In a randomized clinical trial, researchers evaluated a novel Regulation of Cues combined with Behavioral Weight Loss intervention compared with cognitive behavioral therapy for reducing binge eating and promoting weight loss among veterans with binge eating disorder.
The study enrolled 129 veterans (mean [age, 47; 59% male; mean body mass index, 35) who met criteria for either full-syndrome or subthreshold binge eating disorder (BED). Participants were randomized to 18 weekly group sessions of either Regulation of Cues combined with Behavioral Weight Loss (ROC+BWL) (n = 63) or cognitive behavioral therapy (CBT) (n = 66) over 5 months, with follow-up at 6 months posttreatment.
ROC+BWL targeted food responsiveness, satiety responsiveness, and energy intake reduction using psychoeducation, self-monitoring, and exposures to food cues. In contrast, CBT emphasized normalizing eating patterns and cognitive restructuring without a weight loss component. Both groups were prescribed 250 minutes of moderate to vigorous physical activity per week.
Feasibility and acceptability were comparable between groups. Attendance for the median session was 15 in both arms, and 95% of participants completed posttreatment assessments.
In intention-to-treat analyses, ROC+BWL resulted in significantly greater reductions in loss-of-control eating episodes at all time points compared with CBT: midtreatment, posttreatment, and follow-up. ROC+BWL also led to greater body mass index (BMI) reductions at midtreatment and posttreatment, though no significant difference was observed at follow-up. Participants in the ROC+BWL group also reported greater reductions in daily caloric intake than those in CBT at posttreatment and follow-up.
Treatment effects were more pronounced among patients with full-syndrome BED, especially for reductions in loss-of-control episodes and BMI.
Findings suggest that ROC+BWL may offer a more effective short-term strategy than CBT for reducing binge eating and weight among veterans, particularly those with BED, though long-term weight maintenance remains uncertain and warrants further study. Limitations included reliance on self-reported diet and physical activity data, limited power for subgroup comparisons, and potential recruitment bias due to the emphasis on weight loss in study advertisements.
Full disclosures can be found in the published study.
Source: JAMA Network Open
