A cognitive/behavioral approach to type I diabetic females with recurrent binge eating: a 3-year follow-up study

Objective: To describe a comprehensive, cognitive/behavioral approach to the treatment of type I diabetic females with recurrent binge eating and to assess its effectiveness. Research design and methods: At the first visit to our outpatient clinic, type I diabetic females with recurrent binge eating (n=28) were diagnosed as either bulimia nervosa (BN) or binge-eating disorder (BED), and underwent "outpatient counseling at first visit". After a period of observation by the referring physician, patients without sufficient improvement were encouraged to undergo "integrated inpatient therapy". According to the eating disorder diagnosis and the presence/absence of inpatient therapy, patients were divided into four groups: BN-inpatients, n=9; BN-outpatients, n=9; BED-inpatients, n=2; BED-outpatients, n=8. Glycosylated hemoglobin (HbA1c); psychological measures assessing eating disorder psychopathology (EDI), depression (SDS), and anxiety (STAI); binge eating and purging behavior for each group were compared between first visit and follow-up. Results: In BED-outpatients, significantly lower HbA1c. SDS score, and frequency and amount of binge eating were seen at 3 years after first visit. In BN-inpatients, significantly lower HbA1c; EDI, SDS, and STAI scores; frequency and amount of binge eating; and rate of purging behaviors were seen at 3 years after discharge. Conclusions: Type 1 diabetic females with recurrent binge eating were effectively treated. BED patients were successfully treated on an outpatient basis, while BN patients needed inpatient therapy. (C) 2002 Elsevier Science B.V. All rights reserved.