Exploring women's experiences of treatment for binge eating disorder: Methylphenidate vs. cognitive behavioural therapy

Prog Neuropsychopharmacol Biol Psychiatry. 2022 Mar 2:114:110492. doi: 10.1016/j.pnpbp.2021.110492. Epub 2021 Dec 1.

Abstract

Objective: The current qualitative study explored the personal experiences of a sample of women with binge eating disorder (BED). The women were previously enrolled in a 12-week randomized controlled trial comparing pharmacotherapy (methylphenidate [MP]) and cognitive behavioural therapy (CBT).

Methods: Semi-structured interviews were conducted with 15 women who completed the trial (8 MP, 7 CBT) to obtain their narrative accounts. Key themes were then identified from transcribed tape recordings, using thematic analysis.

Results: Participants described self-awareness as bringing greater attention to their binge eating, and to their thoughts and emotions. Furthermore, both groups valued the interpersonal relationships with the clinicians and their ability to create a safe and comforting environment. In the MP group, many participants described the medication as reducing their preoccupation with food, and hence, binge frequency. In CBT, there was a focus on psychoeducation and obtaining a "toolbox" of long-term binge-management skills that could also be used following treatment. In both groups, stress was described as a primary trigger for a binge and/or a cause of relapse.

Discussion: Although patients reported having a positive experience in the therapies, it is suggested that broader stress regulation skills training would be useful to evaluate further, to bolster relapse prevention skills. These qualitative findings add a much-needed lived-experience perspective on clinical treatments for binge eating. This is especially significant considering that a psychostimulant similar to MP is the only approved pharmacotherapy for BED, and to date, little is known about the patient's subjective experiences when taking this medication.

Keywords: Binge-eating disorder; Cognitive behavioural therapy; Compulsive overeating; Methylphenidate; Qualitative research.

Publication types

  • Randomized Controlled Trial
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Binge-Eating Disorder / therapy*
  • Central Nervous System Stimulants / therapeutic use*
  • Cognitive Behavioral Therapy*
  • Female
  • Humans
  • Interviews as Topic
  • Methylphenidate / therapeutic use*
  • Qualitative Research
  • Self Concept
  • Stress, Psychological / psychology
  • Treatment Outcome

Substances

  • Central Nervous System Stimulants
  • Methylphenidate