New therapy outperforms standard treatment in reducing binge-eating among veterans

Researchers from the University of California San Diego have found that a novel treatment called regulation of cues combined with behavioral weight loss (ROC+BWL) was more effective than standard cognitive behavioral therapy (CBT) in reducing binge-eating among veterans with overweight or obesity. The benefits of the new treatment were sustained even six months after treatment ended, particularly for veterans with Binge-Eating Disorder (BED).

The results are published in JAMA Network Open.

“The study showed that our treatment could reduce binge-eating more than standard therapy even after the six-month follow-up,” said Kerri Boutelle, Ph.D., professor of pediatrics at UC San Diego Herbert Wertheim School of Public Health and Human Longevity Science and School of Medicine, and corresponding author. “This is encouraging for developing more effective and durable solutions for veterans struggling with disordered eating.”

Binge-eating, characterized by consuming unusually large amounts of food while feeling a loss of control, is highly prevalent among veterans and strongly associated with overweight and obesity. 65% of female and 45% of male veterans report symptoms of binge-eating. Military experiences and norms (e.g., eating quickly, periods of food deprivation) put veterans at greater risk of binge-eating compared to civilians.

Cognitive behavioral therapy (CBT), which helps individuals manage binge-eating by normalizing eating patterns and addressing maladaptive thoughts and behaviors, is the first-line treatment for binge-eating and has the most empirical support. However, CBT typically does not result in meaningful or lasting weight loss.

Regulation of Cues (ROC) is a newer approach that targets two specific appetitive traits: food responsiveness—how strongly someone reacts to external food cues; and satiety responsiveness—how well someone perceives internal fullness signals. ROC is designed to help individuals tolerate cravings and better recognize hunger and satiety. In this study, ROC included a behavioral weight loss (BWL) component which adds calorie monitoring and physical activity goals to promote weight reduction.

The study was conducted over a five-month period as a randomized controlled trial between March 2019 and April 2023, involving 129 veterans with an average Body Mass Index of 34 who were recruited from the Veterans Affairs San Diego Healthcare System and the general San Diego community. Participants randomly assigned to ROC + BWL or CBT attended weekly 90-minute group sessions and were encouraged to complete at least 250 minutes of moderate or vigorous physical activity each week.

Key study findings

• Those who received ROC+BWL had a 20% lower risk of binge-eating at mid-treatment, post-treatment, and at the six-month follow-up, compared to those who received CBT.
• ROC+BWL also led to greater weight loss during the five-month treatment, although weight differences were not sustained at follow up.

“These findings suggest that targeting how individuals respond to food cues, rather than just focusing on eating behaviors or thoughts, may offer a more effective and lasting treatment for binge-eating,” Boutelle added. “But more research is needed on the effects on weight.”