Clinical moderators and predictors of cognitive‐behavioral therapy by guided‐self‐help versus therapist‐led for binge‐eating disorder: Analysis of aggregated clinical trials.

Objective: Cognitive‐behavioral therapy (CBT)—therapist‐led (CBTth) and guided‐self‐help (CBTgsh)—has efficacy for binge‐eating disorder (BED) but many patients do not benefit sufficiently. We examined predictors and moderators for these two CBT methods. Method: Data were aggregated from randomized controlled trials (RCTs) testing psychosocial treatments for BED in the U.S. Predictors and moderators of outcomes (treatment completion and binge‐eating remission) were examined in N = 457 participants who received either CBTgsh (N = 164) or CBTth (N = 293). Results: Analyses, adjusting for demographic/clinical variables, indicated CBTth was significantly superior to CBTgsh for treatment completion (odds ratio [OR] = 20.0) and remission (OR = 14.6). For remission, analyses revealed significant predictors (age, treatment length, Weight Concern), a moderator (weight concern [OR = 5.13]), and a significant interaction between CBT‐type and treatment length (OR = 2.66). For CBTgsh, longer treatment was associated with less remission, whereas for CBTth, longer treatment was associated with greater remission. For CBTgsh, 44.1% with low weight concern versus 56.3% with high weight concern achieved remission whereas for CBTth, 43.5% with high weight concern and 61.0% with low weight concern achieved remission. Discussion: Analyses of aggregated RCT BED data, adjusting for demographic/clinical characteristics, indicated superiority (large effect‐sizes) in treatment outcomes of CBTth over CBTgsh and that Weight Concern moderated outcomes. [ABSTRACT FROM AUTHOR]