Meta-analysis of the effectiveness of psychological and pharmacological treatments for binge eating disorder.

OBJECTIVE The aim of this study was to compute and compare mean effects of various treatments for binge eating disorder. METHOD A total of 38 studies with 1973 participants fulfilled the defined inclusion criteria. Effect sizes, odds ratios, and simple rates were integrated in fixed and random (mixed) effects categorical models. RESULTS From randomized controlled trials, psychotherapy and structured self-help, both based on cognitive behavioral interventions, were found to have large effects on the reduction of binge eating. Regarding pharmacotherapy, mainly comprising antidepressants, randomized controlled trials revealed medium effects for the reduction of binge eating. Uncontrolled studies on weight-loss treatments demonstrated moderate reductions of binge eating. Combination treatments did not result in higher effects compared with single-treatment regimens. Except for weight-loss treatment, none of the interventions resulted in a considerable weight reduction. DISCUSSION Psychotherapy and structured self-help, both based on cognitive-behavioral interventions, should be recommended as the first-line treatments.