Group cognitive-behavioral treatment of binge eating disorder: A comparison of therapist-led versus self-help formats

Objective: The purpose of this study was to compare three group cognitive-behavioral therapy (CBT) treatment models and a waiting list control condition (WL). Method: Sixty-one women who met DSM-IV criteria for binge eating disorder (BED) received treatment with the same cognitive- behavioral treatment manual in 14 one-hour sessions over an 8-week period. All sessions consisted of psychoeducation for the first 30 min and group discussion for the second half hour. In the therapist-led condition (TL; n = 16), a doctoral therapist led both the psychoeducational component and group discussion. In the partial self-help condition (PSH; n = 19), participants viewed a 30-min psychoeducational videotape, followed by participation in a therapist-led discussion. In the structured self-help condition (SH; n = 15), subjects viewed the 30-min psychoeducational videotape and subsequently led their own 30-min discussion. Eleven subjects were assigned to a wait-list control condition (WL). The primary outcome variables were frequency and duration of self-reported binge eating episodes. Results: A mixed effects linear modeling (random regression) analysis indicated that subjects in all three active treatment conditions showed a decrease in binge eating symptoms over time. No group differences in rates of change over time were observed, although analysis of covariance indicated that all three treatment conditions showed significantly greater improvement in binge eating compared to the WL condition. Discussion: The findings from this preliminary study suggest that CBT for BED can be delivered effectively in a structured group self-help format.