Table 3.

Interventions for Binge Eating Disorder.

Author	N (% female)	Recruitment source	Diagnostic/inclusion criteria	Exclusion criteria	Tx conditions (duration and setting)	Primary outcome assessed	Secondary outcome assessed	Primary results	Secondary results
Psychopharmacological Interventions
Antidepressants
Fluoxetine
Arnold et al.76	60 (93)	Community advertisement	DSM-IV BED (≥3 episodes/week), 18–60 years old, >85% IBW	Pregnancy, AN, relevant and severe medical or psychiatric condition, recent tx	6 weeks Outpatient 20–80 mg – FLX – PL	Weekly binge frequency, % reduction in binge frequency	Weight, BMI, CGI, HRSD	FLX > PL On weekly binge frequency	FLX > PL On BMI, weight, CGI
Fluvoxamine
Pearlstein et al.79	20 (85)	Community advertisement/referral	DSM-IV BED	Concurrent tx	12 weeks Outpatient Up to 150 mg – FLV – PL	Binge eating frequency, EDE	Weight, HRSD, CGI, SCL-90, BDI	FLV = PL	FLV = PL
Citalopram
McElroy et al.78	38 (95)	Community advertisement	DSM-IV BED (≥3 episodes/week), 18–60 years old, >85% IBW	Pregnancy, AN, relevant and severe medical or psychiatric condition, recent tx	6 weeks Outpatient 20–60 mg – CIT – PL	Frequency of binge days and episodes, YBOC-BE	BMI, weight, CGI, HRSD	CIT> PL	CIT> PL On weight, CGI
Sertraline
McElroy et al.77	34 (94)	Outpatients	DSM-IV BED (≥3 episodes/week), 18–60 years old, >85% IBW	Current AN, psychosis, mania, severe suicidality, concurrent tx	6 weeks Outpatient 50–200 mg (mean: 187 mg) – SER – PL	% decrease in binge frequency	CGI, BMI, HRSD	SER > PL	SER > PL On CGI, BMI
Other
Topiramate
McElroy et al.80	61 (–)	Community advertisement	DSM-IV-TR BED (≥3 episodes/week), 18–60 years old, BMI > 30	Substance use disorder, severe psychiatric, medical condition, concurrent tx	14 week Outpatient 25–600 mg – TOP – PL	Binge episodes and days in last week	CGI, YBOCS, HRSD, BMI, weight, % body fat	TOP> PL	TOP > PL On BMI, weight CGI, YBOCS
McElroy et al.81	394 (86)	Outpatients from private and university settings	DSM-IV BED (≥3 episodes/week), 18–65 years old, 30 < BMI < 50	Significant medical condition, psychosis, depression, concurrent tx	16 weeks Outpatient Up to 400 mg – TOP – PL	Binge eating days and episodes per week, YBOCS-BE, TFEQ	BMI, CGI, BIS-11, SDS, HRSD, MADRS	TOP> PL	TOP> PL On BMI, CGI, BIS-11, SDS
Sibutramine
Appolinario et al.82	60 (88)	Community advertisement	DSM-IV BED, 18–60 years old, BMI 30–45	Pregnancy, BN, serious medical or psychiatric condition, concurrent tx	12 weeks Outpatient 15 mg – SIB – PL	Frequency of binge days in past week, body esteem scale	BDI, weight	SIB > PL On frequency of binge days	SIB > PL
Milano et al.83	20 (100)	Outpatient	DSM-IV BED, 24–36 years old		12 weeks Outpatient 10 mg/kg/day – SIB – PL	Frequency of binge days, body esteem scale	Weight	SIB > PL	SIB > PL
Wilfley et al.84	304 (90)	Community outpatient advertisement	DSM-IV BED, 18–65 years old, BMI < 45	Serious medial or psychiatric condition, concurrent tx, AN,	24 weeks Outpatient 15 mg – SIB – PL	Frequency of binge episodes and days per week, TFEQ	Weight, BMI, global improvement, IWOQL	SIB > PL	SIB > PL On weight, BMI, global improvement
Psychosocial Interventions
Cognitive Behavioral Therapy
