Treatment outcome in binge eating disorder: Moving ahead!: Cognitive behavior therapy and dialectical behavior therapy compared

Abstract

A relatively new treatment for binge eating disorder (BED) is dialectical behavioural therapy (DBT). DBT-BED focuses on recognising and dealing with emotions, and therefore has a different focus than the current preferential treatment: cognitive behavioural therapy (CBT). CBT focuses on the overvaluing of body shape and weight, and on eating patterns. We compared the effectiveness of an intensive form of CBT (CBT+) with the less intensive DBT-BED. We also looked at whether individual characteristics at the onset of the treatment could be used to predict treatment outcome.

Both treatment with CBT+ and with DBT-BED led to a marked, and in many ways similar, reduction in symptoms. Although CBT+ scored slightly better, DBT-BED is probably more efficient (cost-effective). This makes DBT-BED an interesting treatment option, and a potential alternative to CBT. For patients with high scores on emotional eating or difficulty recognising feelings, DBT-BED might become the first-choice treatment. Treatment can be further improved by paying extra attention to body shape concerns, overvaluing of body shape and weight, emotional eating, and recognising feelings and depressive symptoms.