Stepped Care Treatment for Binge-Eating

Inclusion Criteria:

• Adult female, 18 years to 60 years
• Meets DSM-IV criteria for Binge Eating Disorder
• Resides within commuting distance
• Consents to research protocol, i.e.
• 18-24 months in assessment and treatment
• willing to be part of a biological assessment/physiological assessment
• have to be prepared that they will receive a brief individual treatment and if this does not work for them, that they will receive more intensive treatment including both group and individual treatment.
• agreement not to see other health professionals unless recommended
• seeing their own Primary care Physician/Nurse Practitioner for medical screening prior to study (i.e., before being allocated a guided self-help therapist)
• payment for their own medical assessment, monitoring, and medication if needed

Exclusion Criteria:

• Anorexia nervosa
• Schizophrenia, Schizophreniform, or Schizoaffective Disorders, Psychosis NOS, or Bipolar Mood Disorder
• Needs priority treatment for other debilitating conditions, e.g. current substance dependence requiring inpatient detox
• chronic absence of shelter
• IQ less than 70
• Impending jail/prison, court order to treatment, court order to treatment or to jail, or agency order to treatment or to loss of child custody (due to consequent inability to freely drop-out of treatment)
• Is pregnant, plans to become pregnant during treatment, or becomes pregnant before random assignment to study condition
• Medical instability
• Has had or is seeking Gastric bypass surgery
• On anti-seizure medication, beta-blockers, asthma medication, medication for heart disease, or any other medication that affects appetite or weight
• Psychotropics are acceptable if the doses are stable for at least 3 months prior to screening