CPG for Eating Disorders

Scientific EvidenceThere is insufficient evidence to determine if there are significant differences betweenCBT-BN and IPT in the number of dropouts by the end of treatment (2 RCTs; N=270;Agras, 1989 222 ; Fairburn ,1991 224 ; RR: 1.24; 95% CI: 0.84 to 1.83).RCT1 ++One RCT (Wilson, 2002) 234 claimed that the overall dropout rate by the end oftreatment was 30% and 41% at follow-up. No adverse effects were reportedOne RCT (Wilfley, 1993; USA) 235 compared group CBT to group IPT and to wait-listin 56 adult women with BN. Overall dropout rate was 14% (CBT: 33%, IPT: 11%,and on wait-list: 0%). No adverse effects were reported.RCT1 +RCT1 ++Summary of the Evidence(See summary of the evidence for psychological treatment)Recommendations(See recommendations 9.GP.12 to 9.GP.17)9.5.3. Binge-Eating Disorder9.5.3.1. What is the efficacy of IPT in patients with BED?Evidence is derived from the NICE CPG (2004) 30 where outcome variables are described andfrom high-quality SRSE (1++) elaborated by AHRQ of the US (2006) 31 and by Brownley, et al.(2007) 245 . The updated search has not yielded any new evidence.Variable: BMIThere is evidence that indicates is not likely that there is a clinically significantdifference between CBT-BED and IPT-BED in body weight variation by the end oftreatment (BMI when possible) (1 RCT, N=158; Wilfley, 2002 234 ; SMD: 0.06; 95% CI:-0.26 to 0.37).RCT1 ++Variables: reduction / remission of binge-eating and purgingThere is evidence that indicates it is not likely that there is a significant differencebetween CBT-BED and IPT-BED in the reduction of binge-eating frequency by the endof treatment (2 RCTs; N=194; Wilfley, 1993 235 and 2002 234 ; SMD: -0.07; 95% CI: -0.35RCT1 ++120CLINICAL PRACTICE GUIDELINE FOR EATING DISORDERS