暴饮暴食症干预:综述、现状和启示。

IF 9.5 2区 医学 Q1 ENDOCRINOLOGY & METABOLISM
Current Obesity Reports Pub Date : 2023-09-01 Epub Date: 2023-07-13 DOI:10.1007/s13679-023-00517-0
Carlos M Grilo, Adrienne Juarascio
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引用次数: 0

摘要

综述目的:暴饮性饮食障碍(BED)是一种严重的精神问题,与大量的发病率有关,不幸的是,它经常被忽视和治疗。这篇综述总结了成人BED的行为、心理、药理学和联合治疗的现状,特别关注最近的发现和进展。最近的发现:某些特定的心理治疗,特别是CBT和IPT,以及在某种程度上的DBT,已经证明了疗效,并与治疗后的持久益处有关。某些特定的低成本可扩展干预措施,特别是CBTgsh,已经证明了疗效,并有可能更广泛地使用。一个重要的进展是新出现的随机对照试验数据表明,BWL是一种多面手和可用的行为生活方式干预措施,在减少暴饮和饮食障碍精神病理学方面的有效性接近CBT,但也具有适度减肥的优势。目前只有一种药物(LDX)被美国食品药品监督管理局批准用于“中度至重度”BED。对其他“标示外”药物的研究得出了适度且喜忧参半的结果,其中一些药物在短期内在统计上优于安慰剂,几乎没有长期数据。几乎所有将药物和心理治疗相结合的研究都未能提高结果(联合治疗似乎优于仅药物治疗,但不优于仅心理治疗)。许多患有BED的人在沉默和羞耻中受苦,得不到治疗,很少接受循证治疗。患者和从业者需要认识到,研究已经确定了几种有效的BED干预措施,这些措施对许多患者来说可以很快奏效。未来的研究应该为那些没有从初始干预中获益的人确定治疗方法,确定额外的药物选择,测试具有相关作用机制的药物,并利用创新的适应性“SMART”设计来确定治疗方法以提高初始应答者的疗效,并测试替代治疗方法以帮助初始无应答者。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Binge-Eating Disorder Interventions: Review, Current Status, and Implications.

Purpose of review: Binge-eating disorder (BED) is a serious psychiatric problem associated with substantial morbidity that, unfortunately, frequently goes unrecognized and untreated. This review summarizes the current status of behavioral, psychological, pharmacological, and combined treatments for BED in adults with a particular focus on recent findings and advances.

Recent findings: Certain specific psychological treatments, notably CBT and IPT, and to some extent DBT, have demonstrated efficacy and are associated with durable benefits after treatment. Certain specific lower-cost scalable interventions, notably CBTgsh, have demonstrated efficacy and have potential for broader uptake. An important advance is the emerging RCT data indicating that BWL, a generalist and available behavioral lifestyle intervention, has effectiveness that approximates that of CBT for reducing binge eating and eating-disorder psychopathology but with the advantage of also producing modest weight loss. There exists only one pharmacological agent (LDX) with approval by the FDA for "moderate-to-severe" BED. Research with other "off label" medications has yielded modest and mixed outcomes with a few medications statistically superior to placebo over the short-term and almost no longer-term data. Nearly all research combining medications and psychological treatments has failed to enhance outcomes (combined appears superior to pharmacotherapy-only but not to psychotherapy-only). Many people with BED suffer in silence and shame, go untreated, and rarely receive evidence-based treatments. Patients and practitioners need to recognize that research has identified several effective interventions for BED, and these can work quickly for many patients. Future research should identify treatments for those who do not derive benefit from initial interventions, identify additional pharmacological options, test agents with relevant mechanisms of action, and utilize innovative adaptative "SMART" designs to identify treatments to enhance outcomes among initial responders and to test alternative treatments to assist initial non-responders.

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来源期刊
Current Obesity Reports
Current Obesity Reports Medicine-General Medicine
CiteScore
16.40
自引率
1.10%
发文量
25
期刊介绍: The main objective of Current Obesity Reports is to provide expert review articles on recent advancements in the interdisciplinary field of obesity research. Our aim is to offer clear, insightful, and balanced contributions that will benefit all individuals involved in the treatment and prevention of obesity, as well as related conditions such as cardiovascular diseases, endocrine disorders, gynecological issues, cancer, mental health, respiratory complications, and rheumatological diseases. We strive to redefine the way knowledge is expressed and provide organized content for the benefit of our readership.
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