Randomized Controlled Trial of Behavioral Weight Loss and Stepped Care for Binge-Eating Disorder: 12-Month Follow-up

Objective This study aimed to examine longer-term effects of behavioral weight loss (BWL) and Stepped Care for binge-eating disorder and obesity through 12-month follow-up after completing treatments. Methods A total of 191 patients with binge-eating disorder/obesity were randomized to 6 months of BWL (n = 39) or Stepped Care (n = 152). Within Stepped Care, patients began BWL (1 month), treatment responders continued BWL, nonresponders switched to cognitive behavioral therapy, and all were randomized (double-blind) to weight-loss medication or placebo (5 months). Patients were independently assessed throughout/after treatment and at 6- and 12-month follow-ups. Results Intent-to-treat analyses of remission rates revealed that BWL and Stepped Care did not differ significantly at posttreatment (74.4% vs. 66.5%), 6-month follow-up (38.2% vs. 33.3%), or 12-month follow-up (44.7% vs. 41.0%). Mixed models of binge-eating frequency indicated significant reductions through posttreatment but no significant changes or differences between BWL and Stepped Care during follow-up. Mixed models revealed significant weight loss with no differences between BWL and Stepped Care (5.1% vs. 5.8%) at posttreatment and significant time effects (larger percent weight loss at 6-month than at 12-month follow-up) with no differences between BWL and Stepped Care (-5.1% vs. -5.2% and -3.4% vs. -5.0%, respectively). Conclusions Binge-eating improvements and weight loss produced by BWL and adaptive Stepped Care did not differ significantly 12 months after completing treatments.