Discussion
obesity, eating disorders
OBESITY, REMISSION
The present prospective controlled Specifically, maintenance treatment with placebo following good response to acute treatment with naltrexone/bupropion was associated with significantly increased binge-eating frequency, significantly decreased probability of binge-eating remission, and no weight loss. In sharp contrast, maintenance treatment with naltrexone/bupropion following good response to acute treatment with naltrexone/bupropion was associated with good maintenance of binge-eating remission and low frequency of binge-eating frequency and significant Our findings supporting naltrexone/bupropion maintenance treatment parallel those reported by Hudson et al. (This controlled pharmacological maintenance study also provided new information about maintenance treatment following BWL treatment for BED. Maintenance medication (naltrexone/bupropion We note potential methodological strengths and limitations as context for interpreting the implications of these findings. Study strengths include the randomized double-blind design to test pharmacological maintenance treatment, pharmacotherapy delivered by trained/monitored faculty-level study physicians, independent assessments using well-validated measures, minimal exclusionary criteria intended to enhance generalizability, and high retention rates. A further methodological consideration concerns the nature of the initial acute treatment. In contrast to the We note that the generalizability of the findings to different clinical settings or to persons with different sociodemographic is uncertain. The participant group lacked robust diversity: 85% were female, 71% White, 95% heterosexual, and 88% attended at least some college; notably, however, the sample comprised some degree of racial/ethnic representation (15% Black and 14% Hispanic). White women comprise the ‘overwhelming’ majority of participants in treatment studies for eating disorders (Burnette, Luzier, Weisenmuller, & Boutte, With the caution regarding generalizability noted with the broader context of the pressing need for greater diversity in treatment research for BED, we note several points for consideration. First, sex (Lydecker, Gueorguieva, Masheb, White, & Grilo, With these methodological considerations and potential limitations as context, we conclude that adult patients with BED with co-existing obesity who have good responses to acute treatment with naltrexone/bupropion should be offered maintenance treatment with naltrexone/bupropion. BWL for BED had durable outcomes regardless of pharmacological maintenance treatment.