Glucose-Dependent Insulinotropic Polypeptide/Glucagon-Like-Peptide-1 Use Following 10-Session Cognitive-Behavioural Therapy for Binge-Eating Disorder: A Single-Case Experimental Design.

OBJECTIVE

Many patients with larger bodies present to eating disorder (ED) treatment seeking weight loss. Whether glucose-dependent insulinotropic polypeptide/glucagon-like-peptide receptor agonists (GIP/GLP-1s) are helpful or harmful for such patients remains unknown. This single case experimental design study examined the effects of Tirzepatide (7.5 mg/0.05 mL), a GIP/GLP-1 following 10-session cognitive-behavioural therapy (CBT-T) in a patient with binge-eating disorder (BED) and obesity.

METHOD: A 37-year-old female presented to an outpatient ED clinic with BED and a body mass index of 68.9 kg/m2. We assessed weekly and then monthly ED behaviours and cognitions using the Eating Disorder 15 (ED-15) across two treatment phases: CBT-T (3 months) and GIP/GLP-1 administration (9 months).

RESULTS

As hypothesised, ED cognitions and binge frequency decreased during CBT-T. Also as hypothesised, during GIP/GLP-1 phase, binge frequency remained low and dietary restraint absent. We observed continued reductions in ED cognitions and 39-pound weight loss.

DISCUSSION: GIP/GLP-1 treatment after CBT-T was followed by ED remission and weight loss without serious adverse events. CBT-T skills may mitigate risk of disordered eating during GIP/GLP-1 use. The combination of psychotherapy and GIP/GLP-1s may further reduce binge-eating and lead to weight loss. Research is needed to explore risks and benefits of GIP/GLP-1s for patients with EDs.