Hostname: page-component-586b7cd67f-dsjbd Total loading time: 0 Render date: 2024-11-22T09:39:26.974Z Has data issue: false hasContentIssue false
  • English
  • Français

Brief cognitive behavioural therapy for binge-eating disorder: clinical effectiveness in a routine clinical setting

Published online by Cambridge University Press:  24 June 2021

Elana Moore ,
Michelle Hinde  and
Glenn Waller Open the ORCID record for Glenn Waller [Opens in a new window]
Elana Moore
Affiliation:
South Yorkshire Eating Disorders Association, 26–28 Bedford Street, SheffieldS6 3BT, UK
Michelle Hinde
Affiliation:
South Yorkshire Eating Disorders Association, 26–28 Bedford Street, SheffieldS6 3BT, UK
Glenn Waller*
Affiliation:
Department of Psychology, University of Sheffield, Cathedral Court, 1 Vicar Lane, Sheffield, UK
*
*Corresponding author. Email: [email protected].
Get access Rights & Permissions [Opens in a new window]

Abstract

Brief cognitive behavioural therapy (CBT) is effective in working with non-underweight eating disorder patients across transdiagnostic groups. However, it is not clear whether it will be as effective in the treatment of binge-eating disorder, where emotional eating is likely to play a larger role than starvation-driven eating. This case series tested whether brief, 10-session CBT (CBT-T) would be effective in a case series of 53 patients with binge-eating disorder. Attrition rates were comparable to previous research. Eating attitudes, binge frequency, anxiety and depression were measured. Remission was measured comparing different categorical methods: ‘cut-off’; reliable change index (RCI); and clinically significant change (CSC). CBT-T was effective for binge-eating disorder patients, at comparable levels to other non-underweight patients. All measures of pathology were significantly reduced, with large to moderate effect sizes. When categorical changes were used to indicate remission, RCI and CSC levels were more appropriate than existing cut-off methods, potentially because of the lower levels of initial restrained eating in this clinical group. CBT-T’s effectiveness in transdiagnostic groups is replicated in binge-eating disorder patients, despite their greater level of emotionally driven eating. More stringent definitions of remission (CSC and RCI) should be used more widely, to ensure realistic estimates.

Key learning aims

  1. (1) What is necessary for brief CBT to be effective for binge-eating disorder (BED)?

  2. (2) Is CBT for BED effective in the absence of purging behaviours?

  3. (3) What is the most appropriate way to measure remission in CBT for BED?

Keywords

binge-eating disordercognitive behavioural therapyinterventionremission
Type
Original Research
Information
the Cognitive Behaviour Therapist , Volume 14 , 2021 , e17
Copyright
© The Author(s), 2021. Published by Cambridge University Press on behalf of the British Association for Behavioural and Cognitive Psychotherapies

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Further reading

Dingemans, A., Danner, U., & Parks, M. (2017). Emotion regulation in binge eating disorder: a review. Nutrients, 9, 1274. doi: 10.3390/nu9111274 CrossRefGoogle ScholarPubMed
Leehr, E. J., Krohmer, K., Schag, K., Dresler, T., Zipfel, S., & Giel, K. E. (2015). Emotion regulation model in binge eating disorder and obesity – a systematic review. Neuroscience & Biobehavioral Reviews, 49, 125–134. doi: 10.1016/j.neubiorev.2014.12.008.CrossRefGoogle ScholarPubMed

