Dialectical behavior therapy compared to cognitive behavior therapy in binge‐eating disorder: An effectiveness study with 6‐month follow‐up

Abstract

Objective: To evaluate whether the results of a quasi-randomized study, comparing dialectical behavior therapy for binge-eating disorder (DBT-BED) and an intensive, outpatient cognitive behavior therapy (CBT+) in individuals with BED, would be replicated in a nonrandomized study with patients who more closely resemble everyday clinical practice. Method: Patients with (subthreshold) BED (N = 175) started one of two group treatments: DBT-BED (n = 42) or CBT+ (n = 133), at a community eating disorder service. Measures of eating disorder pathology, emotion regulation, and general psychopathology were examined at end of treatment (EOT) and at 6-month followup using generalized linear models with multiple imputation. Results: Both treatments lead to substantial decreases on primary and secondary measures. Statistically significant, medium-size differences between groups were limited to global eating disorder psychopathology (d = À.62; 95% CI = .231, .949) at EOT and depressive symptoms at follow-up (d = À.45; 95% CI = .149, 6.965), favoring CBT+. Dropout of treatment included 15.0% from CBT+ and 19.0% from DBT-BED (difference nonsignificant). Discussion: Decreases in global eating disorder psychopathology were achieved faster with CBT+. Overall, improvements in DBT-BED were comparable to those observed in CBT+. Findings of the original trial, favoring CBT+ on the number of OBE episodes, emotional dysregulation and self-esteem at EOT, and on eating disorder psychopathology and self-esteem at follow-up, were not replicated. With similar rates of treatment dropout and about half of the therapy time used in CBT+, DBT-BED can be considered a relevant treatment for BED in everyday clinical practice. Public Significance: In this effectiveness study, dialectical behavior therapy (DBT) resulted in clinically relevant improvements in individuals with binge eating disorder.Changes were broadly comparable to those of cognitive behavior therapy (CBT), the current treatment of choice. Although CBT resulted in decreases in eating disorder

Latent profiles of emotion dysregulation among individuals with binge‐spectrum eating disorders: Associations with eating disorder pathology

“…Other treatments, such as Dialectical Behavioural Therapy (DBT) are effective in targeting emotion regulation deficits in individuals with eating disorders (Lammers et al., 2022; Linardon et al., 2017; Telch et al., 2001). DBT subscribes more closely to the affect regulation model of binge eating than CBT does, and teaches skills to specifically target emotion dysregulation to facilitate treatment (Telch et al., 2001).…”

“…DBT subscribes more closely to the affect regulation model of binge eating than CBT does, and teaches skills to specifically target emotion dysregulation to facilitate treatment (Telch et al., 2001). In an effectiveness study comparing DBT and CBT in individuals diagnosed with BED, there were no significant differences in primary outcomes (global eating pathology and frequency of objective binge episodes) at follow‐up, indicating DBT's relevance in clinical practice as compared to CBT (Lammers et al., 2022). Furthermore, preliminary research has found other emotion focused treatments such as emotion‐focused therapy, acceptance and commitment therapy, and integrative cognitive‐affective therapy effective in reducing eating disorder pathology and behaviours in individuals with B‐ED's (Juarascio et al., 2013; Osoro et al., 2022; Wonderlich et al., 2014).…”

Current Discoveries and Future Implications of Eating Disorders

“…The act of dialectic behavior therapy: It reduces the desire to overeat through studying behavioral skills that can help regulate emotions and perfect relationships with other people [114][115][116].…”