Cognitive Therapy for Binge-Eating Disorder
Condition: Obesity; Eating Disorders
MeSH terms: Bulimia; Feeding and Eating Disorders; Binge-Eating Disorder
Study type: Interventional

Summary: 
      The purpose of this study is to compare the efficacy of a CD-ROM-based cognitive-behavioral
      therapy (CBT) to traditional manual-based group therapy for obese individuals with
      binge-eating disorder (BED) and other unhealthy eating behaviors. A second goal is to
      encourage a healthy lifestyle in patients with BED.
    

Detailed description: 
      Although eating and weight-related disorders are treatable, most afflicted individuals never
      receive proper treatment.

      CD-ROM-based CBT may be an efficacious and cost-effective intervention, a useful adjunct to
      traditional psychotherapy, or an introductory step to treatment which familiarizes patients
      with the principles and techniques of CBT and increases their comfort and motivation to seek
      additional help.

      Potential participants undergo a brief telephone screening to ensure their understanding of
      the study. Individuals who meet preliminary criteria are then scheduled for an initial
      assessment.

      Patients are randomized to 1 of 3 groups. One group is given a copy of the CD-ROM program to
      complete at home over 10 weeks. At the end of each week, these patients upload and transmit
      their encrypted tracking data to the research coordinator. At the end of the treatment,
      participants who have not improved are offered a course of traditional manual-based group
      therapy, follow-up in an ongoing maintenance group in an eating disorders program, or an
      alternative treatment.

      A second group undergoes standard group CBT. Therapy is administered over 10 weeks in five
      90-minute sessions. The key topics are similar to those covered in the CD-ROM group:
      psychoeducation, developing a personal profile, standardizing meal times, recognizing
      emotional eating, increasing daily activity, learning the language of CBT, identifying
      automatic thoughts, restructuring thoughts, identifying cues and consequences, chaining,
      "surfing the urge," and preventing relapses. Therapy sessions include a didactic section
      followed by group interaction and discussion. All group sessions are audiotaped and
      monitored.

      Participants in the wait list control group undergo an initial assessment but receive no
      active intervention for 10 weeks. After 10 weeks, these patients undergo post-treatment
      assessment and are offered the opportunity to either enter group treatment in an eating
      disorders program or enter other appropriate treatment. Three-month follow-up data are not
      collected from these individuals.

      Assessments occur at study start, at the end of treatment, and at a 3-month follow-up.
      Assessments include height and weight measurements and measurements of changes in exercise-
      and nonexercise-related activity. All participants are given tests and interviews to assess
      eating disorder symptoms, depression, psychoactive substance abuse and dependence, and
      functioning. Patients complete self-report questionnaires to assess their cognitive
      restraint, hunger, disinhibition, strength of urges to binge, and degree of confidence in
      their ability to resist a binge. Patients also rate the suitability of treatment both prior
      to and following completion of the intervention.
    

Intervention name(s): CBT
Intervention type(s): Procedure
Other intervention name(s): Cognitive Behavioral Therapy
Allocation: Randomized
Intervention model: Parallel Assignment
Masking: None (Open Label)
Primary purpose: Treatment