Table 1.
Features of included randomized controlled trials.
| Trial | Sample | Diagnostic Criteria/Classification System (Instrument) | Intervention | Time Point of Assessments Relative to the Start of the Interventions | End of Treatment Outcomes (Binge Remission/Frequency and BMI/Weight Loss) | Follow-Up of Active Treatments Outcomes (Binge Remission/Frequency and BMI/Weight Loss) |
|---|---|---|---|---|---|---|
| Trials which all participants had BMI ≥ 27 and the eating disorder diagnosis was determined by a validated instrument | ||||||
| Alfonsson et al. Sweden/2015 [27] | n = 100# 94%♀/6%♂ Mean age 44.3 Mean BMI 41.1 | BED/DSM-5 (EDE) | 1. Behavioural activation 2. Delayed treatment Group sessions |
Baseline EoT 10 weeks FU 3–6 months |
No differences between groups in binge eating frequency. No BMI results. | Only for active treatment – no comparison. |
| Gorin et al. USA/2003 [28] | n = 94# 100%♀ Mean age 45.2 Mean BMI 39.42 | BED/DSM-IV (SCID-I/P) | 1. Standard cognitive behavioural therapy 2. CBT-spouse involvement 3. Delayed treatment Group sessions |
Baseline EoT 12 weeks FU 6 months |
Comparison between active treatments: no differences in binge eating frequency or BMI. Active treatments compared to wait-list: better results for binge eating frequency and BMI for CBT groups. | Only comparison between active treatments: no differences in binge eating frequency or BMI. |
| Grilo and Masheb USA/2005 [29] | n = 90 79%♀/21♂ Mean age 46.3 Mean BMI 35.5 | BED/DSM-IV (SCID-I/P+EDE) | 1. CBTgsh 2. BWLgsh 3. Self-monitoring control Individual sessions |
Baseline EoT 12 weeks |
CBTgsh had greater results for binge eating frequency compared to BWLgsh and the control. No differences between groups for BMI. | No follow-up. |
| Grilo et al. USA/2011 [30] | n = 125# 67%♀/33%♂ Mean age 44.8 Mean BMI 38.8 | BED/DSM-IV (SCIDI/P+ EDE) | 1. CBT 2. BWL 3. CBT + BWL Group sessions |
Baseline EoT 24 weeks (CBT and BWL) FU 6–12 months |
No differences between groups in binge remission and binge eating frequency. BWLT and CBT + BWL had significant greater per cent BMI loss than CBT. | No differences between groups in binge remission rates. Binge eating frequency significantly lower in CBT than BWL at both follow-up. At six-month significant BMI loss in BWL than CBT, but not sustained at 12-month. |
| Grilo et al. USA/2013 [31] | n = 48 79%♀/21%♂ Mean age 45.8 Mean BMI 37.62 | Threshold and subthreshold BED/DSM-IV (SCID-I/P + EDE) | 1. Self-help CBT 2. Usual care Self-help |
Baseline EoT 4 months |
No differences between groups in binge remission, frequency of binge eating or BMI. | No follow-up. |
| Kristeller et al. USA/2014 [32] | n = 150# 88%♀/12%♂ Mean age 46.5 Mean BMI 40.2 | Threshold and subthreshold BED/DSM-IV-R (EDE) | 1. Mindfulness-based eating awareness training 2. Psychoeducational cognitive-behavioural treatment 3. Delayed treatment Group sessions |
Baseline EoT 1 month FU 4 months |
Comparison between active treatments: no differences in binge eating frequency or BMI. Active treatments compared to wait-list: better results for binge eating frequency and BMI for both active interventions. | Same results found at end of treatment. |
| Masheb et al. USA/2011 [33] | n = 50# 76%♀/24♂ Mean age 45.8 Mean BMI 39.1 | BED/DSM-IV-TR (SCID-I/P+EDE) | 1. CBT + low-energy- density diet 2. CBT + general nutrition Individual sessions |
Baseline EoT 6 months FU 12 months |
No differences between groups in binge remission or BMI. | Same results found at end of treatment. |
| Munsch et al. Switzerland/2007 [34] and Munsch et al. Switzerland/2012 [35] | n = 80 89%♀/11%♂ Mean age 46.1 Mean BMI 34.0 n = 52 90%♀/10%♂ Mean age 52.3 Mean BMI 32.5 | BED/DSM-IV-TR (EDE) BED/DSM-IV-TR (EDE-Q) | 1. CBT 2. BWLT Group sessions |
Baseline EoT 4 months FU 12 months FU 6 years |
CBT improved significantly for binge remission and binge eating frequency. However, BWLT was significantly better in weight loss. | No differences between groups in binge remission, binge eating frequency or BMI. Comparing the end of treatment to six-year follow-up, these outcomes significantly worsened. Comparing the baseline to six-year follow-up these measures still improved with medium to large effect sizes. |
| Ricca et al. Italy/2010 [36] | n = 144# 86%♀/14%♂ Mean age 46.9 Mean BMI 38.1 | Threshold and subthreshold BED/DSM-IV (SCID-I/P) | 1. Individual CBT 2. Group CBT |
Baseline EoT 24 weeks for I-CBT 22 weeks for G-CBT FU 3 years |
No differences between groups in reduction of binge eating episodes and BMI. | Same results found at end of treatment. |
| Shapiro et al. USA/2007 [37] | n = 66 92%♀/8%♂ Mean age 39.5 Mean BMI 37.3 | Threshold and subthreshold BED/DSM-IV (SCID-I/P) | 1. Group CBT 2. CD-ROM 3. Delayed treatment |
Baseline EoT 10 weeks FU 2 months |
No differences between groups in binge eating frequency or BMI. | Same results found at end of treatment. |
