of Binge Eating Disorder
DENISE E. WILFLEY
Individuals with binge eating disorder (BED) typically present to treatment with the multiple problems of binge eating, varied eating disorder psychopathology (e.g., overeating in general and extreme concerns about eating, shape, and weight), psychiatric symptoms, and overweight (see Chapter 31). Accordingly, evaluation of treatments for BED need to take into consideration the impact of the intervention on these multiple problems in both the short and long term. Over the past decade, a number of controlled studies have been conducted on the treatment of BED. Promising, short-term findings have accrued for several conceptually and procedurally distinct psychological treatments, including specialist treatments, behavioral weight loss treatment, and self-help approaches. Positive, longterm outcomes have also been demonstrated for the two specialist treatments cognitivebehavioral therapy (CBT) and interpersonal psychotherapy (IPT). Nevertheless, central questions regarding the specificity of specialist treatment effects and whether BED patients require intervention beyond behavioral weight loss treatment remain unanswered.
To date, the two most intensively studied psychological treatments are CBT and IPT.
CBT, the most frequently studied treatment for BED, uses similar cognitive and behavioral techniques as CBT for bulimia nervosa (see Chapter 54); however, modifications are necessary, because BED patients exhibit lower levels of dietary restraint, more chaotic eating patterns, and higher levels of overweight than bulimia nervosa patients. The adap