Q & A: Patients with BED and Diabetes Type 2

Reprinted from Eating Disorders Review
January/February 2009 Volume 20, Number 2
©2009 Gürze Books

Q: In my practice I routinely see a number of obese patients with binge eating disorder (BED) who have diabetes mellitus and who are trying to lose weight to help their diabetes. Is there anything I can tell these patients about how their binge eating disorder will affect their changes of losing weight? (R.B., Cincinnati)

A: Although clinicians have long suspected that BED further complicates chances for weight loss, a recent large-scale prospective study has finally provided clear-cut evidence on this issue. In the Look AHEAD trial (Action for Health in Diabetes), a prospective study on weight loss in type 2 diabetes mellitus, 5145 overweight and obese adults with diabetes mellitus were randomly assigned to an intensive lifestyle intervention or enhanced usual care (consisting of a diabetes support and education program). Based on whether individuals reported binge eating at baseline and/or at 1 year into the trial, four groups were compared for analysis. Most individuals (85.4%) reported no binge eating either at baseline or at one year. In contrast, 7.5% reported binge eating only at baseline, 3.4% reported binge eating only after a year, and 3.7% reported binge eating both at baseline and at one year. Across both the lifestyle intervention and the enhanced support group, the highest weight losses were reported by those who reported binge eating at baseline but not at 1 year (average 5.3 kg) or no binge eating at either time (4.8 kg), compared to those who reported binge eating at both times (3.1 kg) or who reported first binge eating when in the trial (3.0 kg) (Arch General Psychiatry.2008. 65:1447). The take-home message for patients appears to be this: Even if you start out as a binge eater, if you can disrupt and master that problem, your ability to lose weight should be the same as if you never experienced binge eating.


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