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Rapid response predicts 12-month post-treatment outcomes in binge-eating disorder: theoretical and clinical implications

Published online by Cambridge University Press:  16 September 2011

C. M. Grilo ,
M. A. White ,
G. T. Wilson ,
R. Gueorguieva  and
R. M. Masheb
C. M. Grilo*
Affiliation:
Department of Psychiatry, Yale School of Medicine, New Haven, CT, USA
M. A. White
Affiliation:
Department of Psychiatry, Yale School of Medicine, New Haven, CT, USA
G. T. Wilson
Affiliation:
Graduate School of Applied and Professional Psychology, Rutgers – The State University of New Jersey, Piscataway, NJ, USA
R. Gueorguieva
Affiliation:
Division of Biostatistics, Yale School of Public Health, New Haven, CT, USA
R. M. Masheb
Affiliation:
Department of Psychiatry, Yale School of Medicine, New Haven, CT, USA
*
*Address for correspondence: Dr C. M. Grilo, Yale University School of Medicine, 301 Cedar Street (2nd Floor), New Haven, CT 06519, USA. (Email: carlos.grilo@yale.edu)
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Abstract

Background

We examined rapid response in obese patients with binge-eating disorder (BED) in a clinical trial testing cognitive behavioral therapy (CBT) and behavioral weight loss (BWL).

Method

Altogether, 90 participants were randomly assigned to CBT or BWL. Assessments were performed at baseline, throughout and post-treatment and at 6- and 12-month follow-ups. Rapid response, defined as ⩾70% reduction in binge eating by week four, was determined by receiver operating characteristic curves and used to predict outcomes.

Results

Rapid response characterized 57% of participants (67% of CBT, 47% of BWL) and was unrelated to most baseline variables. Rapid response predicted greater improvements across outcomes but had different prognostic significance and distinct time courses for CBT versus BWL. Patients receiving CBT did comparably well regardless of rapid response in terms of reduced binge eating and eating disorder psychopathology but did not achieve weight loss. Among patients receiving BWL, those without rapid response failed to improve further. However, those with rapid response were significantly more likely to achieve binge-eating remission (62% v. 13%) and greater reductions in binge-eating frequency, eating disorder psychopathology and weight loss.

Conclusions

Rapid response to treatment in BED has prognostic significance through 12-month follow-up, provides evidence for treatment specificity and has clinical implications for stepped-care treatment models for BED. Rapid responders who receive BWL benefit in terms of both binge eating and short-term weight loss. Collectively, these findings suggest that BWL might be a candidate for initial intervention in stepped-care models with an evaluation of progress after 1 month to identify non-rapid responders who could be advised to consider a switch to a specialized treatment.

Keywords

Binge eatingcognitive behavior therapyeating disordersobesitytreatmentweight loss
Type
Original Articles
Information
Psychological Medicine , Volume 42 , Issue 4 , April 2012 , pp. 807 - 817
Copyright
Copyright © Cambridge University Press 2011

