of women (8)(9)(10)(11)(12)(13)(14) and psychiatric problems associated with as well (8,9).…”

The Effects of Cognitive Behavioral Therapy on Body Image in Infertile Women

“…This finding is in agreement with the results of previous studies, focusing on the effect of CBT on groups with a negative body image (24,(32)(33)(34)(35), Iranian female students (30), and women undergoing mastectomy (16). In addition, studies have been performed on the effects of CBT on patients with body dysmorphic disorder (17,19,21,36,37), burns (15), and eating disorders (18,20). In this program, individuals focus on their perceptions, thoughts, and feelings about body image and recognize how they have been developed (38).…”

Binge-eating disorder: emerging treatments for a new diagnosis

“…There is debate whether the DSM-5 criteria fully represents BED in children and adolescents [6] because many adolescents may not meet the full diagnostic criteria [7]. As a result, a lower threshold for diagnosis has been proposed for BED in children and adolescents [7].…”

“…As a result, a lower threshold for diagnosis has been proposed for BED in children and adolescents [7]. At this time, it is crucial to treat subthreshold BED in children and adolescents, as such symptoms are associated with marked distress and impairment with an increased risk of developing the full disorder over time [6].…”