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A Randomized Comparison of Group Cognitive-Behavioral Therapy and Group Interpersonal Psychotherapy for the Treatment of Overweight Individuals With Binge-Eating Disorder
Denise E. Wilfley, PhD;
R. Robinson Welch, PhD;
Richard I. Stein, PhD;
Emily Borman Spurrell, PhD;
Lisa R. Cohen, PhD;
Brian E. Saelens, PhD;
Jennifer Zoler Dounchis, BA;
Mary Ann Frank, PhD;
Claire V. Wiseman, PhD;
Georg E. Matt, PhD
Arch Gen Psychiatry. 2002;59:713-721.
Background Cognitive-behavioral therapy (CBT) has documented efficacy for the treatment
of binge eating disorder (BED). Interpersonal psychotherapy (IPT) has been
shown to reduce binge eating but its long-term impact and time course on other
BED-related symptoms remain largely unknown. This study compares the effects
of group CBT and group IPT across BED-related symptoms among overweight individuals
with BED.
Methods One hundred sixty-two overweight patients meeting DSM-IV criteria for BED were randomly assigned to 20 weekly sessions
of either group CBT or group IPT. Assessments of binge eating and associated
eating disorder psychopathology, general psychological functioning, and weight
occurred before treatment, at posttreatment, and at 4-month intervals up to
12 months following treatment.
Results Binge-eating recovery rates were equivalent for CBT and IPT at posttreatment
(64 [79%] of 81 vs 59 [73%] of 81) and at 1-year follow-up (48 [59%] of 81
vs 50 [62%] of 81). Binge eating increased slightly through follow-up but
remained significantly below pretreatment levels. Across treatments, patients
had similar significant reductions in associated eating disorders and psychiatric
symptoms and maintenance of gains through follow-up. Dietary restraint decreased
more quickly in CBT but IPT had equivalent levels by later follow-ups. Patients'
relative weight decreased significantly but only slightly, with the greatest
reduction among patients sustaining recovery from binge eating from posttreatment
to 1-year follow-up.
Conclusions Group IPT is a viable alternative to group CBT for the treatment of
overweight patients with BED. Although lacking a nonspecific control condition
limits conclusions about treatment specificity, both treatments showed initial
and long-term efficacy for the core and related symptoms of BED.
From the Joint Doctoral Program in Clinical Psychology, San Diego State
University and University of California, San Diego (Drs Wilfley, Welch, Stein,
and Matt, and Ms Dounchis); Brown University, Providence, RI (Dr Spurrell);
Anxiety and Traumatic Stress Program, Payne Whitney Clinic, New York Presbyterian
Hospital, New York City (Dr Cohen); Division of Psychology, Children's Hospital
Medical Center, Cincinnati, Ohio (Dr Saelens); Department of Psychology, Yale
University, New Haven, Conn (Dr Frank); and the Department of Psychology,
Trinity College, Hartford, Conn (Dr Wiseman).
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