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References

Agras, WS, Crow, SJ, Halmi, KA, Mitchell, JE, Wilson, GT, Kraemer, HC (2000). Outcome predictors for the cognitive behavior treatment of bulimia nervosa: data from a multisite study. American Journal of Psychiatry 157, 1302–1308.Google Scholar
Allison, KC, Grilo, CM, Masheb, RM, Stunkard, AJ (2005). Binge eating disorder and night eating syndrome: a comparative study of disordered eating. Journal of Consulting and Clinical Psychology 73, 1107–1115.Google Scholar
American Psychiatric Association (1994). Diagnostic and Statistical Manual of Mental Disorders (4th edn.). American Psychiatric Association: Washington, DC.Google Scholar
Brownell, KD (2000). The LEARN Program for Weight Management 2000. American Health: Dallas, TX.Google Scholar
Devlin, MJ, Goldfein, JA, Petkova, E, Jiang, H, Raizman, PS, Wolk, S, Mayer, L, Carino, J, Bellace, D, Kamenetz, C, Dobrow, I, Walsh, BT (2005). Cognitive behavioral therapy and fluoxetine as adjuncts to group behavioral therapy for binge eating disorder. Obesity Research 13, 1077–1088.CrossRefGoogle ScholarPubMed
Eldredge, KL, Agras, WS, Arnow, B, Telch, CF, Bell, S, Castonguay, L, Marnell, M (1997). The effects of extending cognitive-behavioral therapy for binge eating disorder among treatment non-responders. International Journal of Eating Disorders 21, 347–352.Google Scholar
Fairburn, CG, Agras, WS, Walsh, BT, Wilson, GT, Stice, E (2004). Early change in treatment predicts outcome in bulimia nervosa. American Journal of Psychiatry 161, 2322–2324.Google Scholar
Fairburn, CG, Cooper, Z (1993). The Eating Disorder Examination (12th edition). In Binge Eating: Nature, Assessment, and Treatment (ed. Fairburn and, C. G.Wilson, G. T.), pp. 317–360. Guilford Press: New York.Google Scholar
Fairburn, CG, Marcus, MD, Wilson, GT (1993). Cognitive-behavioral therapy for binge eating and bulimia nervosa: a comprehensive treatment manual. In Binge Eating: Nature, Assessment, and Treatment (ed. Fairburn and, C. G.Wilson, G. T.), pp. 361–404. Guilford Press: New York.Google Scholar
First, MB, Spitzer, RL, Gibbon, M, Williams, JBW (1996). Structured Clinical Interview for DSM-IV Axis I Disorders – Patient Edition (SCID-I/P, Version 2.0). New York State Psychiatric Institute, Biometrics Research Department: New York.Google Scholar
Foster, GD, Wyatt, HR, Hill, JO, McGuckin, BG, Brill, C, Mohammed, BS, Szapary, PO, Rader, DJ, Edman, JS, Klein, S (2003). A randomized trial of a low-carbohydrate diet for obesity. New England Journal of Medicine 348, 2082–2090.CrossRefGoogle ScholarPubMed
Grilo, CM, Hrabosky, JI, White, MA, Allison, KC, Stunkard, AJ, Masheb, RM (2008). Overvaluation of shape and weight in binge eating disorder and overweight controls: refinement of a diagnostic construct. Journal of Abnormal Psychology 117, 414–419.CrossRefGoogle ScholarPubMed
Grilo, CM, Masheb, RM (2005). A randomized controlled comparison of guided self-help cognitive behavioral therapy and behavioral weight loss for binge-eating disorder. Behaviour Research and Therapy 43, 1509–1525.CrossRefGoogle ScholarPubMed
Grilo, CM, Masheb, RM (2007). Rapid response predicts binge eating and weight loss in binge-eating disorder: findings from a controlled trial of orlistat with guided self-help cognitive behavioral therapy. Behaviour Research and Therapy 45, 2537–2550.Google Scholar
Grilo, CM, Masheb, RM, Lozano-Blanco, C, Barry, DT (2004). Reliability of the Eating Disorder Examination in patients with binge eating disorder. International Journal of Eating Disorders 35, 80–85.Google Scholar
Grilo, CM, Masheb, RM, Salant, SL (2005 a). Cognitive behavioral therapy guided self-help and orlistat for the treatment of binge eating disorder: a randomized double-blind placebo-controlled trial. Biological Psychiatry 57, 1193–1201.CrossRefGoogle ScholarPubMed
Grilo, CM, Masheb, RM, White, MA (2010). Significance of overvaluation of shape and weight in binge-eating disorder: comparative study with overweight and bulimia nervosa. Obesity 18, 499–504.Google Scholar
Grilo, CM, Masheb, RM, Wilson, GT (2001 a). A comparison of different methods for assessing the features of eating disorders in patients with binge eating disorder. Journal of Consulting and Clinical Psychology 69, 317–322.Google Scholar
Grilo, CM, Masheb, RM, Wilson, GT (2001 b). Different methods for assessing the features of eating disorders in patients with binge eating disorder: a replication. Obesity Research 9, 418–422.Google Scholar
Grilo, CM, Masheb, RM, Wilson, GT (2005 b). Efficacy of cognitive behavioral therapy and fluoxetine for the treatment of binge eating disorder: a randomized double-blind placebo-controlled comparison. Biological Psychiatry 57, 301–309.Google Scholar
