Weight Loss Treatment and CBT for Veterans with Binge Eating

NIH RePORTER · VA · I01 · · view on reporter.nih.gov ↗

Abstract

The objective of this research is to address the dual problems of overweight/obesity and binge eating among Veterans. Obesity is a leading cause of preventable death and one of the most serious public health problems faced by our nation. Binge eating is a common problem found amongst overweight/obese individuals that poses additional risk for psychiatric and medical comorbidity. Of great concern for the Veterans Health Administration (VHA) is that Veterans are disproportionately affected by obesity; 77 percent of Veterans seeking healthcare through the VHA are classified as overweight/obese compared to 68 percent of the general population. Also of concern is that binge eating is a highly prevalent problem among Veterans. Over 78 percent of Veterans seeking weight loss treatment through the VHA experience some binge eating, and almost half experience recurrent binge eating, defined as engaging in binge eating at least once per week. Evidence suggests that individuals who report recurrent binge eating have significant clinical impairment or distress despite not meeting full diagnostic criteria for Binge Eating Disorder (BED). In clinical trials it is unequivocal that cognitive-behavioral therapy (CBT) is the best-established treatment for BED, and that guided self-help CBT (gshCBT) is the preferred first-line approach. While CBT produces robust and lasting effects for binge eating and mental health, the effect on weight loss has been shown to be minimal at best. Our previous work, and the work of others, has demonstrated better weight outcomes, but worse binge eating and mental health outcomes, for patients with BED who receive weight loss treatment compared to CBT. To capitalize on the best of both treatments, we have recently completed an NIH-funded efficacy trial that combined manualized behavioral weight loss treatment with CBT in a sample of overweight/obese non-Veterans with clinical BED. Findings demonstrated that when CBT is combined with behavioral weight loss treatment that the benefits on binge eating are not compromised by the weight loss intervention, and that there are additional and significant improvements in weight and metabolic outcomes. The proposed study will address binge eating in Veterans, a population that has been overlooked with regard to this problem. Additionally, this effectiveness trial will extend the predominately efficacy treatment literature by leveraging the existing program for weight management within the VHA, and treating patients with both clinical and subclinical BED. Overweight/obese Veterans with at least recurrent binge eating, who are recruited through orientation sessions for the VHA weight management program, MOVE!, will be eligible to participate. Participants will be randomized to receive MOVE! (treatment- as-usual) or MOVE!+gshCBT. Given the VHA strategic plan to address the needs of women Veterans, we will also oversample for women. Major outcome assessments will be performed by an independent evalu...

Key facts

NIH application ID
10186491
Project number
5I01HX002028-04
Recipient
VA CONNECTICUT HEALTHCARE SYSTEM
Principal Investigator
Robin Meryl Masheb
Activity code
I01
Funding institute
VA
Fiscal year
2021
Award amount
Award type
5
Project period
2017-08-01 → 2023-07-31