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PeerJ. 2018 Jun 21;6:e5113. doi: 10.7717/peerj.5113. eCollection 2018.

Psychological, pharmacological, and combined treatments for binge eating disorder: a systematic review and meta-analysis.

Author information

1
Division of Psychology, Department of Clinical Neuroscience, Karolinska Institute, Sweden.
2
Swedish Agency for Health Technology Assessment, and Assessment of Social Services, Stockholm, Sweden.
3
University Health Care Research Centre, Faculty of Medical Sciences, University College of Örebro, Örebro, Sweden.
4
Centre for Psychiatry Research, Department of Clinical Neuroscience, Karolinska Institute, Stockholm, Sweden.
5
Department of Clinical Sciences, Lund University, Lund, Sweden.
6
Gillberg Neuropsychiatry Centre, University of Gothenburg, Gothenburg, Sweden.
7
Stockholm Health Care Services, Stockholm County Council, Stockholm, Sweden.

Abstract

Objective:

To systematically review the efficacy of psychological, pharmacological, and combined treatments for binge eating disorder (BED).

Method:

Systematic search and meta-analysis.

Results:

We found 45 unique studies with low/medium risk of bias, and moderate support for the efficacy of cognitive behavior therapy (CBT) and CBT guided self-help (with moderate quality of evidence), and modest support for interpersonal psychotherapy (IPT), selective serotonin reuptake inhibitors (SSRI), and lisdexamfetamine (with low quality of evidence) in the treatment of adults with BED in terms of cessation of or reduction in the frequency of binge eating. The results on weight loss were disappointing. Only lisdexamfetamine showed a very modest effect on weight loss (low quality of evidence). While there is limited support for the long-term effect of psychological treatments, we have currently no data to ascertain the long-term effect of drug treatments. Some undesired side effects are more common in drug treatment compared to placebo, while the side effects of psychological treatments are unknown. Direct comparisons between pharmaceutical and psychological treatments are lacking as well as data to generalize these results to adolescents.

Conclusion:

We found moderate support for the efficacy of CBT and guided self-help for the treatment of BED. However, IPT, SSRI, and lisdexamfetamine received only modest support in terms of cessation of or reduction in the frequency of binge eating. The lack of long-term follow-ups is alarming, especially with regard to medication. Long-term follow-ups, standardized assessments including measures of quality of life, and the study of underrepresented populations should be a priority for future research.

KEYWORDS:

Binge eating disorder; Eating disorder; Lisdexamfetamine; Meta-analysis; Psychotherapy; SSRI

Conflict of interest statement

The authors declare that they have no competing interests.

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