A novel treatment called regulation of cues combined with behavioral weight loss (ROC+BWL) was more effective than standard cognitive behavioral therapy (CBT) in reducing binge eating among veterans with overweight or obesity even 6 months after treatment ended, particularly for veterans with binge eating disorder, according to recently published study data.1
“This [study] is encouraging for developing more effective and durable solutions for veterans struggling with disordered eating,” Kerri Boutelle, PhD, professor of pediatrics at UC San Diego Herbert Wertheim School of Public Health and Human Longevity Science and School of Medicine, and corresponding author, explained in a press release about the study.2
Binge eating, characterized by consuming unusually large amounts of food while feeling a loss of control, is highly prevalent among veterans and strongly associated with overweight and obesity. A total of 65% of female and 45% of male veterans report symptoms of binge eating.
Military experiences and norms like eating quickly and periods of food deprivation put veterans at greater risk of binge eating compared with civilians, according to the researchers. CBT, which helps individuals manage binge eating by normalizing eating patterns and addressing maladaptive thoughts and behaviors, is the first-line treatment for binge eating and has the most empirical support. However, CBT typically does not result in meaningful or lasting weight loss.
ROC is a newer approach that targets 2 specific appetitive traits: food responsiveness and satiety responsiveness. In this study, ROC included a BWL component that adds calorie monitoring and physical activity goals to promote weight reduction.
The study was conducted over a 5-month period as a randomized controlled trial between March 2019 and April 2023, involving 129 veterans with an average body mass index of 34 who were recruited from the Veterans Affairs San Diego Healthcare System and the general San Diego community. Participants were randomly assigned to ROC+BWL or CBT and attended weekly 90-minute group sessions. They were encouraged to complete at least 250 minutes of moderate or vigorous physical activity each week.
Key study findings include:
- Those who received ROC+BWL had a 20% lower risk of binge eating at midtreatment, posttreatment, and at the 6-month follow-up compared with those who received CBT
- ROC+BWL also led to greater weight loss during the 5-month treatment, although weight differences were not sustained at follow-up
These findings suggest that targeting how individuals respond to food cues, rather than just focusing on eating behaviors or thoughts, may offer a more effective and lasting treatment for binge eating, Dr Boutelle said, adding, “more research is needed on the effects on weight.”
The work was supported by the Assistant Secretary of Defense for Health Affairs endorsed by the Department of Defense through the Peer-Reviewed Medical Research Program under award No. W81XWH-18-1-0220. This research was also supported by the UC San Diego Altman Clinical and Translational Research Institute from the National Institutes of Health.
References
- Boutelle KN, Afari N, Obayashi S, et al. Regulation of cues vs cognitive behavioral therapy for binge eating and weight loss among veterans: a feasibility and randomized clinical trial. JAMA Netw Open. 2025;8(8):e2525064.
- UC San Diego. New therapy outperforms standard treatment in reducing binge eating among veterans [press release]. August 4, 2025. Accessed August 11, 2025. https://today.ucsd.edu/story/new-therapy-outperforms-standard-treatment-in-reducing-binge-eating-among-veterans