Bulimia nervosa (BN) and related eating disorders involving binge eating (e.g., Eating Disorder not Otherwise Specified, EDNOS; Binge Eating Disorder, BED) are serious mental health problems, particularly among young adult women but increasingly also among men. BN and its spectrum variants are associated with adverse long-term health and mental health outcomes. These disorders also are associated with elevated health services utilization, yet these services rarely target the eating disorder (ED) specifically. Cognitive- Behavioral Therapy (CBT), offered by trained professionals with specific expertise, is considered the treatment of choice f or BN and has also been shown to be effective in treating BED. Studies have found, however, that this evidence-based treatment reaches only a minority of individuals with an ED: few individuals receive care specifically for an ED, and when they do, most therapists use treatments other than CBT. Experts have called for the development of a more disseminable form of CBT as an important step within a model of treatment that progresses from minimal interventions to increasingly complex treatments. Several studies have reported the successful use of CBT-based Guided Self-Help (GSH) treatments for BN and BED, but the data are limited by small sample sizes, a restricted range of patients, and very brief follow-up. Finally, in light of the low rates of treatment seeking, the stepped care approach should include a proactive attempt to reach ED patients. The overall aim of t he proposed study is to determine the acceptability and effectiveness of CBT-GSH when delivered to a community population of women and men with a severe binge eating disorder following a large-scale outreach (screening) effort. Specifically, the study aims to determine the clinical effectiveness of CBT-GSH in the treatment of BN, BED and related EDNOS; subsidiary aims are to examine the acceptability of the CBT-GSH intervention t o potential participants and the cost-effectiveness of CBT-GSH relative to usual clinical care in a health maintenance organization. We propose to screen a random sample of 30,000 adults (ages 18 to 35) for binge eating disorders, and enroll an estimated sample of 285 of those women and men with BN, BED or EDNOS in a randomized clinical trial of CBT-GSH. The primary outcome will be change in binge eating. Secondary outcomes will include changes in associated eating pathology (e.g., body image disturbance), associated psychopathology (e.g., depression), functional impairment, body mass index, and health services use. The proposed study will answer the question whether CBT- GSH is an effective early step intervention for the treatment of binge eating disorders.
| Striegel Weissman, Ruth; Rosselli, Francine (2017) Reducing the burden of suffering from eating disorders: Unmet treatment needs, cost of illness, and the quest for cost-effectiveness. Behav Res Ther 88:49-64 |
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| Dickerson, John F; DeBar, Lynn; Perrin, Nancy A et al. (2011) Health-service use in women with binge eating disorders. Int J Eat Disord 44:524-30 |
| Harvey, Kate; Rosselli, Francine; Wilson, G Terence et al. (2011) Eating patterns in patients with spectrum binge-eating disorder. Int J Eat Disord 44:447-51 |
| Striegel-Moore, Ruth H; Wilson, G Terence; DeBar, Lynn et al. (2010) Cognitive behavioral guided self-help for the treatment of recurrent binge eating. J Consult Clin Psychol 78:312-21 |
| Striegel-Moore, Ruth H; Rosselli, Francine; Wilson, G Terence et al. (2010) Nocturnal eating: association with binge eating, obesity, and psychological distress. Int J Eat Disord 43:520-6 |
| Lynch, Frances L; Striegel-Moore, Ruth H; Dickerson, John F et al. (2010) Cost-effectiveness of guided self-help treatment for recurrent binge eating. J Consult Clin Psychol 78:322-33 |
| Striegel-Moore, Ruth H; Perrin, Nancy; DeBar, Lynn et al. (2010) Screening for binge eating disorders using the Patient Health Questionnaire in a community sample. Int J Eat Disord 43:337-43 |
| DeBar, Lynn L; Yarborough, Bobbi Jo; Striegel-Moore, Ruth H et al. (2009) Recruitment for a guided self-help binge eating trial: potential lessons for implementing programs in everyday practice settings. Contemp Clin Trials 30:326-33 |
| Striegel-Moore, Ruth H; Rosselli, Francine; Perrin, Nancy et al. (2009) Gender difference in the prevalence of eating disorder symptoms. Int J Eat Disord 42:471-4 |
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