Grilo, CM, Masheb, RM, Wilson, GT (2006). Rapid response to treatment for binge eating disorder. Journal of Consulting and Clinical Psychology 74, 602–613.Google Scholar
Grilo, CM, Masheb, RM, Wilson, GT, Gueorguieva, R, White, MA (2011). Cognitive-behavioral therapy, behavioral weight loss, and sequential treatment for obese patients with binge eating disorder: a randomized controlled trial. Journal of Consulting and Clinical Psychology. doi: 10.1037/a0025049.Google Scholar
Grilo, CM, White, MA, Masheb, RM (2009). DSM-IV psychiatric disorder comorbidity and its correlates in binge eating disorder. International Journal of Eating Disorders 42, 228–234.Google Scholar
Hilbert, A, Saelens, B, Stein, R, Mockus, D, Welch, R, Matt, G, Wilfley, DE (2007). Pretreatment and process predictors of outcome in interpersonal and cognitive behavioral psychotherapy for binge eating disorder. Journal of Consulting and Clinical Psychology 75, 645–651.CrossRefGoogle ScholarPubMed
Hudson, JI, Hiripi, E, Pope, HG, Kessler, RC (2007). The prevalence and correlates of eating disorders in the National Comorbidity Survey Replication. Biological Psychiatry 61, 348–358.Google Scholar
Ilardi, SS, Craighead, WE (1994). The role of nonspecific factors in cognitive-behavior therapy for depression. Clinical Psychology: Science and Practice 1, 138–156.Google Scholar
Lynch, FL, Striegel-Moore, RH, Dickerson, JF, Perrin, N, Debar, L, Wilson, GT, Kraemer, HC (2010). Cost-effectiveness of guided self-help treatment for recurrent binge eating. Journal of Consulting and Clinical Psychology 78, 322–333.CrossRefGoogle ScholarPubMed
Masheb, RM, Grilo, CM (2007). Rapid response predicts treatment outcomes in binge eating disorder: implications for stepped care. Journal of Consulting and Clinical Psychology 75, 639–644.CrossRefGoogle ScholarPubMed
Masheb, RM, Grilo, CM (2008). Examination of predictors and moderators for self-help treatments of binge-eating disorder. Journal of Consulting and Clinical Psychology 76, 900–904.Google Scholar
National Institute for Clinical Excellence (2004). Eating Disorders – Core Interventions in the Treatment and Management of Anorexia Nervosa, Bulimia Nervosa, Related Eating Disorders. NICE Clinical Guideline No. 9. NICE: London.Google Scholar
Pope, HG, Lalonde, JK, Pindyck, LJ, Walsh, BT, Bulik, CM, Crow, SJ, McElroy, SL, Rosenthal, N, Hudson, JI (2006). Binge eating disorder: a stable syndrome. American Journal of Psychiatry 163, 2181–2183.CrossRefGoogle ScholarPubMed
Reas, DL, Grilo, CM (2008). Review and meta-analysis of pharmacotherapy for binge-eating disorder. Obesity 16, 2024–2038.Google Scholar
Safer, DL, Joyce, EE (2011). Does rapid response to two group psychotherapies for binge eating disorder predict abstinence? Behaviour Research and Therapy 49, 339–345.Google Scholar
Streiner, DL, Cairney, J (2007). What's under the ROC? An introduction to receiver operating characteristics curves. Canadian Journal of Psychiatry 52, 121–128.Google Scholar
Sysko, R, Sha, N, Wang, Y, Duan, N, Walsh, BT (2010). Early response to antidepressant treatment in bulimia nervosa. Psychological Medicine 40, 999–1005.CrossRefGoogle ScholarPubMed
Walsh, BT, Sysko, R, Parides, MK (2006). Early response to desipramine among women with bulimia nervosa. International Journal of Eating Disorders 39, 72–75.CrossRefGoogle ScholarPubMed
Wilfley, DE, Welch, RR, Stein, RI, Spurrell, E, Cohen, L, Saelens, B, Dounchis, JZ, Frank, MA, Wiseman, CV, Matt, GE (2002). A randomized comparison of group cognitive behavioral therapy and group interpersonal psychotherapy for the treatment of overweight individuals with binge eating disorder. Archives of General Psychiatry 59, 713–721.CrossRefGoogle ScholarPubMed
Wilson, GT, Fairburn, CG, Agras, WS, Walsh, BT, Kraemer, H (2002). Cognitive-behavioral therapy for bulimia nervosa: time course and mechanisms of change. Journal of Consulting and Clinical Psychology 70, 267–274.Google Scholar
Wilson, GT, Grilo, CM, Vitousek, KM (2007). Psychological treatments of eating disorders. American Psychologist 72, 199–216.Google Scholar
Wilson, GT, Loeb, KL, Walsh, BT, Labouvie, E, Petkova, E, Lin, X, Waternaux, C (1999). Psychological versus pharmacological treatments of bulimia nervosa: predictors and processes of change. Journal of Consulting and Clinical Psychology 67, 451–459.Google Scholar
Wilson, GT, Vitousek, KM (1999). Self-monitoring in the assessment of eating disorders. Psychological Assessment 11, 480–489.Google Scholar
Wilson, GT, Wilfley, DE, Agras, WS, Bryson, SW (2010). Psychological treatments of binge eating disorder. Archives of General Psychiatry 67, 94–101.Google Scholar
Wonderlich, SA, Gordon, KH, Mitchell, JE, Crosby, RD, Engel, SG (2009). The validity and clinical utility of binge eating disorder. International Journal of Eating Disorders 42, 687–705.CrossRefGoogle ScholarPubMed