Cognitive-Behavioral Therapy and Lisdexamfetamine, Alone and Combined, for Binge-Eating Disorder: Secondary Outcomes of a Randomized Controlled Trial.

OBJECTIVE

A 12-week randomized controlled trial (RCT) found cognitive-behavioral therapy (CBT), lisdexamfetamine (LDX), and combined CBT + LDX showed significant improvements in BED, with combined CBT + LDX being superior to the individual treatments. This report details the treatment effects on secondary outcomes comprising behavioral, psychological, and metabolic variables intended to build on the primary outcomes to broaden our understanding of BED treatment.

METHOD

RCT randomized N = 141 patients with BED to one of three 12-week treatments: CBT (N = 47), LDX (N = 47), or CBT + LDX (N = 47). 87.2% completed posttreatment assessments.

RESULTS

Mixed models revealed significant decreases in eating (food cravings and hedonic drive to eat palatable foods) and metabolic (cholesterol and triglycerides) variables in all treatments, with CBT + LDX having the largest reduction and significantly outperforming CBT and LDX. Overvaluation of shape/weight and impulsivity decreased significantly in all treatments but did not differ significantly between treatments. Delayed discounting did not change overall during treatment nor show an interaction with specific treatments.

CONCLUSIONS

Significant improvements in secondary outcomes in this RCT for BED suggest CBT and LDX, and particularly their combination, are associated with broad positive effects beyond their significant effects on binge eating. Future research should examine moderator/mediational effects of these variables on differential treatment responses in BED.

CLINICALTRIALS

gov Registration: NCT03924193 (Cognitive-Behavioral and Pharmacologic (LDX) Treatment of Binge-Eating Disorder and Obesity: Acute Treatment).