References

American Psychiatric Association (2013). Diagnostic and Statistical Manual of Mental Disorders (5th edn). American Psychiatric Association.Google Scholar
Byrne, S. M., Fursland, A., Allen, K. L., & Watson, H. (2011). The effectiveness of enhanced cognitive behavioral therapy for eating disorders: an open trial. Behaviour Research and Therapy, 49, 219–226. doi: 10.1016/j.brat.2011.01.006 CrossRefGoogle Scholar
Dalle Grave, R., Calugi, S., Sartirana, M., & Fairburn, C. G. (2015). Transdiagnostic cognitive behaviour therapy for adolescents with an eating disorder who are not underweight. Behaviour Research and Therapy, 73, 79–82. doi: 10.1016/j.brat.2015.07.014 CrossRefGoogle Scholar
Evans, C. (1998). Reliable Change Criterion Indicator. https://www.psyctc.org/stats/rcsc1.htm Google Scholar
Fairburn, C. G. (2008). Cognitive Behavior Therapy and Eating Disorders. New York, USA: Guilford Press.Google ScholarPubMed
Fairburn, C. G., Cooper, Z., Doll, H. A., O’Connor, M. E., Bohn, K., Hawker, D. M., … & Palmer, R. L. (2009). Transdiagnostic cognitive-behavioral therapy for patients with eating disorders: a two-site trial with 60-week follow-up. American Journal of Psychiatry, 166, 311–319. doi: 10.1176/appi.ajp.2008.08040608 CrossRefGoogle ScholarPubMed
Ghaderi, A. (2006). Does individualization matter? A randomized trial of standardized (focused) versus individualized (broad) cognitive behaviour therapy for bulimia nervosa. Behaviour Research and Therapy, 44, 273–288. doi: 10.1016/j.brat.2005.02.004 CrossRefGoogle Scholar
Jacobson, N. S., & Truax, P. (1991). Clinical significance: a statistical approach to defining meaningful change in psychotherapy research. Journal of Consulting and Clinical Psychology, 59, 12–19. doi: 10.1037/0022-006X.59.1.12 CrossRefGoogle ScholarPubMed
Kendall, P. C., Marrs-Garcia, A., Nath, S. R., & Sheldrick, R. C. (1999). Normative comparisons for the evaluation of clinical significance. Journal of Consulting and Clinical Psychology, 67, 285–299. doi: 10.1037/0022-006X.67.3.285 CrossRefGoogle ScholarPubMed
Knott, S., Woodward, D., Hoefkens, A., & Limbert, C. (2015). Cognitive behaviour therapy for bulimia nervosa and eating disorders not otherwise specified: translation from randomized controlled trial to a clinical setting. Behavioural and Cognitive Psychotherapy, 43, 641–654. doi: 10.1017/S1352465814000393 CrossRefGoogle Scholar
Kroenke, K., Spitzer, R. L., & Williams, J. B. (2001). The PHQ-9: validity of a brief depression severity measure. Journal of General Internal Medicine, 16, 606–613. doi: 10.1080/13642537.2017.1386226 Google ScholarPubMed
National Health Service Health Research Authority (2011). National Research Ethics Service Guidance: Does My Project Require Review by a Research Ethics Committee? Downloaded from: https://www.hra.nhs.uk/documents/2013/09/does-my-project-require-rec-review.pdf Google Scholar
National Institute for Health and Care Excellence (NICE) (2017). Eating Disorders: Recognition and Treatment. London, UK: National Institute for Health and Care Excellence.Google Scholar
Pellizzer, M., Waller, G., & Wade, T. (2019). Ten-session cognitive behaviour therapy (CBT-T) for eating disorders: outcomes from a pragmatic pilot study of Australian non-underweight clients. Clinical Psychologist, 23, 124–132. doi: 10.1111/cp.12170 CrossRefGoogle Scholar
Raykos, B. C., Watson, H. J., Fursland, A., Byrne, S. M., & Nathan, P. (2013). Prognostic value of rapid response to enhanced cognitive behavioral therapy in a routine clinic sample of eating disorder outpatients. International Journal of Eating Disorders, 46, 764–770. doi: 10.1002/eat.22169 CrossRefGoogle Scholar
Rose, C., & Waller, G. (2017). Cognitive-behavioral therapy for eating disorders in primary care settings: does it work, and does a greater dose make it more effective? International Journal of Eating Disorders, 50, 1350–1355. doi: 10.1002/eat.22778 CrossRefGoogle ScholarPubMed
Signorini, R., Sheffield, J., Rhodes, N., Fleming, C., & Ward, W. (2018). The effectiveness of enhanced cognitive behavioural therapy (CBT-E): a naturalistic study within an out-patient eating disorder service. Behavioural and Cognitive Psychotherapy, 46, 21–34. doi: 10.1017/S1352465817000352 CrossRefGoogle ScholarPubMed
Spitzer, R. L., Kroenke, K., Williams, J. B., & Löwe, B. (2006). A brief measure for assessing generalized anxiety disorder: the GAD-7. Archives of Internal Medicine, 166, 1092–1097. doi: 10.1001/archinte.166.10.1092 CrossRefGoogle ScholarPubMed
Turner, H., Bryant-Waugh, R., & Marshall, E. (2015a). The impact of early symptom change and therapeutic alliance on treatment outcome in cognitive-behavioural therapy for eating disorders. Behaviour Research and Therapy, 73, 165–169. doi: 10.1016/j.brat.2015.08.006 CrossRefGoogle ScholarPubMed
Turner, H., Marshall, E., Stopa, L., & Waller, G. (2015b). Cognitive-behavioural therapy for outpatients with eating disorders: effectiveness for a transdiagnostic group in a routine clinical setting. Behaviour Research and Therapy, 68, 70–75. doi: 10.1016/j.brat.2015.03.001 CrossRefGoogle Scholar
Waller, G., Gray, E., Hinrichsen, H., Mountford, V., Lawson, R., & Patient, E. (2014). Cognitive-behavioral therapy for bulimia nervosa and atypical bulimic nervosa: effectiveness in clinical settings. International Journal of Eating Disorders, 47, 13–17. doi: 10.1002/eat.22181 CrossRefGoogle ScholarPubMed
Waller, G., Pugh, M., Mulkens, S., Moore, E., Mountford, V. A., Carter, J., Wicksteed, A., Maharaj, A., Wade, T. D., Wisniewski, L., Farrell, N. R., Raykos, B., Jorgensen, S., Evans, J., Thomas, J. J., Osenk, I., Paddock, C., Bohrer, B., Anderson, K., Turner, H., Hildebrandt, T., Xanidis, N., & Smit, V. (2020). Cognitive-behavioral therapy in the time of coronavirus: clinician tips for working with eating disorders via telehealth when face-to-face meetings are not possible. International Journal of Eating Disorders, 53, 1132–1141. doi: 10.1002/eat.23289.CrossRefGoogle Scholar
Waller, G., Tatham, M., Turner, H., Mountford, V. A., Bennetts, A., Bramwell, K., … & Ingram, L. (2018). A 10-session cognitive behavioral therapy (CBT-T) for eating disorders: outcomes from a case series of nonunderweight adult patients International Journal of Eating Disorders, 51, 262–269. doi: 10.1002/eat.22837 CrossRefGoogle ScholarPubMed
Waller, G., Turner, H., Tatham, M., Mountford, V. A., & Wade, T. D. (2019). Brief Cognitive Behavioural Therapy for Non-Underweight Patients: CBT-T for Eating Disorders. Hove, UK: Routledge.CrossRefGoogle Scholar
Submit a response

Comments

No Comments have been published for this article.