Binge Eating and Weight Loss Outcomes in Individuals with Type 2 Diabetes: 4-Year Results from the Look AHEAD Study

OBJECTIVE: To assess whether an intensive lifestyle intervention (ILI) for weight reduction precipitates binge eating (BE) and whether BE attenuates 4-year weight loss among participants with type 2 diabetes and overweight/obesity. METHODS: Participants (n=4,901) were from Look AHEAD, an RCT that compared ILI to diabetes support and education (DSE). We used annual assessments of measured weight and self-reported BE. Using yearly time points a person endorsed BE, participants were classified as: no BE; remitted BE; incident BE; inconsistent BE (2–3 years including baseline); and consistent BE (≥4 years including baseline). We used Cox regression and mixed-effects models for analyses. RESULTS: ILI participants were marginally more likely to report incident BE at year 4 than those in DSE (p=0.06). At year 4, ILI participants with remitted BE lost more weight (4.7±0.8%) than those with consistent BE (1.9 ±1.0%; p=0.03). ILI participants with no BE lost more weight (4.6 ±0.2%) than those with incident BE (3.1 ±0.6%; p=0.02) and consistent BE (p=0.01). DSE participants with remitted BE lost more weight than those with incident and consistent BE. CONCLUSIONS: Preexisting BE does not seem to be a contraindication for ILI, although persistent BE attenuates weight loss. Patients who report new or ongoing BE need additional treatment.