Binge-Eating Disorder and Cognitive-Behavioral Therapy: Fast Recovery is Better

June 2006 article in the Journal of Consulting and Clinical Psychology offered a simple and grabbing title: “Rapid Response to Treatment for Binge-Eating Disorder" (Grilo, Masheb, and Wilson, 2006). Everyone wants rapid response to treatment. This article, however, was ultimately more interested in long-term recovery.

The authors’ main purpose was to investigate whether a rapid response to treatment was a good predictor of solid recovery. They argued that since about two-thirds of overall improvement in symptoms usually occurs within the first four weeks (Ilardi & Craighead, 1994, as referenced in Grilo, Masheb, and Wilson, 2006), it might make sense that a quick improvement means a better and more permanent improvement.

Results: Cognitive-Behavioral Therapy for Binge-Eating Disorder

They studied a group of 108 persons with bulimia nervosa and binge-eating disorder as they received 16 weekly, hour-long sessions of cognitive-behavioral therapy (CBT). Sure enough, those who showed a big drop in binging up front (defined as a 65% drop in the first four weeks) were more likely to have better symptom improvement when the treatment ended.

Nearly three out of four of those who had fast improvements in symptoms reported at the end of treatment that they had binged at most once in the prior 28 days. Those who started more slowly showed improvement also, but not as much.

What You Can Do for Binge-Eating Disorder

So what does that mean for someone entering treatment? If your therapist uses CBT, you might hope for a fast improvement in symptoms. But if you don’t see a quick improvement, don’t bail out of treatment right away. A lack of quick improvement means that it’s a good time to talk things over with your therapist, for several reasons.

First, you may be one of the few who responds just as well to treatment over time, but takes longer to get to your goals. Ask your therapist if she thinks you’re in this category. Are you seeing some improvement? If you improve at this rate, will it get you to your treatment goals?

Second, it may be that you and your therapist are not a good match for each other. No therapist is right for everyone. Personality differences, styles, and other factors can hamper treatment. A wise therapist will be willing to discuss with you whether you are well-matched (and will refer you if not).

Finally, perhaps you’re reluctant to be in treatment. Some of this feeling is quite natural, but too much reluctance can get between you and recovery. A good question to ask: “Do I really want to get better right now? Or is it too scary to give up the binges?”

An honest answer can do wonders for you. If you really don’t want to stop binge eating, tell your therapist. Together you may be able to understand specifically why change doesn’t look as good as staying where you are. Knowing reasons for this may help you move forward. If not, at least you will have a better idea when you are ready to make changes.

It’s good to know that cognitive-behavioral therapy can help your symptoms improve quickly. The key is not to get discouraged if you don’t see things happening as fast as you’d like. You are a unique person with unique needs and preferences. Work with your therapist to give yourself every advantage.

References

Grilo, Carlos M., Robin M. Masheb, and G. Terence Wilson. Rapid Response to Treatment for Binge Eating Disorder.” Journal of Consulting and Clinical Psychology 74 (June 2006).

Ilardi, S. S. & W.E. Craighead. “The Role of Nonspecific Factors in Cognitive-Behavior Therapy for Depression. Clinical Psychology: Science and Practice 1 (1994), 138-156.