Randomized Controlled Trial of Weight Management Versus Weight Management With Concurrent Cognitive-Behavioral Therapy for Binge-Eating Disorder in US Veterans With High Weight.

IF 4.7 2区医学 Q1 NUTRITION & DIETETICS

International Journal of Eating Disorders Pub Date : 2025-06-09 DOI:10.1002/eat.24476

Robin M Masheb, Eugenia Buta, Jennifer L Snow, Lindsay F Munro, Mark Lawless, Erica A Abel, Nicole E McWain, Alison Marsh, Amanda Cary, Carlos M Grilo, Susan D Raffa, Christopher B Ruser

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引用次数: 0

Abstract

Objective: To determine the effectiveness of adding a brief psychological eating-disorder treatment (CBT) to weight management for addressing DSM-5 binge-eating disorder (BED) in US military Veterans with high weight.

Method: One hundred and nine Veterans, with DSM-5 BED, seeking weight management services were randomly assigned to VA's Weight Management Program (MOVE!), or MOVE! plus a brief, clinician-led cognitive-behavioral therapy (MOVE! + CBT). Primary (eating disorder psychopathology and binge eating), secondary (mental health, quality of life, and eating- and appearance-related), and exploratory (weight) outcomes were analyzed with mixed-effects models for four timepoints (baseline, 3-month [post-treatment], and 9- and 15-month follow-ups).

Results: MOVE! + CBT reported significantly less overall eating disorder psychopathology compared to MOVE! at all post-randomization timepoints: difference at 3 months -0.18 (-0.3, -0.06, p = 0.003), 9 months -0.15 (-0.3, 0, p = 0.05), and 15 months -0.27 (-0.42, -0.12, p < 0.001). There were no differences between groups in binge-eating frequency. MOVE! + CBT remission rates were 28% at 3 months, 42% at 9 months, and 27% at 15 months. MOVE! remission rates were 22% at 3 months, 26% at 9 months, and 20% at 15 months. MOVE! + CBT was superior at post-treatment through 15 months on eating-, weight-, and shape-related (p's < 0.05), but few other, secondary outcomes. A 5% weight loss ranged from 26% to 38% for MOVE! + CBT, and 17% to 33% for MOVE!.

Discussion: Weight management alone and with concurrent CBT resulted in significant improvements in BED. The addition of CBT enhanced some specific outcomes but not weight loss. Findings provide evidence-based clinical guidance and population-level impact for addressing BED in the context of high weight, especially among Veteran populations.

Trial registration: Clinical Trial Registry Number: NCT03234881(Weight Loss Treatment for Veterans with Binge Eating).

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体重管理与体重管理并发认知行为疗法治疗美国高体重退伍军人暴食症的随机对照试验

目的：探讨在体重管理中加入简短的心理饮食障碍治疗（CBT）对美国高体重退伍军人的暴食症（BED）的治疗效果。方法：109名退伍军人，与DSM-5床，寻求体重管理服务，随机分配到VA的体重管理计划（MOVE!），或MOVE！加上一个简短的，由临床医生主导的认知行为疗法（MOVE! + CBT）。用混合效应模型分析四个时间点（基线、治疗后3个月、9个月和15个月随访）的原发性（饮食失调、精神病理和暴饮暴食）、继发性（心理健康、生活质量、饮食和外貌相关）和探索性（体重）结果。结果:动!与MOVE相比，CBT报告的总体饮食失调精神病理显著减少。在随机化后的所有时间点：差异在3个月-0.18 (-0.3,-0.06,p = 0.003)， 9个月-0.15 （-0.3,0,p = 0.05）和15个月-0.27 （-0.42,-0.12,p）。讨论：单独体重管理和并发CBT导致BED的显著改善。CBT的加入提高了一些特定的结果，但没有减轻体重。研究结果为解决高体重人群（尤其是退伍军人）的BED问题提供了循证临床指导和人群层面的影响。试验注册：临床试验注册号：NCT03234881（退伍军人暴食减肥治疗）。

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来源期刊

International Journal of Eating Disorders 医学-精神病学

CiteScore

10.00

自引率

12.70%

发文量

204

审稿时长

4-8 weeks

期刊介绍： Articles featured in the journal describe state-of-the-art scientific research on theory, methodology, etiology, clinical practice, and policy related to eating disorders, as well as contributions that facilitate scholarly critique and discussion of science and practice in the field. Theoretical and empirical work on obesity or healthy eating falls within the journal’s scope inasmuch as it facilitates the advancement of efforts to describe and understand, prevent, or treat eating disorders. IJED welcomes submissions from all regions of the world and representing all levels of inquiry (including basic science, clinical trials, implementation research, and dissemination studies), and across a full range of scientific methods, disciplines, and approaches.