The findings of a randomized controlled trial suggested that cognitive-behavioral therapy (CBT) should be considered for adults with binge-eating disorder who do not show improvement with initial pharmacological interventions. The objective was to evaluate the effectiveness of CBT for binge-eating disorder.

Overall, 31 subjects with binge-eating disorder and obesity who were non-responders to initial acute treatments such as Naltrexone/Bupropion and/or behavioral therapy were included. The mean age of the volunteers was 46.3 years, with 77.4% being women, 80.6% White, and a mean body mass index of 38.99 kg/m2. They were randomly assigned to either receive CBT (n = 18) or not receive CBT (n = 13). Additionally, all participants continued their ongoing double-blinded pharmacotherapy.

Independent evaluations were conducted at different stages of the treatment, including baseline, throughout the intervention, and post-intervention, with 83.9% of people completing the post-treatment assessments. The remission rates, based on intention-to-treat analysis, were substantially greater in the CBT group compared to the group without CBT.

By employing mixed models to assess binge-eating frequency using complementary methods, the researchers observed a significant interaction between CBT and time, indicating that CBT had a positive effect. Binge-eating frequency declined with CBT but did not show alteration in the group without CBT. Moreover, when the analysis was restricted to the subset of patients who received pharmacotherapy during the acute treatment (27 patients, with only four of them also receiving behavioral therapy), the findings remained consistent, further supporting CBT effectiveness compared to those not receiving CBT. For adult patients with binge-eating disorder unresponsive to initial pharmacological treatments, CBT is a promising alternative.