Obesity is a leading cause of preventable death and one of the most serious public health problems faced by our nation. Of great concern for the Veterans Health Administration (VHA) is that Veterans are disproportionately affected by obesity and have poor response to weight loss treatment. Also critical to the VHA is that binge eating, a problem strongly associated with psychiatric and medical illness, is highly prevalent among Veterans. Over three-quarters of overweight or obese Veterans who seek weight loss treatment engage in binge eating behavior, and as a result, will have suboptimal weight loss outcome. To date there are no treatments that have been established in the VHA to address binge eating. The current project aims to leverage the VHA's national weight management program, MOVE!, by combining it with cognitive-behavioral therapy (CBT), the best-established treatment for binge eating. We anticipate that the combined treatment will reduce binge eating, improve mental health, and enhance weight loss response.
The objective of this research is to address the dual problems of overweight/obesity and binge eating among Veterans by conducting an RCT to assess: (a) the effectiveness of MOVE! (treatment-as-usual) compared to MOVE!+gshCBT (guided self-help CBT) for improving binge eating and mental health, (b) the effectiveness of MOVE! compared to MOVE!+gshCBT for improving weight loss treatment engagement and weight outcomes, and (c) for predictors, moderators and correlates of treatment outcome.
To achieve this objective overweight/obese Veterans (108 men and women) with recurrent binge eating will be enrolled. Potential participants will be recruited from MOVE! group orientation meetings at two VA CT sites that take place several times per month. Major assessments will be performed at pre-treatment (baseline), at the end of gshCBT treatment (3 months), and at 6- and 12-months following treatments (9 and 15 months after randomization). The primary outcome will be improving binge eating and mental health, and exploratory outcomes will be improving weight loss treatment engagement and weight outcomes (including weight loss and biomarkers of disease).
At this time there are no results/findings to report.
This study will provide important information about the effectiveness and durability of treatment approaches for overweight/obese Veterans with binge eating, and will inform future grants regarding the implementation of the treatment for binge eating across VA medical centers.
- Masheb RM, Chan SH, Raffa SD, Ackermann R, Damschroder LJ, Estabrooks PA, Evans-Hudnall G, Evans NC, Histon T, Littman AJ, Moin T, Nelson KM, Pagoto S, Pronk NP, Tate DF, Goldstein MG. State of the art conference on weight management in VA: Policy and research recommendations for advancing behavioral interventions. Journal of general internal medicine. 2017 Apr 1; 32(Suppl 1):74-78.
Mental, Cognitive and Behavioral Disorders, Health Systems
Treatment - Efficacy/Effectiveness Clinical Trial, TRL - Development
Behavioral Therapy, Gender Differences, Outcomes - Patient