Janet A. Lydecker, Ralitza Gueorguieva, Carlos M. Grilo
{"title":"对暴饮暴食症的行为/药物肥胖治疗的快速反应预示着更好的临床结果。","authors":"Janet A. Lydecker, Ralitza Gueorguieva, Carlos M. Grilo","doi":"10.1002/oby.24292","DOIUrl":null,"url":null,"abstract":"<div>\n \n \n <section>\n \n <h3> Objective</h3>\n \n <p>The objective of this study was to examine rapid response and its prognostic significance in participants with binge-eating disorder (BED) and obesity in a randomized clinical trial testing behavioral and pharmacological obesity treatments for BED.</p>\n </section>\n \n <section>\n \n <h3> Methods</h3>\n \n <p>A total of 136 participants were randomly assigned (balanced 2 × 2 factorial) to 16-week behavioral and/or pharmacological (naltrexone/bupropion) obesity interventions. Masked assessments occurred monthly throughout treatment and at posttreatment.</p>\n </section>\n \n <section>\n \n <h3> Results</h3>\n \n <p>Rapid response (≥65% reduction in frequency of binge-eating episodes after 1 month of treatment), observed in 55% (<i>n</i> = 75/136) of participants, was unrelated to baseline sociodemographic and clinical characteristics. Rapid response was more common in behavioral therapy than not and in naltrexone/bupropion than placebo. Rapid response was associated with binge-eating remission. Mixed models revealed that rapid response was associated with greater reductions in binge-eating frequency, eating-disorder psychopathology, percent weight loss, and metabolic variables (total cholesterol, glycated hemoglobin A1c) at posttreatment. Rapid response effects on outcomes did not vary by treatment.</p>\n </section>\n \n <section>\n \n <h3> Conclusions</h3>\n \n <p>In a randomized clinical trial testing behavioral and pharmacological obesity treatments for BED with co-occurring obesity, rapid response was a robust prognostic indicator of binge-eating remission and significantly better behavioral, psychological, and metabolic outcomes. Non-rapid response to behavioral and pharmacological obesity treatments could signal a need to switch to alternative treatments.</p>\n </section>\n </div>","PeriodicalId":215,"journal":{"name":"Obesity","volume":"33 6","pages":"1067-1075"},"PeriodicalIF":4.2000,"publicationDate":"2025-04-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Rapid response to behavioral/pharmacological obesity treatments for binge-eating disorder predicts better clinical outcomes\",\"authors\":\"Janet A. Lydecker, Ralitza Gueorguieva, Carlos M. Grilo\",\"doi\":\"10.1002/oby.24292\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<div>\\n \\n \\n <section>\\n \\n <h3> Objective</h3>\\n \\n <p>The objective of this study was to examine rapid response and its prognostic significance in participants with binge-eating disorder (BED) and obesity in a randomized clinical trial testing behavioral and pharmacological obesity treatments for BED.</p>\\n </section>\\n \\n <section>\\n \\n <h3> Methods</h3>\\n \\n <p>A total of 136 participants were randomly assigned (balanced 2 × 2 factorial) to 16-week behavioral and/or pharmacological (naltrexone/bupropion) obesity interventions. Masked assessments occurred monthly throughout treatment and at posttreatment.</p>\\n </section>\\n \\n <section>\\n \\n <h3> Results</h3>\\n \\n <p>Rapid response (≥65% reduction in frequency of binge-eating episodes after 1 month of treatment), observed in 55% (<i>n</i> = 75/136) of participants, was unrelated to baseline sociodemographic and clinical characteristics. Rapid response was more common in behavioral therapy than not and in naltrexone/bupropion than placebo. Rapid response was associated with binge-eating remission. Mixed models revealed that rapid response was associated with greater reductions in binge-eating frequency, eating-disorder psychopathology, percent weight loss, and metabolic variables (total cholesterol, glycated hemoglobin A1c) at posttreatment. Rapid response effects on outcomes did not vary by treatment.</p>\\n </section>\\n \\n <section>\\n \\n <h3> Conclusions</h3>\\n \\n <p>In a randomized clinical trial testing behavioral and pharmacological obesity treatments for BED with co-occurring obesity, rapid response was a robust prognostic indicator of binge-eating remission and significantly better behavioral, psychological, and metabolic outcomes. Non-rapid response to behavioral and pharmacological obesity treatments could signal a need to switch to alternative treatments.</p>\\n </section>\\n </div>\",\"PeriodicalId\":215,\"journal\":{\"name\":\"Obesity\",\"volume\":\"33 6\",\"pages\":\"1067-1075\"},\"PeriodicalIF\":4.2000,\"publicationDate\":\"2025-04-23\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Obesity\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://onlinelibrary.wiley.com/doi/10.1002/oby.24292\",\"RegionNum\":2,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q1\",\"JCRName\":\"ENDOCRINOLOGY & METABOLISM\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Obesity","FirstCategoryId":"3","ListUrlMain":"https://onlinelibrary.wiley.com/doi/10.1002/oby.24292","RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q1","JCRName":"ENDOCRINOLOGY & METABOLISM","Score":null,"Total":0}
Rapid response to behavioral/pharmacological obesity treatments for binge-eating disorder predicts better clinical outcomes
Objective
The objective of this study was to examine rapid response and its prognostic significance in participants with binge-eating disorder (BED) and obesity in a randomized clinical trial testing behavioral and pharmacological obesity treatments for BED.
Methods
A total of 136 participants were randomly assigned (balanced 2 × 2 factorial) to 16-week behavioral and/or pharmacological (naltrexone/bupropion) obesity interventions. Masked assessments occurred monthly throughout treatment and at posttreatment.
Results
Rapid response (≥65% reduction in frequency of binge-eating episodes after 1 month of treatment), observed in 55% (n = 75/136) of participants, was unrelated to baseline sociodemographic and clinical characteristics. Rapid response was more common in behavioral therapy than not and in naltrexone/bupropion than placebo. Rapid response was associated with binge-eating remission. Mixed models revealed that rapid response was associated with greater reductions in binge-eating frequency, eating-disorder psychopathology, percent weight loss, and metabolic variables (total cholesterol, glycated hemoglobin A1c) at posttreatment. Rapid response effects on outcomes did not vary by treatment.
Conclusions
In a randomized clinical trial testing behavioral and pharmacological obesity treatments for BED with co-occurring obesity, rapid response was a robust prognostic indicator of binge-eating remission and significantly better behavioral, psychological, and metabolic outcomes. Non-rapid response to behavioral and pharmacological obesity treatments could signal a need to switch to alternative treatments.
期刊介绍：
Obesity is the official journal of The Obesity Society and is the premier source of information for increasing knowledge, fostering translational research from basic to population science, and promoting better treatment for people with obesity. Obesity publishes important peer-reviewed research and cutting-edge reviews, commentaries, and public health and medical developments.
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