WEIGHT-LOSS, COGNITIVE-BEHAVIORAL, AND DESIPRAMINE TREATMENTS IN BINGE-EATING DISORDER - AN ADDITIVE DESIGN

The aim of this study was to compare the effects of weight loss treatm ent, cognitive-behavioral treatment, and desipramine on binge eating a nd weight in a three group additive design involving 108 overweight pa rticipants with binge eating disorder. Subjects were allocated at rand om to either 9-months weight-loss-only treatment; 3-months of cognitiv e-behavioral treatment followed by weight loss treatment for 6-months; or the combination treatment with desipramine added for the last 6-mo nths. After 3-months of treatment, those receiving cognitive-behaviora l therapy had reduced binge eating significantly more than participant s receiving weight loss therapy only, and the weight loss only group h ad lost significantly more weight than those in the cognitive-behavior al groups. The addition of medication did not lead to greater reductio ns in the frequency of binge eating. Hence, there was no evidence that either cognitive-behavioral therapy or desipramine added to the effec tiveness of weight loss therapy. However, those receiving medication l ost significantly more weight than the comparable group without medica tion at follow-up. Abstinence from binge eating was associated with si gnificantly greater weight losses. Overall, however, the achieved weig ht losses were small and the abstinence rates low. Moreover, there wer e no differences between the three groups either at the end of treatme nt or at follow-up. Suggestions for further research aimed at improvin g the therapeutic results for this difficult clinical problem are disc ussed.