Wilfley et al.89	162 (83)	Community advertisement	DSM-IV BED, 18–65 years old, BMI 27–48	Pregnancy, concurrent tx, severe psychiatric conditions	20 sessions Outpatient – gCBT – gIPT 1 year follow-up	Recovery, EDE, Binge eating days/episodes		gCBT = gIPT Follow-up: gCBT = gIPT
Hilbert and Tuschen-Caffier 96	28 (100)	Community advertisement	DSM-IV-TR BED (≥1 episode/week)	Concurrent tx, suicidality, psychosis, substance dependence, pregnancy	19 sessions – CBT body exposure (CBT-E) – CBT cognitive restructuring (CBT-C)	EDE weight and shape concern, BSQ, EDE restraint, eating concerns	BDI	CBT-E = CBT-C	CBT-E = CBT-C
Grilo and Masheb88	90 (79)	Community advertisement	DSM-IV BED, 18–60 years old, BMI > 27	Concurrent tx, serious medical or psychiatric conditions, pregnancy	12 weeks Outpatient – CBTgsh – BWLgsh – Self-monitoring (CTRL)	Remission over the past month, EDE-Q, TFEQ, frequency of binge eating	BDI, RSES, BMI	CBTgsh > BWLgsh, CTRL on remission CBTgsh > BWLgsh on frequency of binge eating, hunger BWLgsh > CBTgsh on increasing restraint	CBTgsh = BWLgsh
Wilson et al.90	208 (85)	Community advertisement and clinic referrals	DSM-IV BED, >18 years old, BMI 27–45	Concurrent tx, serious medical or psychiatric conditions, pregnancy	24 weeks – IPT – BWL – CBTgsh – 1 and 2 year follow-up	Binge eating days per month, weight, EDE	BDI, RSES, SAS,	BWL > IPT, CBTgsh on reducing BMI, body weight BWL > CBTgsh on dietary restraint On bingeing: 1-year follow-up: BWL = IPT = CBTgsh 2-year follow-up: IPT, CBTgsh > BWL	IPT = BWL = CBTgsh
Grilo et al.91	125 (67)	Community advertisement	DSM-IV BED, 18–65 years old, BMI 30–55	Concurrent tx, serious medical or psychiatric conditions	16 sessions Outpatient – CBT – BWL – CBT +BWL (32 sessions for combined) – 6, 12 month follow-up	Abstinence from binge eating, EDE	BDI, BMI	BWL= CBT +BWL = CBT on binging At follow-up: CBT> BWL on binge eating	BWL, CBT + BWL > CBT on BMI
Dialectical Behavior Therapy
Telch et al.92	44 (100)	Community advertisement	DSM-IV BED, 18–65 years old	Concurrent tx, suicidality, psychosis, substance abuse, pregnancy	20 weeks Outpatient – DBT – WL	Binge days and episodes, EDE, BES, EES	Weight, BDI, PANAS, NMRS, RSES	DBT> WL On binge days and episodes, on emotional eating in response to anger	DBT = WL
Weight Loss Treatment
Grilo and Masheb88	90 (79)	Community advertisement	DSM-IV BED, 18–60 years old, BMI > 27	Concurrent tx, serious medical or psychiatric conditions, pregnancy	12 weeks Outpatient – CBTgsh – BWLgsh – Self-monitoring (CTRL)	Remission over the past month, EDE-Q, TFEQ, frequency of binge eating	BDI, RSES, BMI	CBTgsh > BWLgsh, CTRL on remission CBTgsh > BWLgsh on frequency of binge eating, hunger BWLgsh > CBTgsh on increasing restraint	CBTgsh = BWLgsh
Wilson et al.90	208 (85)	Community advertisement and clinic referrals	DSM-IV BED, >18 years old, BMI 27–45	Concurrent tx, serious medical or psychiatric conditions, pregnancy	24 weeks – IPT – BWL – CBTgsh – 1 and 2 year follow-up	Binge eating days per month, weight	BDI, RSES, SAS	BWL > IPT, CBTgsh on reducing BMI, body weight 1 year follow-up: BWL = IPT = CBTgsh on binge eating 2-year follow-up: IPT, CBTgsh > BWL on binge eating	BWL > CBTgsh on increasing dietary restraint
Interpersonal Psychotherapy