| Wilfley et al. USA/2002 [38] | n = 162 83%♀/17%♂ Mean age 45.2 Mean BMI 37.4 | BED/DSM-IV (SCID for DSM-III-R + EDE) | 1. CBT 2. Interpersonal therapy Group sessions + three individual sessions |
Baseline EoT 20 weeks FU 4–8–12 months |
No differences between groups in binge eating frequency or BMI. | Same results found at end of treatment. |
| Wilson et al. USA/2010 [17] | n = 205# 79%♀/21%♂ Mean age 48.4 Mean BMI 36.4 | BED/DSM-IV (SCID-I + EDE) | 1. CBTgsh 2. Interpersonal therapy 3. BWLT Individual sessions for Interpersonal therapy and BWLT |
Baseline EoT 24 weeks FU 12–24 months |
No differences between groups in binge remission and binge eating frequency. BWLT was significantly more effective in BMI reduction than the two other treatments. | 1-year FU: no differences between groups in measures of binge eating and more significant BMI gain for the BWL group compared to CBTgsh group. Two-year FU: IPT and CBTgsh were more effective for remission of binge episodes. No difference for BMI comparing all groups. |
| Trials which included under 10% participants with BMI ≤ 27 and/or the eating disorder diagnosis was not determined by a validated instrument | ||||||
| Agras et al. USA/1995 [39] | n = 50 86%♀/14%♂ Mean age 47.6 Mean BMI 37.1 | BED/not specified (Structured clinical interview) | 1. CBT 12 weeks followed by 12 weeks of either IPT for non -responders or weight loss therapy for responders to CBT 2. Delayed treatment Group sessions |
Baseline EoT 24 weeks |
Active treatment compared to wait-list: better results for binge eating frequency and BMI for active intervention. IPT group: binge eating increased and weight increased with IPT not significant. Weight loss therapy: significant weight loss and maintained reduced binge eating. | No follow-up. |
| Dingemans et al. Netherlands/ 2007 [40] | n = 52 94%♀/6%♂ Mean age 37.6 Mean BMI 39.0 n = BMI < 27 * | BED/DSM-IV (Instrument not specified) | 1. CBT 2. Delayed treatment Group sessions |
Baseline EoT 20 weeks FU 12 months |
Significant binge remission and reduction in frequency in binge eating in CBT group. No significant BMI change. | Only for active treatment—no comparison. |
| Eldredge et al. USA/1997 [41] | n = 46 96%♀/4%♂ Mean age 45.2 Mean BMI 38.4 | BED (No other information) | 1. CBT 2. Delayed treatment Group sessions |
Baseline EoT 12 weeks FU 24 weeks |
Significant binge remission and reduction in frequency in binge eating in CBT group. No significant BMI change. | No information. |
| Nauta et al. Netherlands/2000 [42] | n = 74 100% ♀ Mean age 38.3 Mean BMI 33.1 Mixed sample of binge eating and non-binge eating participants | BED/DSM-IV (Structured interview) | 1. Cognitive treatment 2. Behavioural treatment Group sessions |
Baseline EoT 15 weeks FU 6 months |
At post-treatment 67% binge abstinence with cognitive treatment vs. 44% abstinence with behavioural treatment in obese binge eating participants. Other outcomes not reported separately for binge eating participants. | 86% binge abstinence with cognitive treatment vs. 44% abstinence with behavioural treatment in obese binge eating participants (significant p < 0.01). |
| Pendleton et al. USA/2002 [43] | n = 114 100% ♀ Mean age 45.0 Men BMI 36.2 | BED (no other information) | 1. CBT + exercise + maintenance 2. CBT + exercise − maintenance 3. CBT − exercise + maintenance 4. CBT − exercise − maintenance Group sessions |
Baseline EoT 4 months FU 6–12 months |
Exercisers had significantly greater reduction in binge frequency and BMI compared to non-exercisers groups. Addition of the maintenance program did not influence on binge eating behaviour but influenced changes in BMI. | Same results found at end of treatment. |
| Safer et al. USA/2010 [44] | n = 101 85% ♀/15%♂ Mean age 52.2 Mean BMI 36.3 n = 9 BMI < 27 * | BED/DSM-IV (EDE) | 1. Dialectical behaviour therapy adapted for binge eating (DBT-BED) 2. Active comparison group therapy (ACGT) Group sessions |
Baseline EoT 21 weeks FU 3, 6, and 12 months |
DBT-BED group achieved significant reduction in binge frequency than ACGT group. No differences found between groups for BMI. | No differences between groups in binge eating frequency or BMI. |
Note: BED: binge eating disorder; BMI: body mass index; BWLgsh: behavioural weight loss – guided self-help; BWLT: behavioural weight loss treatment; CBT: cognitive behavioural therapy; CBTgsh: cognitive-behavioural therapy—guided self-help; EDE: eating disorder examination; EDE-Q: eating disorder examination questionnaire; DSM: diagnostic and statistical manual of mental disorders; EoT: end of treatment; FU: follow-up; SCID-I/P: Structured Clinical Interview for DSM-IV Axis Disorders Patient Version; * Unpublished information on participant BMI numbers provided by author; #: Included a priori power analysis; ♀: women, ♂: men.