The Efficacy of Psychological Therapies in Reducing Weight and Binge Eating in People with Bulimia Nervosa and Binge Eating Disorder Who Are Overweight or Obese-A Critical Synthesis and Meta-Analyses.

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obesity 1000 core feature of Bulimia Nervosa (BN) and Binge Eating Disorder (BED), are frequently comorbid with obesity . Psychological interventions, notably Cognitive Behavioural Therapy (CBT), are effective for binge eating
obesity 1431 to review evidence for efficacy of psychological therapies for BN/BED associated with overweight or obesity in reducing binge frequency and weight. A systematic search for randomized controlled trials with adult
obesity 2327 needed to test the efficacy of psychological treatments for BED or BN with co-morbid overweight or obesity , including trials evaluating binge eating remission and weight loss in the long-term.1. IntroductionEating
obesity 3147 are associated with considerable impairment, both psychological and physical, including overweight or obesity [[2],[6],[7],[8]]. The recently published Noncommunicable Diseases NCD Risk Factor Collaboration that
obesity 3675 from 22.1 kg/m2 to 24.4 kg/m2. If this trend persists, the authors estimate that, in 2025, the global obesity prevalence will be 18% in men and above 21% in women. The relationship between binge eating and obesity
obesity 3779 obesity prevalence will be 18% in men and above 21% in women. The relationship between binge eating and obesity is complex and likely bidirectional [[10]]. An Australian community study that examined the increase
obesity 3932 An Australian community study that examined the increase in prevalence rates of ED’ behaviours and obesity over the 10-year period from 1995 to 2005 reported that rates of obesity associated with ED’ behaviours
obesity 4005 rates of ED’ behaviours and obesity over the 10-year period from 1995 to 2005 reported that rates of obesity associated with ED’ behaviours increased from 8.5% to 20% [[7]]. The findings of increasing rates
obesity 4516 for patients with BN, there was an increase in weight, with individuals reaching the overweight or obesity ranges. The authors argued that in face of the rise of obesity worldwide the appearance of overweight
obesity 4579 individuals reaching the overweight or obesity ranges. The authors argued that in face of the rise of obesity worldwide the appearance of overweight or obesity in individuals with BN should not be unexpected. Indeed,
obesity 4629 ranges. The authors argued that in face of the rise of obesity worldwide the appearance of overweight or obesity in individuals with BN should not be unexpected. Indeed, the National Comorbidity Survey Replication
obesity 4898 and 10.3% for BMI ≥ 40 kg/m2 in individuals with a lifetime diagnosis of BN [[12]].The treatment of obesity is challenging. The Australian Guidelines for the management of obesity consider the most effective
obesity 4970 BN [[12]].The treatment of obesity is challenging. The Australian Guidelines for the management of obesity consider the most effective treatment (based on a weight loss above 10% of baseline weight that is maintained
obesity 5622 as guided self-help intervention had the greatest support, but for patients with BED associated with obesity , behaviour weight loss therapy (BWLT) appeared to be an alternative to CBT, at least in the short-term
obesity 6442 the efficacy of psychological therapies for the treatment of BN and BED associated with overweight or obesity , with a special focus on the effects of BWLT as this is the only therapy currently developed to reduce
obesity 6835 outcomes of interest in the meta-analyses were binge eating frequency and weight/BMI. As weight loss in obesity trials is now routinely reported to one year, this was a second specific outcome [[18]] and a third
obesity 7661 OR bulimia OR binge eating OR binging) NOT (anorexia nervosa OR binge drinking) AND (overweight OR obesity ) AND (psychotherapy OR therapeutics OR cognitive therapy OR psychological therapy OR psychological treatment)
obesity 8317 psychological therapies for the treatment of individuals with BED or BN associated with overweight or obesity . Studies that evaluated psychological interventions such as CBT, Cognitive Behavioural Therapy-Enhanced
obesity 20031 delayed treatment did not show differences for binge eating frequency [[27]]. In participants with obesity and binge eating, an intervention comparing a cognitive treatment with a behavioural treatment for obese
obesity 20450 [[42]].With regards to long-term follow-up, weight loss is being routinely reported to one year in obesity trials [[18]]. This review identified ten studies that reported a follow-up of at least 12 months [[17],[30],[33],[34],[35],[36],[38],[40],[43],[44]].
obesity 24857 from trials where psychological therapies were tested in people with EDs co-morbid with overweight or obesity . All trials identified were of participants with BED and none included participants with BN or subthreshold
obesity 26989 addition of exercise in the psychological treatment of persons with BED associated with overweight or obesity , both in research and in clinical practice. It would also be important to report in future trials physical
obesity 27741 beginning of this review, the purpose was to include trials evaluating BN associated with overweight or obesity . This review found a major gap in evidence for the management of BN comorbid with obesity, possibly
obesity 27831 overweight or obesity. This review found a major gap in evidence for the management of BN comorbid with obesity , possibly due to existing controversies about potential hazards of diet restrictions in people with
obesity 29154 Conclusions This review provides qualified support for the use of CBT in people with BED comorbid with obesity /overweight. Whilst CBT was favoured compared to BWLT for binge eating reduction in the short term, this
obesity 29806 needed to test the efficacy of psychological treatments for BED and for BN with co-morbid overweight or obesity , including trials evaluating binge eating remission and weight loss in the long term.Figure 1Prisma

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