Wilfley et al.89	162 (83)	Community advertisement	DSM-IV BED, 18–65 years old, BMI 27–48	Pregnancy, concurrent tx, severe psychiatric conditions	20 sessions Outpatient – gCBT – gIPT 1 year follow-up	Recovery, EDE, binge eating days, episodes		gCBT = gIPT Follow-up: gCBT = gIPT
Wilson et al.90	208 (85)	Community advertisement and clinic referrals	DSM-IV BED, >18 years old, BMI 27–45	Concurrent tx, serious medical or psychiatric conditions, pregnancy	24 weeks – IPT – BWL – CBTgsh – 1 and 2 year follow-up	Binge eating days per month, weight, EDE	BDI, RSES, SAS	BWL > IPT, CBTgsh on reducing BMI, body weight BWL > CBTgsh on dietary restraint On bingeing: 1-year follow-up: BWL = IPT = CBTgsh 2-year follow-up: IPT, CBTgsh > BWL	IPT = BWL = CBTgsh
Psychopharmacological + Psychosocial Interventions
Grilo et al.95	50 (88)	Community, outpatient	DSM-IV BED, 35–60 years old, BMI > 30	Concurrent tx, severe medical or psychiatric condition, pregnancy	12 weeks, outpatient – CBTgsh + PL – CBTgsh + orlistat (860 mg)	Remission, binge episodes per month, EDE	BDI, RSES, weight loss, weight loss >5%	CBTgsh + ORL > CBTgsh + PL on remission	CBTgsh + ORL > CBTgsh + PL on weight loss
Grilo et al.93	108 (78)	Community outpatient	DSM-IV BED, 18–60 years old, 100%–200% IBW	Concurrent tx, severe medical or psychiatric condition, pregnancy	16 weeks Outpatient 60 mg – CBT +FLX – CBT +PL – FLX – PL	Remission (abstinence from binge eating in last month), EDE-Q, TFEQ, BSQ	BDI, BMI	CBT + FLX, CBT + PL > FLX, PL CBT +PL > FLX on binge episodes, EDE-Q, cognitive restraint, BSQ CBT +FLX > FLX binge episodes, EDE-Q, hunger, disinhibition	FLX = PL CBT + FLX = CBT +PL CBT + PL> FLX on BDI CBT + FLX > FLX on BDI

Note: Greater than symbol (>) refers to significantly better outcome.

Abbreviations: AN, Anorexia Nervosa; BDI, Beck Depression Inventory; BED, Binge Eating Disorder; BES, Binge Eating Scale; BIS-11, Barrett Impulsivity Scale; BMI, Body Mass Index; BN, Bulimia Nervosa; BSQ, Body Shape Questionnaire; BT, Behavior Therapy; BWL, Behavioral Weight Loss; CBT, Cognitive Behavioral Therapy; CBTsh, Cognitive Behavioral Therapy self-help; CGI, Clinical Global Impression; CIT, Citalopram; CT, Cognitive Therapy; CTRL, Control group; DBT, Dialectical Behavior Therapy; DES, Desipramine; ED, Eating Disorder; EDE, Eating Disorders Examination; EDE-Q, Eating Disorders Examination Questionnaire; EES, Emotional Eating Scale; FLX, Fluoxetine; FLV, Fluvoxamine; FCI, Food Craving Index; g, Group Therapy; gsh, Guided Self Help; HRSD, Hamilton Rating Scale for Depression; IBW, Ideal Body Weight; IIP, Inventory of Interpersonal Problems; IWOQL, Impact of Weight on Quality of Life-Lite; IPT, Interpersonal Psychotherapy; MADRS, Montgomery Asberg Depression Rating Scale; NMRS, Negative Mood Regulation Scale; ORL, Orlistat; PANAS, Positive and Negative Affectivity Scale; PL, Placebo; RSES, Rosenberg Self Esteem Scale; SAS, Weissman Social Adjustment Scale; SCL-90, Symptom Checklist; SER, Sertraline; SFT, Separated Family Therapy; SDS, Sheehan Disability Scale; SH, Self Help; SIB, Sibutramine; TFEQ, Three Factor Eating Questionnaire; TOP, Topiramate; WL, Wait List Control; YBOCS-BE, Yale-Brown Obsessive Compulsive Scale-Binge Eating.