In-person therapy remains the best way to treat binge eating disorder

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While internet based therapies may be helpful for some people with binge eating disorder, a new study shows that traditional face-to-face cognitive behavioral therapy (CBT) remains the most effective way to treat the eating disorder.

“Although there is evidence that structured self-help treatments based on cognitive-behavioral therapy may be effective for patients, it was unclear how the effects of an Internet-based application are in comparison with cognitive-behavioral therapy,” said senior author Anja Hilbert, of the University of Leipzig Medical Center.

Hilbert says binge eating disorder, characterized by uncontrollable periods of eating excessive amounts of food, affects approximately 1.9 percent of people around the world.

For the study published in JAMA Psychiatry, Hilbert and colleagues randomly assigned 178 individuals with binge eating disorder who were either overweight or obese into two groups. One group participated in 20 sessions of 50-minutes of face-to-face cognitive behavioral therapy, while the other group received 11 internet self-help sessions over four months.

Both groups received a structured treatment focusing on nutrition, body image, and stress. In addition, those placed in the self-help group met with a specialist before starting the program and received weekly emails.

At the outset of the study, the participants experienced an average of 14 days with binge eating episodes during the past 28 days. At the end of the four-month treatment programs, those in the self-help group reported an average of 4 days. The CBT group reported just 2 days of binge eating episodes on average.

After six months, the numbers for both groups increased only slightly; the self-help group experienced 5 days of binge eating during the last 28 days, compared to 3 days for the CBT group.

The team says the number of patients who reported no longer binge eating was also higher for those who received cognitive behavioral therapy in person.

Hilbert believes the increased effectivity of CBT is likely because the treatment method is more intense and is paired with support from a professional.

“However, (self-help) was confirmed as a viable alternative to (cognitive-behavioral therapy), and may be offered to patients with reduced access to (cognitive-behavioral therapy) or who do not wish to participate in an individual psychotherapy,” she said.

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