Predictors and moderators of treatment outcome in a randomized clinical trial for binge-eating disorder

Lisa M. Anderson, Kathryn M. Smith, Lauren M. Schaefer, Ross D. Crosby, Li Cao, Scott G. Engel, Scott J. Crow, Stephen A. Wonderlich, Carol B. Peterson

Research output: Contribution to journalArticlepeer-review

3 Scopus citations


Objective: The current study examined predictors and moderators of two interventions for binge-eating disorder (BED). Method: Participants were 112 adults with BED (Mage = 39.7 ± 13.4 years; MBMI= 35.1 ± 13.4 kg/m2; 82% female; 91% Caucasian) randomly assigned to integrative cognitive-affective therapy for BED (ICAT-BED) or guided self-help cognitive-behavioral therapy (CBTgsh). Generalized linear models examined predictors and moderators of objective binge-eating episode (OBE) frequency and OBE abstinence at end-of-treatment (EOT) and 6-month follow-up (FU). Results: Lower levels of baseline dietary restraint and emotion regulation difficulties predicted greater reductions in OBE frequency at EOT and FU, respectively. At EOT, greater pretreatment self-control predicted greater reductions in OBE frequency in ICAT-BED than CBTgsh (ps <.05). In addition, low shape/weight overvaluation predicted greater reductions in OBE frequency in ICAT-BED than CBTgsh, whereas high shape/weight overvaluation predicted comparable reductions in OBE frequency across treatments at EOT (ps <.02). At EOT and FU, greater baseline actual-ideal self-discrepancy predicted significantly greater reductions in OBE frequency in ICAT-BED, than CBTgsh (ps <.02). No significant predictor or moderator effects were observed for models examining OBE abstinence. Conclusion: This study identified two general predictors and four moderators of BED treatment response. However, only one predictor (actual-ideal self-discrepancy) interacted with treatment type to differentially predict OBE frequencies at both EOT and FU. Altogether, findings suggest that ICAT-BED may confer specific and durable improvements in OBE frequencies among individuals with high actual-ideal self-discrepancy. Therefore, patients demonstrating these characteristics may be more likely to benefit from ICAT-BED. This study suggests that ICAT-BED is an efficacious treatment for BED and may be particularly effective for reducing binge-eating frequency among individuals with certain symptom presentations. This study highlights the potential importance of assessing pretreatment patient characteristics, particularly actual-ideal self-discrepancy, to inform treatment plans and selection of targeted intervention approaches.

Original languageEnglish (US)
Pages (from-to)631-642
Number of pages12
JournalJournal of consulting and clinical psychology
Issue number7
StatePublished - Jul 2020

Bibliographical note

Funding Information:
Research reported in this article was supported by the National Institute of Mental Health of the National Institutes of Health under Awards R34 MH099040-01A1, R34 MH098995-01A1, and T32 MH082761. The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health.


  • Binge-eating disorder
  • Moderators
  • Predictors
  • Psychotherapy
  • Treatment outcome

PubMed: MeSH publication types

  • Journal Article
  • Randomized Controlled Trial

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