Binge eating and weight loss outcomes in overweight and obese individuals with type 2 diabetes: results from the Look AHEAD trial

Arch Gen Psychiatry. 2008 Dec;65(12):1447-55. doi: 10.1001/archpsyc.65.12.1447.


Context: Binge eating (BE) is common in overweight and obese individuals with type 2 diabetes mellitus, but little is known about how BE affects weight loss in this population.

Objective: To determine whether BE was related to 1-year weight losses in overweight and obese individuals with type 2 diabetes participating in an ongoing clinical trial.

Design, setting, and participants: The Look AHEAD (Action for Health in Diabetes) trial is a randomized controlled trial examining the long-term effect of intentional weight loss on cardiovascular disease in overweight and obese adults with type 2 diabetes. A total of 5145 overweight and obese individuals aged 45 to 76 years with type 2 diabetes participated in this study.

Interventions: Participants were randomly assigned to an intensive lifestyle intervention or to enhanced usual care (a diabetes support and education control condition).

Main outcome measures: At baseline and 1 year, participants had their weight measured and completed a fitness test and self-report measures of BE and dietary intake. Four groups were created based on BE status at baseline and 1 year (yes/yes, no/no, yes/no, and no/yes). Analyses controlled for baseline differences between binge eaters and non-binge eaters.

Results: Most individuals (85.4%) did not report BE at baseline or 1 year (no/no), 7.5% reported BE only at baseline (yes/no), 3.7% reported BE at both times (yes/yes), and 3.4% reported BE only at 1 year (no/yes), with no differences between intensive lifestyle intervention and diabetes support and education conditions (P = .14). Across intensive lifestyle intervention and diabetes support and education, greater weight losses were observed in participants who stopped BE at 1 year (mean [SE] weight loss, 5.3 [0.4] kg) and those who reported no BE at either time (mean [SE] weight loss, 4.8 [0.1] kg) than in those who continued BE (mean [SE] weight loss, 3.1 [0.6] kg) and those who began BE at 1 year (mean [SE] weight loss, 3.0 [0.6] kg) (P < .001). Post hoc analyses suggested that these differences were due to changes in caloric intake.

Conclusion: Overweight and obese individuals with type 2 diabetes who stop BE appear to be just as successful at weight loss as non-binge eaters after 1 year of treatment.

Trial registration: Identifier: NCT00017953.

Publication types

  • Randomized Controlled Trial
  • Research Support, N.I.H., Extramural
  • Research Support, N.I.H., Intramural
  • Research Support, Non-U.S. Gov't
  • Research Support, U.S. Gov't, Non-P.H.S.

MeSH terms

  • Aged
  • Alcohol Drinking / epidemiology
  • Anthropometry
  • Body Mass Index
  • Bulimia Nervosa / epidemiology*
  • Demography
  • Diabetes Mellitus, Type 2 / epidemiology*
  • Energy Intake
  • Female
  • Humans
  • Intention*
  • Life Style
  • Male
  • Middle Aged
  • Obesity / epidemiology*
  • Obesity / prevention & control*
  • Prevalence
  • Tobacco Use Disorder / epidemiology
  • Weight Loss*

Associated data


Grant support