The Treatment of Binge Eating Disorder

描述(申请人提供)：过去几十年的研究 一组超重的人有不正常的饮食 以离散的暴饮暴食为特征的模式最好。.的存在 肥胖者暴饮暴食与发病率增加有关 精神病理学，社交功能障碍，早发性肥胖，以及更大的 肥胖的严重程度。然而，最近的研究表明，暴饮暴食 使用某些形式的心理治疗对肥胖患者进行有效治疗 比如认知行为技术，以及某些抗抑郁药物， 这些策略也被证明在抑制暴饮暴食方面很有用 在患有神经性贪食症的正常体重个体中。 某些自助技术也被证明在以下方面非常有用 改善暴饮暴食症状和鼓励健康饮食行为 饮食紊乱的个体。我们的研究小组已经证明了 自助手册在处理神经性暴食症患者中的作用 最近，团体自助方法在目标狂欢中的效用 暴饮暴食超重个体的饮食行为。 因此，作为我们先前研究的延伸，并给出了初步的 将在应用程序中报告的数据，我们建议研究该实用程序 针对暴饮暴食的肥胖者的治疗方法 一项随机分配的平行研究，其中符合纳入条件的受试者 标准将分配给以下6种条件之一：1)基于手动的自助 在没有治疗师参与的情况下以暴饮暴食为目标；2)有监督 基于手动的自助；3)团体自助治疗，不接触 心理治疗师；4)部分通过录像带和 部分由治疗师领导；5)由传统治疗师领导的小组 心理治疗，以及6)等待名单对照，以控制时间的影响 以及参与议定书的非特定影响。值得注意的是， 五个治疗臂中呈现的材料基本上是相同的， 但它们是为自助、视听和治疗演示而编写的 在治疗任务上。 该协议不是用来测试减肥策略的，而是用来 专注于暴饮暴食的策略。这样的战略可以是 与各种减肥药物联合使用或相继使用 超重者的治疗策略(如行为学、药理学)。 减肥的治疗方法目前正在经历重大演变， 在过去的18个月中引入了两种新的药理药物。我们 我认为尝试解决暴饮暴食的策略和 在这项研究中，减肥策略会使问题变得过于复杂。这个 这项研究的结果可能会为治疗这两种疾病的试验设计提供参考 暴饮暴食，促进减肥。

DESCRIPTION (provided by applicant): Research over the last few decades has shown that a sub-group of overweight individuals have an abnormal eating pattern best characterized by discrete binge eating episodes. The presence of binge eating episodes in obese individuals is associated with increased rates of psychopathology, social dysfunction, early onset obesity, and greater severity of obesity. However, recent research suggests that binge eating can be effectively treated in obese individuals using certain forms of psychotherapy such as cognitive behavioral techniques, and certain antidepressant drugs, strategies that have also been shown to be useful in suppressing binge eating in individuals of normal weight with bulimia nervosa. Certain self-help techniques have also been shown to be quite useful in improving binge eating symptoms and in encouraging healthy eating behavior in individuals with disordered eating. Our research groups have demonstrated the utility of a self-help manual in working with individuals with bulimia nervosa and most recently the utility of a group self-help approach in targeting binge eating behavior in overweight individuals with binge eating. Therefore, as an extension of our prior research, and given the preliminary data that will be reported in the application, we propose to study the utility of treatments targeting binge eating in obese individuals who binge eat through a random assignment, parallel study wherein subjects who satisfy inclusion criteria will be assigned to one of 6 conditions: 1) manual-based self-help targeting binge eating without therapist involvement; 2) supervised manual-based self-help; 3) group self-help therapy, without contact with a psychotherapist; 4) group therapy delivered partially through videotapes and partially with therapist leadership; 5) a traditional therapist-led group psychotherapy, and 6) a wait list control to control for the effects of time and the non-specific effects of being involved in the protocol. Of note, the materials presented in the five treatment arms will be essentially identical, but are written for self-help vs. audio-visual vs. therapy presentation based on the treatment assignment. This protocol is not designed to test a weight loss strategy, but instead to focus on strategies for binge-eating. Such strategies could then be administered in combination with, or sequentially with, various weight loss strategies (e.g., behavioral, pharmacologic) in those who are overweight. Treatments for weight loss are currently undergoing significant evolution with the introduction of two new pharmacologic agents in the last 18 months. We believe that to attempt to address both strategies for binge eating and strategies for weight loss in this study would make it overly complex. The result of this study could inform the design of trials to treat both binge-eating and promote weight loss.