Effect of Behavioral Weight Management Interventions on Symptoms of Binge-Eating Disorder and Bulimia Nervosa: A Systematic Review and Meta-Analysis.

In 30 seconds

This systematic review and meta-analysis assessed behavioral weight management interventions and eating-disorder symptoms in people diagnosed with binge-eating disorder (BED) or bulimia nervosa (BN). It included 22 experimental groups from 11 trials, with 890 participants. Symptoms decreased on average from baseline after intervention in all trials. Compared with control groups, interventions showed no significant difference in posttreatment change in binge-eating frequency (MD = 0.59, 95% CI [-0.86, 1.86]), global symptom severity, or pooled symptom outcomes. Results varied according to control-group and intervention type.

Key findings

• Across all trials, eating-disorder symptoms decreased on average from baseline after weight management interventions.
• There was no significant between-group difference in binge-eating frequency change: MD = 0.59, 95% CI [-0.86, 1.86].
• Between-group differences were not significant for global symptom severity (MD = 0.03, 95% CI [-0.15, 0.21]) or pooled outcomes (g = 0.04, 95% CI [-0.20, 0.29]).
• Symptom decreases were greater versus no-treatment than active controls, and outcomes differed by intervention type.

Why it matters

Intentional weight loss has been considered a potential concern for people with BED or BN because it might worsen eating-disorder symptoms. These pooled findings do not show greater posttreatment symptom worsening with behavioral weight management than with comparison conditions, and suggest such interventions may be a treatment option. The evidence remains preliminary and does not establish long-term effects.

What to keep in mind

The review included a small number of trials, with heterogeneity in study designs and outcome measures and sparse long-term outcome data.