recent randomized clinical trial has revealed that a combined therapeutic approach may be more effective than traditional cognitive behavioral therapy (CBT) in reducing binge eating and promoting weight loss among veterans with binge eating disorder (BED).
The study involved 129 veterans (average age 47; 59% male; mean BMI 35) diagnosed with either full-syndrome or subthreshold BED. Participants were randomly assigned to 18 weekly group sessions over five months of either a novel Regulation of Cues combined with Behavioral Weight Loss (ROC+BWL) program (63 participants) or standard CBT (66 participants), with follow-up conducted six months after treatment.
The ROC+BWL intervention focused on improving responses to food cues, enhancing satiety awareness, and reducing energy intake through psychoeducation, self-monitoring, and structured food cue exposures. By contrast, CBT concentrated on normalizing eating patterns and cognitive restructuring, without a targeted weight loss component. Both groups were encouraged to engage in 250 minutes of moderate-to-vigorous physical activity per week.
Researchers reported comparable feasibility and acceptability across both groups, with median attendance reaching 15 sessions and a 95% completion rate for posttreatment assessments.
Analysis revealed that ROC+BWL produced significantly greater reductions in loss-of-control eating episodes at midtreatment, posttreatment, and six-month follow-up compared with CBT. Additionally, participants in the ROC+BWL group experienced larger decreases in BMI at midtreatment and posttreatment, although differences were not statistically significant at follow-up. Daily caloric intake also declined more in the ROC+BWL group at both posttreatment and follow-up.
The benefits were particularly pronounced among veterans with full-syndrome BED, who showed the most substantial reductions in both loss-of-control episodes and BMI.
These findings indicate that ROC+BWL may offer a more effective short-term strategy than CBT for managing binge eating and weight in veterans, especially those with BED. However, long-term weight maintenance remains uncertain and warrants further investigation. Study limitations included reliance on self-reported diet and activity data, limited statistical power for subgroup analyses, and potential recruitment bias due to the weight-loss focus in study advertisements.
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