Cognitive Behavioral Therapy and Lisdexamfetamine, Alone and Combined, for Binge-Eating Disorder With Obesity: A Randomized Controlled Trial

作者：Carlos M. Grilo, Valentina Ivezaj, Cenk Tek, Sydney Yurkow, Ashley A. Wiedemann, Ralitza Gueorguieva · 发表于：American Journal of Psychiatry · 年份：2024 · DOI：10.1176/appi.ajp.20230982 · 被引用次数：16 · 研究领域：Eating Disorders and Behaviors、Obsessive-Compulsive Spectrum Disorders、Impact of Technology on Adolescents

OBJECTIVE: Binge-eating disorder (BED) is a prevalent, costly public health problem associated with serious functional impairments and heightened rates of psychiatric and medical comorbidities. Few evidence-based treatments are currently available for BED. We tested the effectiveness of cognitive-behavioral therapy (CBT), lisdexamfetamine (LDX), and combined CBT+LDX, for BED comorbid with obesity. METHODS: ) were randomized to one of three 12-week treatments: CBT (N=47), LDX (N=47), or CBT+LDX (N=47); 87.2% completed independent posttreatment assessments. RESULTS: Mixed models revealed binge-eating frequency decreased significantly in all treatments, with CBT+LDX having the largest reduction and significantly outperforming CBT and LDX, which did not differ. Intention-to-treat binge-eating remission rates differed significantly between treatments, with CBT+LDX having the highest remission rate (70.2%) followed by CBT (44.7%) and LDX (40.4%). Mixed models revealed percent weight loss increased significantly throughout treatment with LDX and CBT+LDX but remained unchanged in CBT. LDX and CBT+LDX had significantly greater percent weight loss than CBT starting after one month and through posttreatment. Intention-to-treat rates of attaining ≥5% weight loss differed across treatments, with LDX having the highest (53.2%), followed by CBT+LDX (42.6%) and CBT (4.3%). Analyses revealed significant reductions in eating-disorder psychopathology; CBT+LDX had largest reductions and signific...