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

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.

Automated summary

This qualitative study explored the personal experiences of women with binge eating disorder who participated in a 12-week trial comparing pharmacotherapy and cognitive behavioural therapy. Participants highlighted the importance of self-awareness in addressing binge eating behaviors and emotions, as well as the value of interpersonal relationships with clinicians. Medication (MP) was seen to reduce food preoccupation and binge frequency, while CBT focused on psychoeducation and long-term binge management skills. Stress was identified as a primary trigger for binge eating in both groups.