Dialectical Behavior Therapy for Binge Eating Disorders: The Short- and Long-Term Results

Researches show that dialectical behavior therapy (DBT) treatment of binge eating disorders (ED) has quick and clear short-term results, but the long-term results seem to be inconclusive.

Why DBT Can Be Used in Binge ED Treatment

Researchers conceptualize binge eating as a behavioral attempt to influence, change or control painful emotional states, and there exists a considerable amount of research evidence in support of the affect regulation model of binge eating.

The primary hypothesis is that individuals who binge eat have difficulty regulating negative emotions and try to cope with their emotional distress by binge eating. The binge eating temporarily relieves the aversive negative emotional states, thereby reinforcing binge eating.

Dialectical behavior therapy (DBT), a treatment found to be effective for borderline personality disorder, specifically targets emotion regulation by teaching adaptive skills to enhance patients’ emotion regulation capabilities.

DBT conceptualizes self-injury as a functional (albeit maladaptive) affect-regulation behavior in patients with borderline personality disorder, and this might provide a helpful model for understanding the function of binge eating as an emotion-regulation behavior in patients with disordered eating.

The Short- and Long-Term Results

In pilot DBT treatments for eating disorders, researchers taught patients new skills that aimed at enhancing adaptive affect regulation, thus reducing the need to binge eat.

Researchers were able to find clear improvements with pre- and post-treatment comparisons.

In one study with 18 participants and lasted for 20 weeks, researchers found that the group DBT skills training was better than no treatment in eliminating binge eating. Of participants in the DBT group, 89% (16 of 18) had stopped binge eating for at least 4 weeks prior to the end of treatment, compared with just 12.5% (2 of 16) of controls.

In another study, 101 people with eating disorders were assigned to DBT treatment group and comparison group. The results revealed that post-treatment binge abstinence and reductions in binge frequency were achieved more quickly for DBT group than for the comparison group: 64% for DBT vs. 36% for comparison.

However, researchers have not yet found solid proof for the long-term effects of DBT treatment for eating disorders.

In the first study, abstinence rates were reduced to 56% at the 6-month follow-up; the long-term effects are inconclusive not just because of the rates drop (from 64% to 56%), but also because that a period of 6 months is brief given the chronicity of binge eating problems.

In the second study, differences between DBT and comparison groups did not persist over the 3-, 6-, and 12- month follow-up assessments (e.g., 12-month follow-up abstinence rate = 64% for DBT vs. 56% for comparison).


Sources consulted:

Debra L. Safer, Athena Hagler Robinson and Booil Jo. 2010. “Outcome From a Randomized Controlled Trial of Group Therapy for Binge Eating Disorder: Comparing Dialectical Behavior Therapy Adapted for Binge Eating to an Active Comparison Group Therapy.” Behavior Therapy, 41: 106–120.

Telch, Christy F., W. Stewart Agras, and Marsha M. Linehan. 2001. “Dialectical Behavior Therapy for Binge Eating Disorder.” Journal of Consulting and Clinical Psychology 69(6): 1061–1065.