Table 1.
Overview of the psychological treatments for binge eating disorder (BED)
| Treatment | Theoretical approach | Treatment targets | Empirical support for BED |
|---|---|---|---|
| Behavioral weight loss (BWL) | Promote weight loss by decreasing energy intake and increasing energy expenditure | Making gradual lifestyle changes in diet, exercise, and eating habits | No strong empirical support for BWL over specialist treatments for BED on either weight loss or eating pathology outcomes |
| Self-monitoring of food intake, exercise, and thoughts about food | Specialized treatments are more effective than BWL in the long term | ||
| Weight loss goal of one pound per week | BWL may be an effective weight loss option for responders to CBT or IPT | ||
| Cognitive behavioral therapy (CBT) | Disturbed eating patterns and problematic thoughts/beliefs related to eating, shape, and weight contribute to binge eating | Address chaotic eating patterns (e.g., encourage regular meals) | Strong empirical support for therapist-led CBT in short- and long-term outcomes |
| Change dysfunctional thoughts about the self and the importance of weight and shape | Self-help CBT may represent a worthwhile first-line treatment; however it is not recommended for patients with low self-esteem and/or high shape and weight concerns. Retention also remains a challenge. | ||
| Encourage healthy weight-control behaviors (e.g., self-monitoring and exercise) | |||
| Interpersonal psychotherapy (IPT) | Interpersonal stressors contribute to using binge eating as a way to cope with negative affect | Target social deficits and promote mastery in interpersonal domains | Strong evidence demonstrating a short- and long-term reduction in binge eating, comparable to results found in CBT |
| Address problems in four primary areas: interpersonal deficits, interpersonal role disputes, role transitions, and grief | |||
| Dialectical behavior therapy (DBT) | Difficulty regulating affect leads to pathological or maladaptive behaviors, such as binge eating | Teach healthier ways to modulate negative emotional arousal | Preliminary research shows promising results for binge abstinence. |
| Achieve proficiency in four domains: mindfulness skills, distress tolerance, emotion regulation, and interpersonal effectiveness | More research must be conducted to examine its long-term efficacy and success compared with other specialist treatments |