Is there harm in behavioral lifestyle weight management for binge-eating disorder in patients with obesity: Findings from a randomized controlled trial

Area of Science:

• Psychiatry
• Clinical Psychology
• Obesity Research

Background:

• Behavioral lifestyle weight management (BLWM) shows broad benefits for binge-eating disorder (BED) with obesity.
• Concerns exist that BLWM may exacerbate eating disorder psychopathology, potentially contraindicating its use in BED patients.

Purpose of the Study:

• To analyze a randomized controlled trial (RCT) secondary dataset to identify the frequency of individuals experiencing increased symptoms.
• To examine heterogeneity of outcomes in BLWM interventions for BED with obesity.

Main Methods:

• A secondary analysis of an RCT involving 69 participants with BED and obesity.
• Participants were assessed at baseline and posttreatment for binge-eating, eating disorder psychopathology, and weight.
• Individual-level changes were examined in groups receiving placebo (n=34) versus BLWM+placebo (n=35).

Main Results:

• At posttreatment, 3.7% in BLWM+placebo vs. 17% in placebo reported increased binge-eating frequency.
• 7.4% in BLWM+placebo vs. 18% in placebo reported increased eating disorder psychopathology.
• Overall, 7.4% in BLWM+placebo experienced any increase in binge-eating and/or eating disorder psychopathology, with mostly small magnitudes and no significant difference between groups.

Conclusions:

• The frequency of increased binge-eating or eating disorder psychopathology symptoms was rare in patients with BED and obesity receiving BLWM.
• Most symptom increases were of small magnitude and did not significantly differ between BLWM and placebo groups.
• Findings address concerns about BLWM exacerbating psychopathology and provide clinical context for its effectiveness in BED with obesity.