Carlos M Grilo1,2, Marney A White1,3, Valentina Ivezaj1, Ralitza Gueorguieva1,4. 1. Department of Psychiatry, Yale School of Medicine, New Haven, Connecticut, USA. 2. Department of Psychology, Yale University, New Haven, Connecticut,, USA. 3. Department of Social Behavioral Sciences, Yale School of Public Health, New Haven, Connecticut, USA. 4. Department of Biostatistics, Yale School of Public Health, New Haven, Connecticut, USA.
Abstract
OBJECTIVE: This study aimed to examine longer-term effects of behavioral weight loss (BWL) and Stepped Care for binge-eating disorder and obesity through 12-month follow-up after completing treatments. METHODS: A total of 191 patients with binge-eating disorder/obesity were randomized to 6 months of BWL (n = 39) or Stepped Care (n = 152). Within Stepped Care, patients began BWL (1 month), treatment responders continued BWL, nonresponders switched to cognitive behavioral therapy, and all were randomized (double-blind) to weight-loss medication or placebo (5 months). Patients were independently assessed throughout/after treatment and at 6- and 12-month follow-ups. RESULTS: Intent-to-treat analyses of remission rates revealed that BWL and Stepped Care did not differ significantly at posttreatment (74.4% vs. 66.5%), 6-month follow-up (38.2% vs. 33.3%), or 12-month follow-up (44.7% vs. 41.0%). Mixed models of binge-eating frequency indicated significant reductions through posttreatment but no significant changes or differences between BWL and Stepped Care during follow-up. Mixed models revealed significant weight loss with no differences between BWL and Stepped Care (5.1% vs. 5.8%) at posttreatment and significant time effects (larger percent weight loss at 6-month than at 12-month follow-up) with no differences between BWL and Stepped Care (-5.1% vs. -5.2% and -3.4% vs. -5.0%, respectively). CONCLUSIONS:Binge-eating improvements and weight loss produced by BWL and adaptive Stepped Care did not differ significantly 12 months after completing treatments.
RCT Entities:
OBJECTIVE: This study aimed to examine longer-term effects of behavioral weight loss (BWL) and Stepped Care for binge-eating disorder and obesity through 12-month follow-up after completing treatments. METHODS: A total of 191 patients with binge-eating disorder/obesity were randomized to 6 months of BWL (n = 39) or Stepped Care (n = 152). Within Stepped Care, patients began BWL (1 month), treatment responders continued BWL, nonresponders switched to cognitive behavioral therapy, and all were randomized (double-blind) to weight-loss medication or placebo (5 months). Patients were independently assessed throughout/after treatment and at 6- and 12-month follow-ups. RESULTS: Intent-to-treat analyses of remission rates revealed that BWL and Stepped Care did not differ significantly at posttreatment (74.4% vs. 66.5%), 6-month follow-up (38.2% vs. 33.3%), or 12-month follow-up (44.7% vs. 41.0%). Mixed models of binge-eating frequency indicated significant reductions through posttreatment but no significant changes or differences between BWL and Stepped Care during follow-up. Mixed models revealed significant weight loss with no differences between BWL and Stepped Care (5.1% vs. 5.8%) at posttreatment and significant time effects (larger percent weight loss at 6-month than at 12-month follow-up) with no differences between BWL and Stepped Care (-5.1% vs. -5.2% and -3.4% vs. -5.0%, respectively). CONCLUSIONS: Binge-eating improvements and weight loss produced by BWL and adaptive Stepped Care did not differ significantly 12 months after completing treatments.
Authors: Carlos M Grilo; Robin M Masheb; Marney A White; Ralitza Gueorguieva; Rachel D Barnes; B Timothy Walsh; Katherine C McKenzie; Inginia Genao; Rina Garcia Journal: Behav Res Ther Date: 2014-05-02
Authors: Thomas A Wadden; Robert I Berkowitz; Leslie G Womble; David B Sarwer; Suzanne Phelan; Robert K Cato; Louise A Hesson; Suzette Y Osei; Rosalind Kaplan; Albert J Stunkard Journal: N Engl J Med Date: 2005-11-17 Impact factor: 91.245
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