title: Predictors and moderators of response to cognitive behavioral therapy and medication for the treatment of binge eating disorder. Psychotherapy for transdiagnostic binge eating: A randomized controlled trial of cognitive-behavioural therapy, appetite-focused cognitive-behavioural therapy, and schema therapy Reducing eating disorder onset in a very high risk sample with significant comorbid depression: A randomized controlled trial. Evaluating an individualized lifestyle and life skills intervention to prevent antipsychotic-induced weight gain in first-episode psychosis. Short-term cognitive-behavioral therapy for binge eating disorder: long-term efficacy and predictors of long-term treatment success.
abstract: OBJECTIVE To examine predictors and moderators of response to cognitive behavioral therapy ( CBT ) and medication treatments for binge-eating disorder ( BED ) . METHOD 108 BED patients in a r and omized double-blind placebo-controlled trial testing CBT and fluoxetine treatments  were assessed prior , throughout , and posttreatment . Demographic factors , psychiatric and personality disorder comorbidity , eating disorder psychopathology , psychological features , and 2 subtyping methods ( negative affect , overvaluation of shape/weight ) were tested as predictors and moderators for the primary outcome of remission from binge eating and 4 secondary dimensional outcomes ( binge-eating frequency , eating disorder psychopathology , depression , and body mass index ) . Mixed-effects models analyzed all available data for each outcome variable . In each model , effects for baseline value and treatment were included with tests of both prediction and moderator effects . RESULTS Several demographic and clinical variables significantly predicted and /or moderated outcomes . One demographic variable signaled a statistical advantage for medication only ( younger participants had greater binge-eating reductions ) , whereas several demographic and clinical variables ( lower self-esteem , negative affect , and overvaluation of shape/weight ) signaled better improvements if receiving CBT .  Overvaluation was the most salient predictor/moderator of outcomes . Overvaluation significantly predicted binge-eating remission ( 29 % of participants with vs. 57 % of participants without overvaluation remitted ) . Overvaluation was especially associated with lower remission rates if receiving medication only ( 10 % vs. 42 % for participants without overvaluation ) . Overvaluation moderated dimensional outcomes : Participants with overvaluation had significantly greater reductions in eating disorder psychopathology and depression levels if receiving CBT . Overvaluation predictor/moderator findings persisted after controlling for negative affect . CONCLUSIONS Our findings have clinical utility for prescription of CBT and medication and implication s for refinement of the BED diagnosis Cognitive-behavioural therapy ( CBT ) is the recommended treatment for binge eating , yet many individuals do not recover , and innovative new treatments have been called for . The current study compares traditional CBT with two augmented versions of CBT ; schema therapy , which focuses on early life experiences as pivotal in the history of the eating disorder ; and appetite-focused CBT , which emphasises the role of recognising and responding to appetite in binge eating . 112 women with transdiagnostic DSM-IV binge eating were r and omized to the three therapies . Therapy consisted of weekly sessions for six months , followed by monthly sessions for six months . Primary outcome was the frequency of binge eating . Secondary and tertiary outcomes were other behavioural and psychological aspects of the eating disorder , and other areas of functioning . No differences among the three therapy groups were found on primary or other outcomes . Across groups , large effect sizes were found for improvement in binge eating , other eating disorder symptoms and overall functioning .  Schema therapy and appetite-focused CBT are likely to be suitable alternative treatments to traditional CBT for binge eating OBJECTIVE Eating disorders ( EDs ) are serious problems among college-age women and may be preventable . An indicated online eating disorder ( ED ) intervention , design ed to reduce ED and comorbid pathology , was evaluated . METHOD 206 women ( M age = 20 ± 1.8 years ; 51 % White/Caucasian , 11 % African American , 10 % Hispanic , 21 % Asian/Asian American , 7 % other ) at very high risk for ED onset ( i.e. , with high weight/shape concerns plus a history of being teased , current or lifetime depression , and /or non clinical levels of compensatory behaviors ) were r and omized to a 10-week , Internet-based , cognitive-behavioral intervention or waitlist control . Assessment s included the Eating Disorder Examination ( EDE , to assess ED onset ) , EDE- Question naire , Structured Clinical Interview for DSM Disorders , and Beck Depression Inventory-II . RESULTS ED attitudes and behaviors improved more in the intervention than control group ( p = .02 , d = 0.31 ) ; although ED onset rate was 27 % lower , this difference was not significant ( p = .28 , NNT = 15 ) . In the subgroup with highest shape concerns , ED onset rate was significantly lower in the intervention than control group ( 20 % vs. 42 % , p = .025 , NNT = 5 ) . For the 27 individuals with depression at baseline , depressive symptomatology improved more in the intervention than control group ( p = .016 , d = 0.96 ) ; although ED onset rate was lower in the intervention than control group , this difference was not significant ( 25 % vs. 57 % , NNT = 4 ) . CONCLUSIONS An inexpensive , easily disseminated intervention might reduce ED onset among those at highest risk . Low adoption rates need to be addressed in future research AIM Initiating