Treatment Outcome in People with Subthreshold Compared with Full-Syndrome Binge Eating Disorder


University of Tuebingen, Department of Psychosomatic Medicine and Psychotherapy, Osianderstrasse 5, 72076 Tuebingen, Germany. E-mail:


Objective: There is a controversial discussion in the literature as to whether individuals with subthreshold binge eating disorder (subBED) differ clinically significantly from individuals with full-syndrome binge eating disorder (BED). This study was designed to compare eating-related and general psychopathology at baseline and in response to a multimodal treatment program in obese people with subBED compared with BED.

Research Methods and Procedures: A total of 96 obese participants (BMI ≥ 30 kg/m2) were assessed for eating-related and general psychopathology at baseline. Thirty-nine participants meeting criteria for BED and 19 participants meeting criteria for subBED attended a 15-session outpatient group therapy including cognitive behavioral therapy extended by interpersonal therapy, nutritional counseling, and a supervised walking exercise. Participants with eating disorders were reassessed at the end of treatment and at 3-month follow-up. The obese control group without an eating disorder (n = 38) was assessed once. This was not a randomized controlled trial.

Results: Intent-to-treat analyses revealed no differences between subBED and full-syndrome BED participants with regard to eating-related and general psychopathology at baseline and with regard to treatment outcome. All participants experienced substantial improvements, and the results remained stable during follow-up (except for dietary restraint). At follow-up, participants with subBED and BED remained different from non-eating disorder controls in eating-related but not general psychopathology.

Discussion: The findings indicate that our multimodal treatment program is equally effective in obese subBED and BED participants, suggesting that a differentiation currently seems not to be of clinical significance.