Palavras Marly Amorim, Hay Phillipa, Filho Celso Alves Dos Santos, Claudino Angélica
Eating Disorders Program (PROATA), Department of Psychiatry, Federal University of São Paulo (UNIFESP), São Paulo 04038-000, Brazil.
School of Medicine, Western Sydney University, Sydney 2751, Australia.
Nutrients. 2017 Mar 17;9(3):299. doi: 10.3390/nu9030299.
Recurrent binge eating episodes, the core feature of Bulimia Nervosa (BN) and Binge Eating Disorder (BED), are frequently comorbid with obesity. Psychological interventions, notably Cognitive Behavioural Therapy (CBT), are effective for binge eating reduction in BED or BN but less so for weight loss. Behavioural Weight Loss Therapy (BWLT) shows effectiveness for binge eating reduction and weight loss but the latter appears poorly sustained over time. Our aim was to review evidence for efficacy of psychological therapies for BN/BED associated with overweight or obesity in reducing binge frequency and weight. A systematic search for randomized controlled trials with adult samples who had BN or BED was conducted considering articles in English, French, Spanish and Portuguese with no restrictions for the timeline publication ending in March 2016. A quality appraisal of the trials and meta-analyses comparing BWLT to CBT were done. This review identified 2248 articles for screening and 19 published articles were selected. No trials of BN were identified. This review found CBT was favoured compared to BWLT with regard to short-term binge eating reduction. However, insufficient evidence was found for superiority for BWLT efficacy compared to CBT considering binge eating remission, reduction of binge eating frequency and weight loss. More research is needed to test the efficacy of psychological treatments for BED or BN with co-morbid overweight or obesity, including trials evaluating binge eating remission and weight loss in the long-term.
反复出现的暴饮暴食发作是神经性贪食症（BN）和暴食症（BED）的核心特征，常与肥胖症并存。心理干预，尤其是认知行为疗法（CBT），对减少BED或BN中的暴饮暴食有效，但对减肥效果较差。行为减肥疗法（BWLT）对减少暴饮暴食和减肥有效，但随着时间的推移，减肥效果似乎难以持续。我们的目的是回顾心理疗法对与超重或肥胖相关的BN/BED在减少暴饮暴食频率和体重方面的疗效证据。我们对以英语、法语、西班牙语和葡萄牙语发表的文章进行了系统检索，纳入有BN或BED的成人样本的随机对照试验，对时间线无限制，截至2016年3月。对试验进行了质量评估，并对BWLT与CBT进行了荟萃分析。本综述共筛选出2248篇文章，最终选定19篇已发表文章。未检索到BN的试验。本综述发现，在短期减少暴饮暴食方面，与BWLT相比，CBT更受青睐。然而，考虑到暴饮暴食缓解、暴饮暴食频率降低和体重减轻，与CBT相比，未发现足够证据证明BWLT疗效更优。需要更多研究来测试心理治疗对伴有超重或肥胖症的BED或BN的疗效，包括评估长期暴饮暴食缓解和体重减轻情况的试验。