antipsychotic medication frequently induces rapid , clinical ly significant weight gain . We aim ed to evaluate the effectiveness of a lifestyle and life skills intervention , delivered within 4 weeks of antipsychotic medication initiation , in attenuating weight gain in youth aged 14 - 25 years with first-episode psychosis ( FEP ) . METHODS We undertook a prospect i ve , controlled study in two early psychosis community services . Intervention participants ( n = 16 ) received a 12-week individualized intervention delivered by specialist clinical staff ( nurse , dietician and exercise physiologist ) and youth peer wellness coaches , in addition to st and ard care . A comparison group was recruited from a similar service and received st and ard care  ( n = 12 ) . RESULTS The intervention group experienced significantly less weight gain at 12 weeks compared to st and ard care ( 1.8 kg , 95 % CI -0.4 to 2.8 vs. 7.8 kg , 4.8 - 10.7 , P < 0.001 ) . Thirteen per cent ( 2/16 ) of the intervention group experienced clinical ly significant weight gain ( greater than 7 % of baseline weight ) , while 75 % ( 9/12 ) of the st and ard care group experienced this level of weight gain . Similar positive effects of the intervention were observed for waist circumference . CONCLUSIONS A lifestyle and life skills intervention delivered as part of st and ard care attenuated antipsychotic-induced weight gain in young people with FEP . The intervention was acceptable to the young people referred to the service . Such interventions may prevent the seeding of future disease risk and in the long-term help reduce the life expectancy gap for people living with serious mental illness The present study evaluates the long-term efficacy ( four years after treatment ) of a short-term Cognitive-Behavioral Treatment ( CBT ) of Binge Eating Disorder ( BED ) . We examined patient characteristics , mostly measured at the end of treatment , for their predictive value of long-term success . Forty-one BED- patients between 18 and 70 years took part in a r and omized controlled trial ( RCT ) for a short-term treatment and were evaluated until 4 years after treatment . Assessment s comprised structured interviews on comorbid mental disorder/eating disorder pathology and question naires on eating disorder pathology/general psychopathology . BED core symptoms and associated psychopathology improved substantially during treatment phase and further improved or at least remained stable during the follow-up period . End of treatment predictors for long term success were elevated weight and eating concern and higher frequency of objective binges . Tailoring additional interventions to patients ' individual needs could further improve treatment efficacy
target: These have been of limited long-term effectiveness , though early intervention post-first episode psychosis appears to be more promising [ 6 ] .
  Hence , the effectiveness of Cognitive Behaviour Therapy ( CBT ) or
background: Background Eating disorders are understood to no longer be the remit of lean adolescent girls alone [ 1 ] , whatever pop culture offerings such as Netflix ’s To The Bone might continue to present .
  Rather , people with eating disorders are much more diverse , often undiagnosed and often suffering in silence .
  One patient population with a unique but poorly understood vulnerability to eating disorders , as well as obesity and poor physical health , is people with bipolar disorder .
  Bipolar disorder is a complex , serious mental illness that confers significant functional impairment , primarily due to time spent in manic , depressed , or mixed state episodes , difficulty eliminating subthreshold depressive symptoms , and the financial , social and emotional sequelae of illness episodes .
  One significant contributor to disability is physical ill health , with the average life expectancy of someone with bipolar disorder notably reduced due to cardiometabolic illnesses like heart disease and type two diabetes mellitus .
  Furthermore , poorer physical health is associated with poorer mental health in this group , such as higher risk of depressive relapse [ 2 , 3 ] .
  The past two decades has seen increased focus on preserving and improving the physical health of people with bipolar disorder , who are often prescribed long-term medication known to be conducive to weight gain [ 4 ] .
  Trials of a number of interventions have attempted to implement lifestyle interventions to promote healthy eating , physical activity , and social connectedness , in order to prevent or reduce the adverse impact of obesity and improve physical health and psycho-social functioning [ 5 ] .
  The role of disordered eating in contributing to physical and mental health outcomes among individuals with bipolar disorder has rarely been considered , despite the fact that approximately one in three people with bipolar disorder also meet criteria for binge eating disorder , bulimia nervosa , or variants of these disorders [ 7 , 8 ] .
  Alongside studies question ing the impact of medication on weight gain in bipolar disorder [ 9 ] , identifying the role of weight-cycling in higher cardiovascular risk [ 10 ] , and showing that obesity risk pre- date s medication [ 11 ] , are reports of a link between eating disorders and high Body Mass Index ( BMI , kg/m ) [ 12 ] and evidence that baseline binge eating predicts medication-associated weight gain [ 13 ] .
  With these recent developments in mind , the authors were curious about what novel interventions for eating disorders and weight disorder in bipolar disorder exist , and conducted a systematic review about their effectiveness .
  In this search no treatments targeting eating disorders specifically were found to exist [ 14 ] , despite the movement of this area into the spotlight over 10 years ago [ 15 ] .