Objective
Long‐term effectiveness is a critical aspect of the clinical utility of a treatment; however, a meta‐analytic evaluation of psychological and medical treatments for binge‐eating disorder (BED), including weight loss treatments, is outstanding. This meta‐analysis sought to provide a comprehensive evaluation of the long‐term effectiveness in diverse treatments for BED regarding a range of clinically relevant outcomes.
Method
Based on a systematic search up to February 2018, 114 published and unpublished randomized‐controlled (RCTs), nonrandomized, and uncontrolled treatment studies, totaling 8,862 individuals with BED (DSM‐IV, DSM‐5), were identified and analyzed using within‐group random‐effect modeling.
Results
Effectiveness (regarding binge‐eating episodes and abstinence, eating disorder and general psychopathology) up to 12 months following treatment was demonstrated for psychotherapy, structured self‐help treatment, and combined treatment, while the results regarding body weight reduction were inconsistent. These results were confirmed in sensitivity analyses with RCTs on the most common treatments—cognitive‐behavioral therapy and self‐help treatment based on this approach. Follow‐up intervals longer than 12 months were rarely reported, mostly supporting the long‐term effectiveness of psychotherapy. Few follow‐up data were available for pharmacotherapy, and behavioral and self‐help weight loss treatment, while follow‐up data were lacking for pharmacological and surgical weight loss treatment. Study quality varied widely.
Discussion
This comprehensive meta‐analysis demonstrated the medium‐term effectiveness of psychotherapy, structured self‐help treatment, and combined treatment for patients with BED, and supported the long‐term effectiveness of psychotherapy. The results were derived from uncontrolled comparisons over time. Further long‐term high quality research on psychological and medical treatments for BED is required.