Book and talking therapy helped binge eaters cut down, us study


Book and talking therapy helped binge eaters cut down, us study

New research from the US found that reading a self-help book and 12 weeks of talking therapy helped binge eaters cut down for up to a year, and saved them money.

Two studies on the research, by investigators from the Kaiser Permanente Center for Health Research, Wesleyan University and Rutgers University, are due to be published in the Journal of Consulting and Clinical Psychology.

Affecting around 9 million Americans, or more than 3 per cent of the population, binge eating is the most common eating disorder in the US, yet there aren't many ways to treat it.

The condition has received a lot press recently because the American Psychiatric Association has recommended it be regarded as a separate, distinct eating disorder like bulimia and anorexia. This distinction could focus more attention on bingeing and how it should be treated, as well as affect the numbers diagnosed and how insurers will cover treatment, noted the authors.

Lead investigator Dr Ruth H Striegel-Moore, a professor of psychology at Wesleyan University, told the media that:

"People who binge eat more than other people do during a short period of time and they lose control of their eating during these episodes."

"Binge eating is often accompanied by depression, shame, weight gain, loss of self-esteem and it costs the health care system millions of extra dollars," she added.

Described as the first of its kind, the first study found that more than 63 per cent of participants who took part had stopped bingeing by the end of the three-month program, compared to just over 28 per cent of non-participants, and another nine months later, 64 per cent of participants were "binge free" compared to 45 per cent of those who received the "usual care". The second study found that participants also saved money because they spent less on dietary supplements and weight loss programs.

Co-author Frances Lynch, a health economist at the Kaiser Permanente Center for Health Research said that it was unusual to find a program like this that works well and also saves the patient money.

Striegel-Moore said their research shows that "recurrent binge eating can be successfully treated with a brief, easily administered program, and that's great news for patients and their providers".

"It's a win-win for everyone", said Lynch, "this type of program is something that all health care systems should consider implementing".

For their research, the authors carried out a randomized controlled trial from 2004 to 2005 involving 123 people in Oregon and southwest Washington who were members of the Kaiser Permanente health plan. The average age of the participants was 37 and over 90 per cent of them were women.

To take part in the study, the participants had to have had at least one binge eating episode a week for the previous three months, with a maximum of two weeks between episodes.

The participants were randomized to one of two groups: the treatment group and the controls. The treatment group was asked to read a book by a professor of psychiatry and expert on eating disorders, Dr Christopher Fairburn, titled "Overcoming Binge Eating" and attend 8 sessions of talking therapy over 12 weeks.

The book explained the science behind binge eating and outlined a six-step self help approach that included self-monitoring, self-control and tips for problem solving.

The talking therapy was delivered by counsellors who explained how cognitive behavioral therapy works and helped the participants implement the suggestions in the book. The first session lasted for one hour and subsequent sessions lasted 20 to 25 minutes each.

The average cost of the program for the treatment group was $167 per participant.

Both groups were mailed fliers describing their health plan's options for healthy living and eating and encouraged to contact their doctor to find out more about the services (the "usual care" approach). The control group was not invited to read the book and did not attend therapy (ie they received only the "usual care").

All participants in both groups were asked to keep extensive records of any binge eating episodes, including how often they missed work, were less productive at work, and how much money they spent on weight loss programs, health care, and weight loss supplements.

The researchers also noted participants' spend on medication, visits to the doctor and use of health services.

The results showed that:

  • After the 12-week program, 63.5 per cent of the treatment group had stopped binge eating compared with 28.3 per cent of those who received only the usual care (the control group).
  • Half way through the study, at the 6-month milestone, 74.5 per cent of the treatment group had stopped bingeing compared to 44.1 per cent of the controls.
  • At the end of the study, at the 12-month milestone, 64.2 per cent of the treatment group were "binge free", compared to 44.6 per cent of those who received the "usual care".
  • The average total costs were $447 less in the treatment group: this included an average saving of $149 per head for the participants who spent less on over the counter medication, weight loss programs and supplements.
  • The total cost for the treatment group was $3,670 per head per year, and for the control group it was $4,098.
Co-author Dr Lynn DeBar, a clinical psychologist at the Kaiser Permanente Center for Health Research, cautioned that while the program appears to show promising results, anyone who is experiencing binge eating problems should first talk to their doctor before deciding whether this is the right program for them.

-- Journal of Consulting and Clinical Psychology

Source: Kaiser Permanente.

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