Psychological, pharmacological, and combined treatments for binge eating disorder: a systematic review and meta-analysis.

Plain Language Summary

It is estimated that between 1% and 4% of the population suffer from binge eating disorder (BED), which is characterised by episodes of binge eating and a lack of control over eating. People with BED tend to have lower mental wellbeing and are more likely to be overweight or obese, leading to increased risk of related diseases such as type 2 diabetes. Treatments for BED include psychological treatments such as cognitive behavioural therapy (CBT), and medication such as selective serotonin re-update inhibitors (SSRIs) and weight-loss medication, as well as medications that are normally prescribed for attention deficit disorders, addictions and epilepsy. The aim of this review was to evaluate previous trials on the effectiveness of a range of psychological, pharmacological and combined treatments for BED. The authors looked at 45 trials which included over 4,000 participants. They found moderate support for the effectiveness of CBT and guided self-help for the treatment of BED in stopping or reducing the frequency of binge eating. Overall, there was a lack of long-term follow-ups, with no data on the long-term effect of medications. Interesting, the use of SSRIs did not have a significant impact on depressed mood in people with BED and lisdexamfetamine was the only intervention associated with a reduction in BMI (an expected finding as this medication is associated with some loss of appetite). There were very few studies that directly compared psychological treatments with medication, and a lack of evidence on the effectiveness of treatment in younger adults and teenagers. The authors concluded that more long-term studies are needed in the treatment of BED (included exploring quality of life), standardised assessments of BED and people from underrepresented populations (e.g. adolescents).